Intolerable Risk Research Articles

Gas Leakage Risk Management Of Biogas Powerplant Using Aloha Gas Dispersion Modelling And Bowtie Analysis

Biogas, a fuel derived from organic waste, has gained popularity as a sustainable energy source. The adaptability of biogas allows its utilization for electricity and heating. This study aims to evaluate the risk of biogas leakage using ALOHA gas dispersion modeling and Bowtie analysis to identify hazard zones and evaluate the effectiveness of preventive and mitigation measures. The research method using Gas dispersion modeling in ALOHA software can simulate the spread of leaked biogas, identify potential hazard zones, and inform emergency response planning. The results show that gas dispersion reaches up to 296 meters from the leak source in a worst-case scenario without ignition, with significant implications for safety. The ignition scenario produces high thermal radiation, further exacerbating the risk. In conclusion, these findings highlight the intolerable risk of biogas leakage, requiring comprehensive risk mitigation measures. This study recommends the implementation of a robust control system, routine maintenance, and emergency response plan to ensure the safety and sustainability of biogas facility operations

Dynamic risk analysis of hydrogen refueling station gas cloud explosions based upon the bow-tie perspective

The rapid development of hydrogen refueling station (HRS) has induced potentially serious risk exposure to public safety. Consequently, the safety issues associated with HRS have become a research hotspot. A comprehensive methodology for risk analysis of hydrogen facilities was proposed. A failure tree analysis (FTA) was used for hazard analysis while a bow-tie diagram and Bayesian network were applied to model the worst-case accident scenario and to analyse the risks of root event. In addition, the fuzzy set theory combined with FTA was employed to calculate the failure probability of the hydrogen facilities. The risk analysis of a HRS was implemented with the proposed method. The results showed that the vapour cloud explosion (VCE) of compressors in the gas HRS was the most risky scenario with the probability of 8.12E–04 before taking safety measures. The death, severely injured, and minor injured radius of the VCE from compressors was 35.5, 20.0, and 10.3 m, respectively. Results also revealed that after taking several safety barriers, the risk level converted from an intolerable risk level to a tolerable risk with control level.

Status of the Deep Learning-Based Shattered Pellet Injection Shard Tracking at ASDEX Upgrade

Plasma disruptions pose an intolerable risk to large tokamaks, such as ITER. If a disruption can no longer be avoided, ITER’s last line of defense will be the Shattered Pellet Injection. An experimental test bench was created at ASDEX Upgrade to inform the design decisions for controlling the shattering of the pellets and develop the techniques for the generation of the fragment distributions necessary for optimal disruption mitigation. In an effort to analyze the videos resulting from the more than 1000 tests and determine the impact of different settings on the resulting shard cloud, an analysis pipeline, based on traditional computer vision (CV), was created. This pipeline enabled the analysis of 173 of the videos, but at the same time showed the limits of traditional CV when applied in applications with a highly heterogeneous dataset such as this. We created a machine learning-based (ML) alternative as a drop-in replacement to the original image processing code using a semantic segmentation model to exploit the innate adaptability and robustness of deep learning models. This model is capable of labeling the entire dataset quickly, accurately and reliably. This contribution details the implementation of the ML model and the current state and future plans of the project.

Long-term persistence of the risk of agranulocytosis with clozapine compared with other antipsychotics: a nationwide cohort and case–control study in Finland

