Strategies For Prevention Of Loss Research Articles

Innovative Machine Learning Strategies for Early Detection and Prevention of Pregnancy Loss: The Vitamin D Connection and Gestational Health.

Early pregnancy loss (EPL) is a prevalent health concern with significant implications globally for gestational health. This research leverages machine learning to enhance the prediction of EPL and to differentiate between typical pregnancies and those at elevated risk during the initial trimester. We employed different machine learning methodologies, from conventional models to more advanced ones such as deep learning and multilayer perceptron models. Results from both classical and advanced machine learning models were evaluated using confusion matrices, cross-validation techniques, and analysis of feature significance to obtain correct decisions among algorithmic strategies on early pregnancy loss and the vitamin D serum connection in gestational health. The results demonstrated that machine learning is a powerful tool for accurately predicting EPL, with advanced models such as deep learning and multilayer perceptron outperforming classical ones. Linear discriminant analysis and quadratic discriminant analysis algorithms were shown to have 98 % accuracy in predicting pregnancy loss outcomes. Key determinants of EPL were identified, including levels of maternal serum vitamin D. In addition, prior pregnancy outcomes and maternal age are crucial factors in gestational health. This study's findings highlight the potential of machine learning in enhancing predictions related to EPL that can contribute to improved gestational health outcomes for mothers and infants.

Spatial and Temporal Variations of Land Use and Land Cover In Kadiri Watershed Using Rs & Gis Techniques

The change detection and land use and land cover (LULC) maps are more important powerful forces behind numerous ecological systems and fallow land. It is widely known that land use/land cover (LULC) changes significantly alter watershed hydrology and sediment yields. The impact, especially on erosion and sedimentation, is likely to be exacerbated in regions dominated by high rainfall patterns such as monsoons. RS & GIS technologies are very useful to determine the LULC changes. Present research area Kadiri Watershed of Anantapur district of Andhra Pradesh, India, drains an area about 240 km2 including 15 villages. The average annual rainfall in this area varies between 600mm to 700mm in which 60%, 35% and 5% of total rainfall occurs in South-West (S-W),North-East (N-E) and in Summer seasons respectively. The current research focuses on demarcating the spatiotemporal LULC changes. These effects directly affect the ecosystem, land resources, cropping pattern and agriculture. LULC assessment and surveillance are essential for long-term planning and sustainable use of natural resources. The LULC maps were prepared for the study area using Landsat-5, Senthinel 2 images pertaining to pre-monsoon and post-monsoon seasons of 2013, 2017 and 2021. Variations in the extents of agriculture, plantations, scrubs, water bodies, open lands, and built-up areas were noted during these years in the pre-monsoon season, and they ranged from 22 to 35 and 43%, 2 to 3 and 5%, 22 to 28%, 1 to 4%, 52 to 29 and 15%, as well as 1 to 5%, respectively. Similar fluctuations were seen in the post-monsoon season, where they ranged from 29 to 40 and 47%, 3 to 7%, 33 to 30%, 2 to 4%, 32 to 20 and 7%, as well as 1 to 5%. Kadiri watershed, an agriculturally dominant area, has seen an increase in cultivated land due to the conversion of fallow land and open scrub into cropland as a result of good rainfall received during the south-west monsoon during in assessment years and implementation of watershed development activities. These findings highlight the potential impacts of LULC changes in a monsoon-dominated watershed and may contribute to the development of successful LULC-based watershed management strategies for prevention of flooding and sediment loss.

MP65-01 RISK FACTORS FOR PARASTOMAL HERNIATION: A SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS-MEDICARE DATA ANALYSIS

