Quantitative Risk Estimates Research Articles

Security Events and Vulnerability Data for Cybersecurity Risk Estimation.

Current industry standards for estimating cybersecurity risk are based on qualitative risk matrices as opposed to quantitative risk estimates. In contrast, risk assessment in most other industry sectors aims at deriving quantitative risk estimations (e.g., Basel II in Finance). This article presents a model and methodology to leverage on the large amount of data available from the IT infrastructure of an organization's security operation center to quantitatively estimate the probability of attack. Our methodology specifically addresses untargeted attacks delivered by automatic tools that make up the vast majority of attacks in the wild against users and organizations. We consider two-stage attacks whereby the attacker first breaches an Internet-facing system, and then escalates the attack to internal systems by exploiting local vulnerabilities in the target. Our methodology factors in the power of the attacker as the number of "weaponized" vulnerabilities he/she can exploit, and can be adjusted to match the risk appetite of the organization. We illustrate our methodology by using data from a large financial institution, and discuss the significant mismatch between traditional qualitative risk assessments and our quantitative approach.

Estimation and development of 10- and 20-year cardiovascular mortality risk models in an industrial male workers database.

We examined the performance of the Framingham Heart Study (FHS) and the European Systematic Coronary Risk Evaluation (SCORE) models for cardiovascular disease (CVD) mortality prediction in Israeli industrial workers, and developed and validated new risk prediction models for CVD mortality incidence in the same population. Our database was a longitudinal Israeli industrial cohort (CORDIS cohort) of 4809 adult males followed-up for 22years. Performance of the FHS and the SCORE prediction models was analyzed by insertion of the CORDIS cohort measurements to each model separately. The standard prognostic variables and results obtained from the new refined Cox regression analyses were used to construct two new 10- and 20-year CVD mortality risk scoring systems: a modified FHS model (FHS/Cox) and an omnibus model with Cox regression (Omnibus/Cox). The SCORE model of high-risk and low-risk charts yielded 10-year mortality mean risks of 1.12% and 0.64%, respectively, for male subjects aged>30years. The new FHS/Cox and Omnibus/Cox models generated a mean predictive 10-year risk of 1.12% and 1.50%, respectively. The mean 20-year risk predicted by the new FHS/Cox and the Omnibus/Cox models was 2.66% and 3.75%, respectively. Internal validation of both models demonstrated a high and stable area under the receiver operating characteristic curve>0.85. No significant differences were found between the two models. In conclusion, the CVD mortality risk prediction scoring systems tailored for the Israeli workers population demonstrated good performance. Additional studies to externally validate these algorithms will indicate which of these quantitative risk estimation platforms should be used in specific settings.

Varying occurrence of extended‐spectrum beta‐lactamase bacteria among three produce types

AbstractA monitoring effort that spanned across 1.5 years was conducted to examine three types of produce‐associated microbiota. The average amount of antibiotic‐resistant bacteria recovered from lettuce, tomato, and cucumber was 1.02 × 1010, 2.05 × 107, and 4.78 × 109 cells per 50 g of each produce, respectively. A total of 480 bacterial isolates were obtained and identified from their 16S rRNA genes, revealing isolates that were ubiquitously recovered from all three types of produce. However, sporadic presence of Klebsiella pneumoniae and Acinetobacter baumannii was detected on lettuce and cucumbers but not tomatoes. End‐point PCR revealed that the K. pneumoniae and A. baumannii isolates were positive for genes encoding extended spectrum beta‐lactamase. Whole genome sequencing of two of the K. pneumoniae isolates further suggested the presence of the blaCTX‐M‐15 gene in a conjugative plasmid, as well as other antibiotic resistance genes and virulence‐associated traits in either conjugative plasmids or the chromosomal genome. Quantitative microbial risk assessment indicated varying levels of ingestion risk associated with different types of produce. In particular, the risk arising from ESBL‐positive K. pneumoniae in lettuce, but not in cucumbers or tomatoes, was higher than the acceptable annual risk of 10−4.Practical applicationsThree types of vegetables were sampled and evaluated over 1.5 years to determine differences in their associated bacterial isolates. Particular emphasis was placed on identifying pathogenic strains that were positive for extended spectrum beta‐lactamase (ESBL). Quantitative estimates of the microbial risk associated with the ESBL‐positive pathogens showed that different produce types may incur varying levels of ingestion risk. Most of the currently reported ESBL‐positive bacterial isolates have been identified in nosocomial environments. However, the carriage of such drug‐resistant bacteria in vegetables suggests a possible connection between our daily diet and human health.