Agranulocytosis is a life-threatening side-effect of clozapine, the only approved drug for treatment-resistant schizophrenia. The long-term profile of this complication has not yet been well established. Here we aim to describe the risk of clozapine-induced agranulocytosis over the long term. We used the entire population of Finland to identify people diagnosed with schizophrenia or schizoaffective disorder between 1972 and 2014 and developed a Kaplan-Meier model of time to diagnosis of agranulocytosis during clozapine versus non-clozapine treatment over a 22-year observation period (1996 to 2017). Next, we developed a nested case-control model for agranulocytosis matching by sex, age, time since diagnosis, and being in the incident cohort on a 1 to 5 ratio. Various durations of use for clozapine and non-clozapine antipsychotic treatment were compared to the modal antipsychotic use duration, deriving adjusted odds ratios (aORs) in a multivariable regression model. Recurrence and lethality rates for clozapine-induced agranulocytosis were described. These data reflect on all individuals with lived experience of schizophrenia in Finland during the study time, although individuals with lived experience were not included in the design of the study. We identified 61 769 people with schizophrenia or schizoaffective disorder (14 037 individuals treated with clozapine and 47 732 individuals treated with non-clozapine antipsychotics), with a mean age of 46·67 years (IQR 34·44-57·61), of whom 30 721 (49·7%) were female and 31 048 (50·3%) were male (data on ethnicity not available). Among those, 398 individuals were diagnosed with agranulocytosis (231 individuals treated with clozapine and 167 individuals treated with non-clozapine antipsychotics), representing a cumulative incidence of agranulocytosis for 1·37% (95% CI 0·58-3·16) on clozapine and 0·13% (0·04-0·23) on non-clozapine antipsychotics. In the case (n=398) versus control (n=1987) model, the risk of clozapine-induced agranulocytosis decreased steeply over time from an aOR of 36·01 (95% CI 16·79-77·22) for less than 6 months on clozapine to 4·38 (1·86-10·34) for clozapine use of 54 months or more. Only one of 3559 individuals starting clozapine died because of clozapine-induced agranulocytosis. The risk of clozapine-induced agranulocytosis decreases steeply over time but might be persistently greater than that of non-clozapine antipsychotics. This long-term risk excess seems small in absolute terms compared with the known magnitude of the advantages of clozapine in relevant outcomes, including life expectancy. Given the widespread underuse of clozapine, relaxing the long-term neutrophil monitoring could favour the advantages of long-term clozapine use, including greater life expectancy, without incurring the intolerable risk of clozapine-induced agranulocytosis. Northwell Health and Sigrid Jusèlius Foundation.

A novel decision support system for proactive risk management in healthcare based on fuzzy inference, neural network and support vector machine

BackgroundThe nature of activities practiced in healthcare organizations makes risk management the most crucial issue for decision-makers, especially in developing countries. New technologies provide effective solutions to support engineers in managing risks. PurposeThis study aims to develop a Decision Support System (DSS) adapted to the healthcare constraints of developing countries that enables the provision of decisions about risk tolerance classes and prioritizations of risk treatment. MethodsFailure Modes and Effects Analysis (FMEA) is a popular method for risk assessment and quality improvement. Fuzzy logic theory is combined with this method to provide a robust tool for risk evaluation. The fuzzy FMEA provides fuzzy Risk Priority Number (RPN) values. The artificial neural network is a powerful algorithm used in this study to classify identified risk tolerances. The risk treatment process is taken into consideration in this study by improving FMEA. A new factor is added to evaluate the feasibility of correcting the intolerable risks, named the control factor, to prioritize these risks and start with the easiest. The new factor is combined with the fuzzy RPN to obtain intolerable risk prioritization. This prioritization is classified using the support vector machine. FindingsResults prove that our DSS is effective according to these reasons: (1) The fuzzy-FMEA surmounts classical FMEA drawbacks. (2) The accuracy of the risk tolerance classification is higher than 98%. (3) The second fuzzy inference system developed (the control factor for intolerable risks with the fuzzy RPN) is useful because of the imprecise situation. (4) The accuracy of the fuzzy-priority results is 74% (mean of testing and training data). ConclusionsDespite the advantages, our DSS also has limitations: There is a need to generalize this support to other healthcare departments rather than one case study (the sterilization unit) in order to confirm its applicability and efficiency in developing countries.

Abstract 2421: Targeted and low-pass whole genome sequencing of cerebrospinal fluid circulating tumor DNA for the diagnosis and monitoring of pediatric, adolescent and young adult CNS tumors