You have accessJournal of UrologyCME1 Apr 2023MP65-01 RISK FACTORS FOR PARASTOMAL HERNIATION: A SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS-MEDICARE DATA ANALYSIS Diboro Kanabolo, Sarah Holt, Jonathan Wright, and George Schade Diboro KanaboloDiboro Kanabolo More articles by this author , Sarah HoltSarah Holt More articles by this author , Jonathan WrightJonathan Wright More articles by this author , and George SchadeGeorge Schade More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003323.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A frequent complication of stoma creation is parastomal herniation (PSH), defined as any palpable bulge or radiologic defect containing bowel in the parastomal region. Reported incidence rates are up to 50% for patients in the 24 months following ileal conduit (IC) surgery. To better understand risk factors for PSH in those undergoing cystectomy and ileal conduit (RC/IC) procedure, we examined a contemporary cohort of patients through combined Surveillance, Epidemiology and End Results-Medicare data (SEER-MD). METHODS: Using SEER-MD, patients with PSH after cystectomy and IC were identified. This was performed using CPT codes to identify surgery patients and subsequent diagnostic the new ICD-10 PSH specific code (K43.5) post-surgery, for those with surgery between 2015 and 2019. Risk factors of interest included: race, sex, socioeconomic status, marital status, COPD, smoking, obesity status, neoadjuvant chemotherapy administration, and tumor stage. An adjusted Cox Proportional-Hazards model was utilized for statistical analysis, enabling assessment of time to PSH from receipt of surgery and to account for censored patients. RESULTS: Of 1,838 patients identified as having undergone RC/IC, 132 patients (7 %) developed PSH in the followup period. The median time to PSH was 11.5 months (IQR: 6.5-18.7 months). The greatest risk factor in our cohort of patients for development of PSH was obesity (HR 2.05, 95% CI 1.48-2.98). The lowest socioeconomic quartile was also associated with greater risk of PSH (HR 1.49, 95% CI 1.01-2.22). Sex, COPD diagnosis, gender, race, smoking status, neoadjuvant chemotherapy, and tumor stage were not significantly associated with risk of PSH, although the female sex, Black/Hispanic race, and pT4 lesions showed elevated HR estimates. Marital status of “Divorced/Separated/Widowed” was significantly associated with PSH (HR 1.66, 95% CI 1.04-2.66) vs. “Married”, however due to a large portion of “unknown” marital status in our cohort, this finding may not be clinically meaningful. CONCLUSIONS: While the SEER-MD incidence rate is far below 50%, this reflects a mutable coding process subject to variation in capture by provider. With the available cohort, our model demonstrated an increased risk of PSH for obese and low SES patients undergoing RC/IC surgery. Both weight loss prevention strategies and careful symptom monitoring must be pursued in this population. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e890 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Diboro Kanabolo More articles by this author Sarah Holt More articles by this author Jonathan Wright More articles by this author George Schade More articles by this author Expand All Advertisement PDF downloadLoading ...

Strategies for prevention and management of partial flap loss or fat necrosis in microvascular autologous breast reconstruction

Partial flap loss (skin involved) or fat necrosis following autologous breast reconstruction remains a dreaded postoperative complication despite significant advances in microsurgical techniques. Several strategies have been proposed in the preoperative and intraoperative period to prevent this complication ranging from preoperative imaging, intra-operative tissue perfusion assessment, appropriate perforator selection (location and number), maximizing inflow and outflow with additional anastomoses and/or pedicles, and minimizing ischemia time. Postoperative management of partial flap loss (when there is skin involvement) and fat necrosis remains a challenge, with very little published data focusing on classification, timing, and techniques. Early intervention versus close observation may depend on multiple patient factors and the degree or volume of necrosis. Secondary intervention options include hyperbaric oxygen therapy, fat aeration with a needle, liposuction, fat grafting, addition of another flap or implant, depending on the nature of the defect. This review summarizes the current evidence for each of these strategies to help the current surgeon understand their options in preventing and managing patients suffering from partial flap loss.

Economic benefit and social impact derived by a food loss prevention strategy in the vegetable sector: A spatial and temporal analysis at the regional level

IntroductionReduction of food loss in the horticultural sector is critical to simultaneously support the transition toward a diet with higher consumption of vegetables and the achievement of policy goals aimed at halving the quantity of wastage by 2030. However, the lack of precise information and the presence of múltiple interconnected factors makes it difficult to assess the potential socioeconòmic benefits and therefore the decision-making process of food loss reduction strategies.MethodsA case study approach has been used to assess the econòmic loss and nutrional impact of food loss in the horticulture primary production. The selection of the main vegetable products was based on an historical series while econòmic and nutritional impact were estimated starting from national and European indicator.ResultsThe food loss correspond to 26% of the total production and 14% of the total agricultural production econòmic value. The social analysis confirm the possibility of redistributing food loss among the population even in the most critical months and areas.DiscussionThe combination of social and econòmic indicator resulted essential to provide key information at the decision-making level to pave the way for the elaboration of short- and long-term food loss reduction strategies. Indeed, no single-bullet strategy can be applied to overcome the problem of food loss as many actor with different needs are involved.