Abstract Molecular analysis of CNS tumors is essential to their diagnosis and guides individualized treatment for patients, but tissue biopsy of primary and/or relapsed lesions to allow for this characterization often carries intolerable risk. The analysis of genetic material in cerebrospinal fluid (CSF), known as liquid biopsy, can allow for minimally invasive tumor identification and diagnosis. Furthermore, liquid biopsy can serve as a more sensitive test for residual disease than imaging or cytologic analyses. We aimed to implement CSF liquid biopsy at Canada’s largest pediatric hospital. >150 CSF samples were collected from CNS tumor patients with a median age of 9. The most common tumor types were low-grade gliomas (40%), high-grade gliomas (21%) and medulloblastomas (MB) (17%). The majority were collected via lumbar puncture (46%), external ventricular drain (24%) and intraoperatively (22%). The most frequent collection times were diagnosis (53%) and progression/relapse (28%). Cell-free DNA was extracted, and circulating tumor DNA was analyzed using low-pass whole genome sequencing and a targeted hybridization capture glioma gene panel for select cases. Pathogenic mutations and copy number alterations (CNA) were called using an in-house bioinformatics pipeline. Somatic alterations were detected in 57% of samples from patients with pathologically confirmed CNS tumors. CNAs were identified in 5/7 MB patients at the time of pre-treatment staging lumbar puncture. We also detected CNAs in several MB patients during treatment and at progression/relapse, including a patient with disseminated MB who was mid-induction chemotherapy with 1 suspicious cell in their CSF, highlighting our ability to detect minimal residual disease. Among samples with no previous biopsy, we identified tumor DNA in 29%, often providing diagnostic clarity and guiding management. For example, we identified a targetable FGFR1 N546D missense mutation in a patient with an unbiopsied suprasellar lesion. We also diagnosed recurrent MB in a patient 6 years off treatment with a new ambiguous nodule in their tumor bed by detecting an isochromosome 17q CNA. Overall, our liquid biopsy platform is feasible and can yield clinically impactful results. Next steps include refining our assays to increase their sensitivity and systematically evaluating our platform’s efficacy for monitoring response to treatment and tumor surveillance. Citation Format: Ian Burns, Liana Nobre, Yoshiko Nakano, Michelle Ku, Monique Johnson, Javal Sheth, Logine Negm, Chantel Cacciotti, Mansuba Rana, Richard Yuditskiy, Andrew Bondoc, Robert Siddaway, Uri Tabori, Cynthia Hawkins. Targeted and low-pass whole genome sequencing of cerebrospinal fluid circulating tumor DNA for the diagnosis and monitoring of pediatric, adolescent and young adult CNS tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2421.

Concentration and Health Risk of Heavy Metals in Herbs from Electronic Waste Disposal Site in Lagos State, Nigeria

Considering that about 80 % of the world population uses herbs for the treatment of illnesses and the contamination that is prevalent at electronic waste (e-waste) disposal sites, this study evaluated the concentrations of heavy metals and health risks in the use and consumption of Rhynchospora corymbosa, Pentodon pentandrus and Cyclosorus dentatus, herbs commonly found in electronic waste disposal site in Lagos State, Nigeria using appropriate standard methods. The mean concentrations of the heavy metals in the plant were: 100.78±0.91, 0.16±0.02, 25.68±0.44, 258.94±1.62, and 8.51±0.04 mg/kg for Pb, Cd, Ni, Cu and Cr, respectively. Pentodon pentandrus had the highest Pb, Cu and Ni concentrations, Cyclosorus dentatus had the highest Cd concentration while Rhynchospora corymbosa recorded the highest concentration of Cr. The bio-accumulation factor of Cu in Pentodon pentandrus and in Rhynchospora corymbosa and of Cr in Rhynchospora corymbosa were higher than 1. The estimated daily intake of Pb and Ni in Pentodon pentandrus, Cyclosorus dentatus and Rhynchospora corymbosa exceeded the Provisional Maximum Tolerable Intake, indicating an intolerable risk to the consumers’ health. The hazard index of each of the plants indicates that the cumulative health effects of the heavy metals would cause potential health hazards to the consumers. This useful information gives an accurate indication of the levels of contamination of the plants and the potential health risk effects of the consumption of these herbs from the dumpsite.

A study on the impacts of antibiotic pollution and its remediation

AbstractAntibiotics' ability to treat bacterial infections has long been seen as a pillar of modern medicine. Antibiotic abuse and widespread overuse, however, have resulted in unexpected consequences that call for significant adjustments in policy to be mitigated. High levels of antibiotic emissions from manufacturing facilities may help to develop new types of resistant bacteria. Such pollution is acknowledged by many scientists, business leaders, decision‐makers, and other interested parties as an unneeded and intolerable risk to public health worldwide. Antibiotics are frequently produced by soil microorganisms. The bacteria and fungi are microorganisms that produce antibiotics that are helpful in preventing or treating disease. With the invention of Penicillin, antibiotics gained widespread recognition. Since then, they have fundamentally changed how bacterial infections in animals and humans are treated. Since a significant portion of antibiotics are released from human and animal bodies without being degraded, this means that various environmental components, including soils and river water, are contaminated with antibiotics. In this case, it is anticipated that the structure and productivity of the microbiota inhabiting such environments may be impacted by the varied concentration of this type of microbial inhibitor present in different ecosystems. This effect can take place at various levels, including modifications to the population's overall structure, the selection of resistant species, or changes to bacterial physiology.