Effects of Dynamic Land Use/Land Cover Change on Flow and Sediment Yield in a Monsoon-Dominated Tropical Watershed

It is widely known that land use/land cover (LULC) changes significantly alter watershed hydrology and sediment yields. The impact, especially on erosion and sedimentation, is likely to be exacerbated in regions dominated by high rainfall patterns such as monsoons. This study analyzed the hydrological responses of LULC changes in terms of streamflow (SF) and sediment yield (SY) in a monsoon-dominated tropical watershed, the Periyar River Watershed (PRW) in Kerala, India. This watershed drains an area of 4793 km2 characterized by an average monsoon rainfall of 2900 mm from June to November. The watershed hydrology and sediment dynamics were simulated using the Soil and Water Assessment Tool (SWAT) model for the impact assessment at the watershed outlet and the sub-watershed level. Historical LULC data were analyzed for 1988, 1992, 2002, and 2016 using the maximum likelihood method, and future LULC changes were projected for 2030, 2050, 2075, and 2100 using the Markov chain–cellular automata technique. Between 1988 and 2016, the urban area increased by 4.13 percent, while plantation and forest coverage decreased by 1.5 percent. At this rate, by 2100, the urban area is expected to grow by 16.45% while plantations and forest area will shrink by 13.7% compared to 1988. The effects of these changes on SF and SY were found to be minimal at the watershed outlet; however, at the spatial scale of sub-watersheds, the changes varied up to 70% for surface runoff and 200% for SY. These findings highlight the potential impacts of LULC changes in a monsoon-dominated watershed and may contribute to the development of successful LULC-based watershed management strategies for prevention of flooding and sediment loss.

Risk analysis of the sodium hypochlorite production process: Focus on the chlorine line

Mainly in the first part of COVID-19 pandemics, sodium hypochlorite was used as disinfectant, surprisingly also to spray over people. Several hazards may be associated to the production of this compound, such as chlorine gas toxicity and explosive hazards, due to the presence of hydrogen and chlorine, and corrosive hazards. Thus, loss prevention strategies must be ad-hoc developed to mitigate the risks. In the present work, the risk assessment of the first block of the process was performed, focusing the attention on chlorine risks. To this end, HAZOP analysis was first performed to identify the most critical top event, noticing the major issues in the quality of the final product and in the release of chlorine from pipes. Then, the fault tree analysis was built to calculate its failure rate. CFD simulations were used instead of empirical model to assess with a rigorous approach the chlorine dispersion, taking into account all the boundary conditions. In particular, by setting a hazardous chlorine concentration of 180 ppm corresponding to 50% fatalities for chlorine exposition for an exposure of 60 min, results without aspiration demonstrate the possibility for the cloud to impact workers at ground level also very far from the source point, while the chlorine cloud is moved upwards with a maximum length of 6.5 m when an aspiration is used, although the air ventilation speed is kept low.

Pertes hématiques non détectées pendant la chirurgie de la scoliose

IntroductionPosterior spinal fusions (PSF) for adolescent idiopathic scoliosis (AIS) have higher blood loss than other pediatric orthopedic surgeries. There is a paucity of literature estimating the hidden blood loss (HBL) in patients with AIS undergoing PSF. The purpose of this study was to compare intraoperative and postoperative estimated blood loss (EBL) in patients undergoing PSF for AIS to determine HBL. HypothesisWith contemporary blood loss prevention strategies, HBL will be higher than intraoperative EBL. Material and methodsOver a 3-year period, 67 patients with preoperative and postoperative hemoglobin (Hgb) measurements undergoing PSF for AIS were evaluated. Intraoperative EBL was estimated using a volumetric method and recorded by a perfusionist managing a cell saver machine. Total perioperative EBL was estimated using the validated formula: EBL=weight (kg)×age sex factor×(preoperative Hgb−postoperative Hgb)/preoperative Hgb. HBL was calculated as the total perioperative EBL minus the intraoperative EBL. ResultsCalculated total EBL was higher than intraoperative EBL (771±256mL vs. 110±115mL, p<0.001). Mean HBL after wound closure was 660±400mL. Patients 14 years or greater (p=0.03), with a BMI≥25kg/m2 (p=0.02) and with surgical times over 3.5 hours (p=0.05) had increased HBL. Multivariate analysis determined BMI≥25kg/m2 (OR 9.91; CI, 1.01–104.26; p=0.05) was associated with increased HBL. Allogenic blood transfusion was rare (4 %) and associated with increased HBL (897±112mL vs. 540±402mL, p=0.05). DiscussionFor patients undergoing PSF for AIS there is more HBL after wound closure than intraoperative blood loss. This HBL is higher in older patients who undergo longer operations and have a BMI≥25kg/m2. Level of evidenceIV; retrospective cohort study.

Seismic vulnerability analysis of simply supported continuous bridge during construction

PurposeIn order to explore the damage probability of bridge engineering in the event of earthquake in the construction stages, the analysis method of seismic vulnerability in the construction stages is proposed in this paper.Design/methodology/approachBased on the joint simulation function of construction stage conditions and seismic response conditions of MIDAS/Civil finite element analysis software, combined with the method of IDA analysis and compared the relationship between demand and capacity.FindingsThe research shows that: (1) the average seismic loss in different construction stages varies greatly; (2) the seismic vulnerability varies greatly in different construction stages. The vulnerability of the bridge in stage 6 is determined by the longitudinal direction of bridge. Therefore, during the construction of the whole bridge, we should focus on strengthening the disaster and loss prevention strategy of earthquake insurance in the longitudinal direction of bridge. (3) The application of the secondary dead load mainly affects the fragilityin the longitudinal direction of bridge, but has little effect on the fragility in the transversal direction of bridge.Originality/valueThis paper is to explore the seismic vulnerability of a typical simply supported continuous bridge during the construction stages, and to trace the entire construction stage of a typical simply supported continuous bridge. According to the characteristics of the system transformation in the actual construction steps, demand-capacity ratios were established based on incremental dynamic analysis (IDA) and performance indicators of moment curvature and stability, and the seismic vulnerability research is carried out for the construction stages prone to earthquake damage. Furthermore, it provides a basis for seismic risk assessment of such bridges in different construction stages.

Fight inventory shrinkage: Simultaneous learning of inventory level and shrinkage rate

In 2020, inventory shrinkage eroded $61.7 billion profit in the U.S. retail industry. Unfortunately, fighting inventory shrinkage to protect retailers' already slim profits is challenging due to unknown shrinkage rates and invisible inventory levels. While the latter has been studied in the literature, the former has not. To deal with this challenge, we introduce two new features to the Bayesian inventory models: (1) interleaving customer and theft arrival processes that contribute to actual sales and shrinkages, respectively, and (2) learning of both inventory level and shrinkage rate. We first derive the learning formulae using the triple‐censored sales data (invisible lost sales, shrinkages, and “lost shrinkages”) and then use them to construct a POMDP (partially observable Markov decision process) model for making inventory and loss prevention decisions. For a different level of information deficiency, we analyze the model property and design heuristic order policies to capture the benefit of learning. Through a numerical study, we show that our estimated shrinkage rate converges quickly and monotonically to the actual value. For products with high shrinkage rates (5–12%), our heuristic policy can help seize 82–94% of the ideal profit retailers could earn under full information. We note that feature (1) of our model is crucial. It not only reflects the actual arrival order but also allows us to learn the unknown shrinkage rate, which, in turn, can prevent serious underordering and vicious inventory cycles and can increase the profit by 108% in some cases. Our approach thus enables both effective inventory management and early identification of ineffective loss prevention strategies, reducing shrinkage, and increasing sales and profit.