Risk assessment for the distribution and levels of fluoride and nitrate in groundwater in a semi-arid area of northern Mexico

This study assessed groundwater quality and associated risks in a semi-arid region located in a city in the Northern zone of Mexico. To conduct this study, we collected 92 groundwater samples and analyzed 14 physicochemical parameters across 18 sectors. Only fluoride (F−) and nitrate (NO3–N) exceeded Mexican regulations and WHO guidelines for drinking water. Approximately 65 % of samples surpassed the 1.5 mg/L permissible limit for F−, with the highest recorded concentration reaching 3.60 mg/L in two sectors among the 18 studied, 34 % of samples exhibited NO3−-N concentrations in the 10.64–17.27 mg/L range across three sectors, surpassing permissible levels. Pearson Correlation Analysis revealed strong positive correlations with HCO3−, EC, Mg2+, Ca2+, NO3−, Cl−, SO42−, and Na+. Moderate correlations existed for the total hardness, alkalinity, Cl−, NO3−, SO42−, Na+, Mg2+, and EC. K+ showed weak correlations. PIG values indicated significant pollution of F− in all of 18 sectors (PIG <1). HQ for F− exceeded tolerable levels in 14 adult and 16 child sectors, posing an intolerable risk. Nitrate's HQ was below <1 for all age groups, suggesting non-carcinogenic effects. THI indicated high F− and NO3−-N exposure risks for children in the study area. It is recommended to implement effective water treatment technologies, such as reverse osmosis or adsorptive materials, in those sectors reported as a potential risk to human health to ensure access to safe drinking water.

At last, empirical elicitations of the magnitudes of those risks (and costs!) too small to matter and those too large to abide

Scholars, decision-makers, and pundits have long tossed around words and numbers meant to demarcate those health/safety risks that are too small to matter at all (called, variously, “trivial” or “de minimis” or “insignificant”), or risks that are so large as to be abhorrent (“unacceptable,” “intolerable,” and the like). But there has been nothing approaching a consensus about how large or small these important probabilities are, and worse, there have been no serious attempts to explore these concepts via any carefully-elicited preferences from laypeople themselves. Perhaps even more concerning, the dominant paradigm—cost-benefit analysis (CBA)—requires balancing of (monetized) risks against the costs of controlling them, but the parallel concepts of de minimis costs and intolerable costs have never been formally considered. As a result of these lapses, all attempts to consider equity or justice in the distribution of how risks and costs are borne are an absurdity, despite claims to the contrary. This article reports on a pair of elicitations involving 1350 laypeople. In one elicitation, a careful set of background and contextual explanations and a structured series of questions probed where each subject perceived lifetime excess mortality risk (from involuntary exposure) to become “so small you would not spend a moment thinking about it,” and where it becomes so large that “you would strongly object, as an ethical matter, to ever having to face it.” With a separate sample, we asked the parallel questions with regard to regulatory costs imposed by the government in the name of risk reduction. Although there was significant interindividual variation in responses, the central tendency of each of these four science-policy-values “goalposts” was as follows: (1) de minimis risk—a lifetime excess chance of premature death of 1 in 770,000; (2) intolerable risk—1 chance in 570; (3) de minimis cost—$25 per year; and (4) intolerable cost—$775 per year. These results offer, for the first time, a principled and evidence-based starting point for further refinement of which risks or costs to individuals can/should be disregarded in setting policy, and which must dominate policies regardless of how total “monetized lives saved” and total dollar costs compare to each other when viewed simplistically. We offer several prescriptions for how CBA might change, and how environmental/health/safety policy might improve, to take account of these fundamental thresholds in how risks and costs actually impose burdens on citizens. Both those interventions that impose intolerable costs while only reducing diffuse and trivially small risks, and those failures to intervene (sufficiently) that perpetuate intolerable risks for the sake of avoiding trivial and eminently manageable costs, are inefficient, unjust, and are thus unethical.