Hidden blood loss in adolescent idiopathic scoliosis surgery

IntroductionPosterior spinal fusions (PSF) for adolescent idiopathic scoliosis (AIS) have higher blood loss than other pediatric orthopedic surgeries. There is a paucity of literature estimating the hidden blood loss (HBL) in patients with AIS undergoing PSF. The purpose of this study was to compare intraoperative and postoperative estimated blood loss (EBL) in patients undergoing PSF for AIS to determine HBL. HypothesisWith contemporary blood loss prevention strategies, HBL will be higher than intraoperative EBL. Material and methodsOver a 3-year period, 67 patients with preoperative and postoperative hemoglobin (Hgb) measurements undergoing PSF for AIS were evaluated. Intraoperative EBL was estimated using a volumetric method and recorded by a perfusionist managing a cell saver machine. Total perioperative EBL was estimated using the validated formula: EBL=weight (kg)×age sex factor×(preoperative Hgb – postoperative Hgb)/preoperative Hgb. HBL was calculated as the total perioperative EBL minus the intraoperative EBL. ResultsCalculated total EBL was higher than intraoperative EBL (771±256mL vs. 110±115mL, p<0.001). Mean HBL after wound closure was 660±400mL. Patients 14 years or greater (p=0.03), with a BMI≥25kg/m2(p=0.02) and with surgical times over 3.5hours (p=0.05) had increased HBL. Multivariate analysis determined BMI≥25kg/m2 (OR 9.91; CI, 1.01–104.26; p=0.05) was associated with increased HBL. Allogenic blood transfusion was rare (4%) and associated with increased HBL (897±112mL vs. 540±402mL, p=0.05). DiscussionFor patients undergoing PSF for AIS there is more HBL after wound closure than intraoperative blood loss. This HBL is higher in older patients who undergo longer operations and have a BMI≥25kg/m2. Level of evidenceIV; retrospective cohort study.

High-Level Executive Functions: A Possible Role of Sex and Weight Condition in Planning and Decision-Making Performances.

Evidence indicates an association between executive functioning and increased weight, with different patterns ascribed to individual differences (sex, age, lifestyles). This study reports on the relationship between high-level executive functions and body weight. Sixty-five young adults participated in the study: 29 participants (14 males, 15 females) in the normal weight range; 36 participants (18 males, 18 females) in the overweight range. The Iowa Gambling Task (IGT) and Tower of London Task were administered to assess decision making and planning. Planning did not differ in individuals in the normal-weight and overweight groups, and no difference emerged between females and males. However, normal and overweight males and females had different patterns in decision making. On the long-term consequences index of the IGT, females reported lower scores than males. Males in the overweight range had a lower long-term consequences index on the IGT than normal-weight males, while this pattern did not emerge in females. These findings suggest that decision-making responses may differ in the overweight relative to healthy weight condition, with a different expression in males and females. This pattern should be considered in weight loss prevention strategies, possibly adopting different approaches in males and females.

Food Loss and Waste Prevention Strategies from Farm to Fork

About one-third of the food produced globally for human consumption is lost or wasted each year. This represents a loss of natural resources consumed along the food supply chain that can also have negative impacts on food security. While food loss occurs between production and distribution and is prevalent in low-income countries, food waste occurs mainly at the consumer level, in the retail and food service sectors, and especially in developed countries. Preventing food losses and waste is therefore a potential strategy for better balance food supply and demand and is essential to improve food security while reducing environmental impact and providing economic benefits to the different actors in the food supply chain. In this context, we specifically provide an overview of case studies and examples of legislation from different countries and actions carried out by the various actors in the food chain and by non-profit organisations to effectively prevent and or reduce food loss and waste. We also outline current limitations and possible research avenues. We conclude that the comparison and the integration of knowledge, and the awareness of where along the food chain, for which foods and in which countries the greatest losses are produced, is essential to decide where and how to target efforts in the most effective way.