Risk Management in The Packaging Unit at Animal Feed Industry Sidoarjo, Indonesia

Introduction: Animal feed industry Sidoarjo is one of the companies in the animal feed manufacturing industry. The packaging unit is the last unit in the production process that packs the feed ingredients and arranges the finished goods. A location with the most safety hazards based on the work accident reports for 2010-2017 is in the packaging unit as many as 15.78%. The purpose of this research is to analyze the risk management of work safety in the packaging unit of animal feed industry Sidoarjo. Methods: Based on the data collection method, this research was included in observational research with a cross-sectional design. The subjects in this research were workers (37 people) in the animal feed packaging and the Health Safety Environment (HSE) units. The research was conducted at the packaging unit of Animaal Feed Industry, Sidoarjo, Indonesia in November 2019-June 2020. Results: Based on hazard identification, there were 15 hazards with a risk analysis of 53% moderate risk and 47% high risk. The risk evaluation obtained was including 53% tolerable risk and 47% intolerable risk. After controlling efforts, there was a decrease in the risk category. Conclusion: The residual risk obtained after controlling carried out experienced a reduction of moderate risk by 100% and high risk by 71%. The remaining risk was 33% moderate risk and 13% high risk.

Characteristics and occupational risk assessment of occupational silica-dust and noise exposure in ferrous metal foundries in Ningbo, China.

To investigate the major existing occupational hazards and to assess the occupational health risks for ferrous metal foundries (FMFs) in Ningbo, China. Unified questionnaires were formulated to investigate the information on the basic situations, occupational hazards, and occupational health management for 193 FMFs in Ningbo. Furthermore, we used the semi-quantitative risk assessment model, which was developed by the International Council on Mining and Metals (ICMM), to assess occupational health risks for 59 of 193 the FMFs. The casting process of FMFs in Ningbo was mainly divided into sand casting and investment casting, and silica-dust and noise were the major occupational hazards in both sand casting and investment casting foundries. Silica-dust mainly occurred in industries with such work as sand handling, modeling, falling sand, and sand cleaning, with the median of the permissible concentration-time weighted average (PC-TWA) was 0.80, 1.15, 3.52, 0.83 mg/m3, respectively. The noise mainly existed in industries with such work as sand handling, core making, falling sand, sand cleaning, cutting and grinding, and smelting with median of PC-TWA was 81.72 dB(A), 82.93 dB(A), 90.75 dB(A), 80.18 dB(A), 90.05 dB(A), 82.70 dB(A), respectively. In addition, the results of the ICMM assessment model indicated that 100 and 98.7% of the jobs exposed to silica-dust and noise in 59 FMFs have an "intolerable risk" level of risks of causing pneumoconiosis and noise deaf, respectively. The hazard risk of silica-dust and noise is serious for FMFs in Ningbo. It is necessary to supervise enterprises to improve operating environmental conditions, accelerate the reduction of silica-dust and noise exposure risks, and promote the healthy and sustainable development of the foundry industry.

Evaluating the use of Google Maps as navigation application by identifying hazards and assessing risks using HIRA matrix

Google Maps as a navigation application provides route information with the shortest route or fastest travel time, but this technology has a weakness as it does not consider the suitability of road condition with the type of vehicles, therefore the choice of the routes does not accommodate traffic safety aspects. This research aims to evaluate the use of Google Maps as a navigation application by identifying hazards and assessing risks. The method used is based on an analysis using the HIRA (Hazard Identification and Risk Assessment) matrix to determine the level of risk thus the step of mitigation can be executed. The data source obtained was from the results of questionnaires distributed to 1,114 respondents. As the results of analysis, it was found that 11 hazards from the usage of Google Maps came from the driver’s aspect, Google Maps feature’s aspect, and road conditions aspect. Evaluation of risks came from the three sources of hazard classified into 2 risks in the intolerable risk category and 9 risks in the tolerable risk category. After the mitigation efforts were arranged to control the risk, all risks are expected to meet the acceptable risk level. To anticipate the road traffic accident due to the usage of Google Maps, the recommendation for this navigation application is to add more features to warn the users about the road characteristics in the form of voice notification or pop up if not disturb the driver while driving and providing a specific route for truck/heavy vehicle as now the Google Maps is only available for light vehicle.

Weighing up weighted filters

In recent years, the understanding of the mechanisms leading to internal erosion in existing embankment dams and advancement in risk assessments have indicated that a number of UK dams have an intolerable risk of internal erosion. A popular risk-reduction approach is to incorporate a retrofit weighted filter to the downstream slope, which improves both internal erosion resistance and slope stability. In developing such designs, great emphasis is rightly placed on the selection of the correct filter grading to resist erosion; however, a variety of factors need to be considered in parallel, which are sometimes not reported and may affect the effectiveness of the filter in providing sufficient risk reduction. This paper highlights some of these factors to ensure that they are fully considered in risk mitigation and designs.

The Importance of Site Evaluation Management System on the Site Survey Phase for Constructing Nuclear Power Plant in West Kalimantan

Site survey in the potential site of the Nuclear Power Plant (NPP) construction is an essential preliminary activity. Site survey has a crucial role in successful NPP construction. Several factors are contributing to a successful site evaluation. One of them is the Site Evaluation Management System (SEMS). Indonesia National Nuclear Regulatory Body (BAPETEN) had stipulated Head of BAPETEN Decree No. 4 the Year 2010, about Management System for Activities and Facilities. A site survey activity needs to adhere to the requirements in the regulation above, consisting of the management system, management’s responsibility, resources management, implementation process, monitoring, measurement, evaluation, and correction. The implementation of SEMS is conducted with the methods of a plan, do, check, and action and applied to these site survey phases: survey planning, survey implementation, survey audit, and survey review. It found that the SEMS implementation with the preliminary risk assessment significantly improves the safety of the site survey activity. The risk assessment result is categorized as follows: acceptable risk, tolerable risk, intolerable risk, and unacceptable risk. The risk assessment was conducted by following site survey activities: seismic, volcanic, meteorologic, hydrologic, geotechnical and foundation, human-induced events, and population distribution and density. It found that the implementation of SEMS with preliminary risk assessments supports the Indonesia energy security, which includes 4A: Availability (the availability of the energy kind), Accessibility (the accessibility to utilize the energy), Affordability, and Acceptability (public’s acceptance to the energy utilization). Site survey activities that meet the Availability criteria are from these aspects: seismic, volcanic, meteorologic, hydrologic, geotechnical, and foundation; while the site survey activities that meet the acceptability criteria are from these aspects: human-induced events, and population distribution and density. The implementation of SEMS has a better impact on the site survey activity when a series of risk assessments is conducted beforehand. It also found that the implementation of SEMS with preliminary risk assessments fulfills the 4A of Indonesia Energy Security: availability, accessibility, affordability, acceptability.

ANALISIS RISIKO KECELAKAAN KERJA METODE HIRA (HAZARD IDENTIFICATION AND RISK ASSESSMENT) DI PT. X

The HIRA (Hazard Identification, Risk Assessment) method is a process of identifying hazards that occur in all company activities, then conducting a risk assessment of the hazards that occur. Introduction: Based on the initial survey conducted at PT. X, it was found that there were work accidents such as pinched hands, cuts, entanglement in processing machines which caused the risk of accidents. This research was conducted at PT.X in February-August 2021. Methods: This study used a descriptive qualitative method. This study analyzes the risk of work accidents using the HIRA (Hazard Identification, Risk Assessment) method which aims to identify hazards and conduct a risk assessment of these hazards. The research informants were 6 people consisting of 2 key informants and 4 main informants. Results: The results showed that there were 44 types of hazards from 8 work stations at PT. X. Among them, 16% have a small risk of harm (trivial), 38.6% have a tolerable risk, 34.1% have a moderate risk of harm, 4.5% have a substantial risk of harm, 6, 8% have an intolerable risk of harm. Conclusion: Risk analysis is a process by which hazards are identified and risks are estimated to assess the damage caused with the likelihood of damage occurring.

The Use of Screening Algorithm to Defer Blood Donors with Subclinical Malaria.