Fight Inventory Shrinkage: Simultaneous Learning of Inventory Level and Shrinkage Rate

In 2020, inventory shrinkage eroded $61.7 billion in the U.S. retail industry. Unfortunately, fighting inventory shrinkage to protect retailers’ already slim profits is challenging due to unknown shrinkage rates and censored sales data caused by unobservable theft behavior. To deal with such information deficiency, we introduce two new features to a Bayesian inventory model: (1) the invisibility of both inventory level and shrinkage rate, and (2) interleaving customer and theft arrivals (which contribute to actual sales and shrinkages, respectively). In contrast to the previous works, we use triple-censored sales data (invisible lost sales, thefts, and “lost thefts”) to learn inventory level and shrinkage rate simultaneously in real-time. We then use these learning formulae to develop a POMDP (Partially Observable Markov Decision Process) model for making inventory and loss prevention decisions. We analytically solve this model and propose several heuristic order policies to capture the benefit of learning. We demonstrate that our model outperforms several benchmark models. Through a numerical study, we show that our estimated shrinkage rate converges quickly and monotonically to the actual value. For products with high shrinkage rates (5% − 12%), our heuristic policy can help seize 82% − 94% of the ideal profit retailers could earn under full information. Our approach can thus enable early and easy identification of an effective loss prevention strategy, reduce shrinkage, and increase sales.

A preliminary explore to the forced ventilation on the toxic gas release/dispersion and the hazard mitigation within a petrochemical plant

More than thirty-five years ago, the Bhopal disaster shook the whole world and investigators found out that many people survived just because they turned on the fans in their bedrooms. It was postulated that the forced ventilation played an important role in diluting the toxic gas and saved these people. In order to provide evidence to solve this old mystery, this research employed FLACS software to assess the hazardous degree of a toxic gas (hydrogen sulfide) leakage within a petrochemical process. Series of gas dispersion simulations were performed to actualize the hazardous characteristics and the corresponding risks of the release accident. The study shows that the hazardous level and the hazard range can be greatly influenced when parameters, such as the gas leakage circumstances (atmospheric conditions and wind speed) and the mitigation measures (direction of fans and their speed) are altered.By using explosion-proof fans in different positions and ventilation directions, combined with the natural wind in a certain direction, this research attempts to detect the best combination from various mitigation designs and to compare the influence of fan directions on hazard mitigation. It is also the first time of its kind to simulate the effect of forced ventilation on hazard mitigation within a process plant. The results show that the hazardous level of a toxic release can be effectively alleviated, when the direction of the mechanical ventilation is against the natural wind direction. With the help of the CFD simulation and the quantitative risk analysis technique, different loss prevention strategies can be tested via this method in order to establish a safer working environment.

Dietary Methionine Supplementation Exacerbates Gastrointestinal Toxicity in a Mouse Model of Abdominal Irradiation

Identification of appropriate dietary strategies for prevention of weight and muscle loss in cancer patients is crucial for successful treatment and prolonged patient survival. High-protein oral nutritional supplements decrease mortality and improve indices of nutritional status in cancer patients; however, high-protein diets are often rich in methionine, and experimental evidence indicates that a methionine-supplemented diet (MSD) exacerbates gastrointestinal toxicity after total body irradiation. Here, we sought to investigate whether MSD can exacerbate gastrointestinal toxicity after local abdominal irradiation, an exposure regimen more relevant to clinical settings. Male CBA/CaJ mice fed either a methionine-adequate diet or MSD (6.5 mg methionine/kg diet vs 19.5 mg/kg) received localized abdominal X-irradiation (220 kV, 13 mA) using the Small Animal Radiation Research Platform, and tissues were harvested 4, 7, and 10 days after irradiation. MSD exacerbated gastrointestinal toxicity after local abdominal irradiation with 12.5 Gy. This was evident as impaired nutrient absorption was paralleled by reduced body weight recovery. Mechanistically, significant shifts in the gut ecology, evident as decreased microbiome diversity, and substantially increased bacterial species that belong to the genus Bacteroides triggered proinflammatory responses. The latter were evident as increases in circulating neutrophils with corresponding decreases in lymphocytes and associated molecular alterations, exhibited as increases in mRNA levels of proinflammatory genes Icam1, Casp1, Cd14, and Myd88. Altered expression of the tight junction-related proteins Cldn2, Cldn5, and Cldn6 indicated a possible increase in intestinal permeability and bacterial translocation to the liver. We report that dietary supplementation with methionine exacerbates gastrointestinal syndrome in locally irradiated mice. This study demonstrates the important roles registered dieticians should play in clinical oncology and furtherunderlines the necessity of preclinical and clinical investigations in the role of diet in the success of cancer therapy.