Plasmodium falciparum infection in blood donors is common in malaria endemic countries, including Ghana. To date, there are no established exclusion criteria to defer a donor carrying malaria parasites. Therefore, based on significant independent variables identified in this study, donor malaria screening algorithm was developed to be used by blood banks to screen blood donors for subclinical malaria. Each significant variable was weighted one (1) point and its alternative response was weighted negative one (−1) point. Accumulation of the points determines the risk level of the donor. These weighted points were used to categorize infected donors as having negligible (<2 points), tolerable (3-4 points), undesirable (5–8 points), or intolerable (>9 points) risk. Based on accumulated weight of ≥5 points, the algorithm was 94.7% (54/57) sensitive but 82% (298/364) specific. With this level of specificity, 18% of the blood donors without malaria would have been deferred. Therefore, it is imperative that all donors with accumulated risk ≥5 be screened for malaria using either malaria rapid test kit or microscopy.

Risk Assessment of COVID-19 in the Iranian Health System.

The outbreak of coronavirus disease 2019 (COVID-19) has exerted unprecedented pressure on healthcare systems throughout the world. This study was designed to develop a national health emergency management program based on risk assessment for COVID-19. Mixed-methods research was used. Based on recommendations of the national epidemiology committee, 2 risk scenarios were used as basic scenarios for risk assessment. Two rounds of Focus Group Discussions (FGDs) were conducted between January and May 2020 with 30 representatives of the health system. The data were collected, analyzed, and integrated by the research team. In the risk matrix, "contamination of environment and individuals" and "burnout of medical staff" occupied the red zone (intolerable risk). "Defects in screening and admissions," "process disruption in medical care and rehabilitation," "increased mental disorders," "social dissatisfaction," "the decline in healthcare services," and "loss of medical staff" were identified as the orange zone (significant risk) of the matrix. The avoidance of environmental and individual contamination and healthcare worker burnout are the priorities in Iran. Attention to intersectoral cooperation, the involvement of non-governmental organizations and private center capacities, integration of information health systems, and developing evidence-based protocols are other measures that can improve the health system's capacity in the response COVID-19.

The Political Economy of Securities Industry Bars

Financial regulators can bar or exclude people from various industries. Yet securities regulators tend to impose too many broker bars, and too few against other financial professionals. While scholars have taken this pattern for granted, it presents a puzzle for securities law: what are these sanctions’ function? They are how securities law implements its distributive commitment to investor protection—making investors better off at brokers’ expense. Their function is to designate certain securities law rules as giving rise to a property-rule-like entitlement to capital owners not to have their profits from investing involuntarily transferred away from them by market intermediaries. Drawing from law and political economy, this article argues that industry bars' function reflects the particular social and historical context in which the securities laws arose. Despite decades of failed attempts, financial mar-ket reform happened only after a critical mass of modestly wealthy Americans, who had newly began investing in the stock market, found their savings defrauded or manipulated away from them. The early securities laws borrowed industry exclusion from the stock exchanges’ self-regulatory practice, and subsequent amendments have expanded exclusion’s role. Exclusion remains today the doctrinal tool that securities law uses for determining that certain misconduct reflects intolerable risk that a person working in the financial industry will involuntarily redistribute the returns on investors’ capital. This project aims to bring a political-economy approach back in to corporate and securities law scholarship—identifying hidden ways that doctrine and practice in capital markets regulation reflect and reinforce distributions of power and wealth and society.

Gender and life-stage dependent reactions to the risk of radioactive contamination: A survey experiment in Sweden.

This article proposes and examines gender and life-stage factors as determinants of public worry and risk avoidance in a nuclear fallout scenario. Drawing on a survey (N 2,291) conducted in Sweden, the article demonstrates statistically significant results that women as well as parents with children at home are more likely to express high levels of worry for radiation exposure and have a preference to move away from a fallout area despite assurance of successful remediation. Moreover, a negative relationship is shown between age and both worry for radiation exposure and preference to move. These novel results from Northern Europe thus support a life-stage framing of public risk attitudes. As radiation physicists develop new methods showing that women and children are at higher risk of cancer than other groups at the same radiation exposure, we may actually see the precaution among women and parents as a regulating mechanism for the higher objective risk they face. The results are moreover in agreement with studies of public risk reactions in Japan, creating a strong knowledge base that human-induced radiation pollution is largely an intolerable risk to the public. Considering the public opinion, managing an intolerable risk through risk mitigation by remediation alone is likely insufficient in many cases. A viable strategy would offer a range of social support options that enable individual decision-making and the protection of risk groups.