Hearing loss as a risk factor for dementia

In the last decades, there has been an increase in life expectancy in the world, with the consequent modification in the proportion of adults over 60 years. This is accompanied by an increase in pathologies for which aging is the main risk factor, such as dementia and hearing loss, which profoundly affect the quality of life of individuals and their family and impact health system costs. Given the lack of disease-modifying treatments for dementia, the study of mechanisms to prevent its occurrence has become a world priority. In the year 2017, the Lancet "Commission for dementia prevention, intervention, and care" proposed a model, in which hearing loss emerged as a new modifiable risk factor for the development of dementia. This result undoubtedly has important consequences for the understanding the multifactorial nature of dementia, our daily clinical practice and public policies aimed at its prevention and treatment. In this article, we review the current evidence supporting the association between dementia and hearing loss, discussing the available strategies for prevention, detection and treatment of hearing loss and its possible impact on the natural course of dementia. A flow chart for the clinical management of different subgroups of patients is proposed.

Loss Prevention Strategies to Mitigate the Effects of Covid-19 Pandemic Especially Among Small Business Owners of African American Decent

Loss Prevention Strategies to Mitigate the Effects of Covid-19 Pandemic Especially Among Small Business Owners of African American Decent

Minimizing Audit Findings by increasing Operational Discipline and Process Safety Culture

Many major accidents have taken place in the chemical and petrochemical industry over the past 40 years (e.g. Bhopal (India, 1984), Texas City (USA, 2005)), which have been key driving forces for issuing new regulations (governments), publishing standards (industry groups), developing policies (companies), and ultimately for improving Loss Prevention strategies and Process Safety Management (PSM). On this context, a key standard is the OSHA PSM (29 CFR 1910.119), a process-based program aiming at preventing or minimizing the consequences of catastrophic releases of toxic, reactive, flammable, or explosive chemicals.The present paper focuses on the results from several PSM audits performed between 2010 and 2016, at several different Chemical Process Industry (CPI) facilities. On the one hand, we have evaluated how well these facilities complied with the requirements of the OSHA PSM Standard. On the other hand, the data from the audit findings has been compiled and statistically processed in order to compare the main common findings with the results of those analyzed by OSHA's Refinery and Chemical National Emphasis Programs (NEP) in 2012.Key audit findings from the CPI are a valued source of information for understanding current safety weaknesses. The lessons learned from this study help us to identify operational discipline and process safety leadership and culture benefits towards minimizing or avoiding audit findings, and therefore, to contributing to an optimized and sustainable Process Safety management system.

Muscle loss: The new malnutrition challenge in clinical practice

Recent definitions of malnutrition include low muscle mass within its diagnostic criteria. In fact, malnutrition is one of the main risk factors of skeletal muscle loss contributing to the onset of sarcopenia. However, differences in the screening and diagnosis of skeletal muscle loss, especially as a result of malnutrition in clinical and community settings, still occur mainly as techniques and thresholds used vary in clinical practice. The objectives of this position paper are firstly to emphasize the link between skeletal muscle loss and malnutrition-related conditions and secondly to raise awareness for the timely identification of loss of skeletal muscle mass and function in high risk populations. Thirdly to recognize the need to implement appropriate nutritional strategies for prevention and treatment of skeletal muscle loss and malnutrition across the healthcare continuum. Malnutrition needs to be addressed clinically as a muscle-related disorder and clinicians should integrate nutritional assessment with muscle mass measurements for optimal evaluation of these two interrelated entities to tailor interventions appropriately. The design of monitoring/evaluation and discharge plans need to include multimodal interventions with nutrition and physical exercise that are key to preserve patient's muscle mass and function in clinical and community settings.