LOGICAL AND PROBABILISTIC METHOD FOR RISK MANAGEMENT IN SOCIO-ECONOMIC SYSTEMS

In this paper we research the application of logical and probabilistic method to manage risk in socio-economic systems. Logical and probabilistic method is widely used for estimation of reliability and safety in structural complex technical systems. Authors have applied this method to estimate and analyze risk in some practical applications in economics and business. Based on risk scenario as tree of events, logics and probabilistic functions, this approach provides exact quantitative estimation of risk, risk analysis and decision-making procedures. Some promising results were obtained in banking industry and security portfolio management but application of the method has some features.

Quantitative Estimation of Risks for Production Unit Based on OSHMS and Process Resilience

Three principal elements in the production field of chemical/petrochemical industry are (i) Production Units, (ii) Production Plant Personnel and (iii) Production Support System (computer system introduced for improving productivity). Each principal element has production process resilience, i.e. a capability to restrain disruptive signals occurred in and out of the production field. In each principal element, risk assessment is indispensable for the production field. In a production facility, the occupational safety and health management system (Hereafter, referred to as OSHMS) has been introduced to reduce a risk of accidents and troubles that may occur during production. In OSHMS, a risk assessment is specified to reduce a potential risk in the production facility such as a factory, and PDCA activities are required for a continual improvement of safety production environments. However, there is no clear statement to adopt the OSHMS standard into the production field. This study introduces a metric to estimate the resilience of the production field by using the resilience generated by the production plant personnel and the result of the risk assessment in the production field. A method for evaluating how OSHMS functions are systematically installed in the production field is also discussed based on the resilience of the three principal elements.

Risk of heart failure in survivors of Hodgkin lymphoma: effects of cardiac exposure to radiation and anthracyclines

AbstractHodgkin lymphoma (HL) survivors treated with radiotherapy and/or chemotherapy are known to have increased risks of heart failure (HF), but a radiation dose-response relationship has not previously been derived. A case-control study, nested in a cohort of 2617 five-year survivors of HL diagnosed before age 51 years during 1965 to 1995, was conducted. Cases (n = 91) had moderate or severe HF as their first cardiovascular diagnosis. Controls (n = 278) were matched to cases on age, sex, and HL diagnosis date. Treatment and follow-up information were abstracted from medical records. Mean heart doses and mean left ventricular doses (MLVD) were estimated by reconstruction of individual treatments on representative computed tomography datasets. Average MLVD was 16.7 Gy for cases and 13.8 Gy for controls (Pdifference = .003). HF rate increased with MLVD: relative to 0 Gy, HF rates following MVLD of 1-15, 16-20, 21-25, and ≥26 Gy were 1.27, 1.65, 3.84, and 4.39, respectively (Ptrend < .001). Anthracycline-containing chemotherapy increased HF rate by a factor of 2.83 (95% CI: 1.43-5.59), and there was no significant interaction with MLVD (Pinteraction = .09). Twenty-five–year cumulative risks of HF following MLVDs of 0-15 Gy, 16-20 Gy, and ≥21 Gy were 4.4%, 6.2%, and 13.3%, respectively, in patients treated without anthracycline-containing chemotherapy, and 11.2%, 15.9%, and 32.9%, respectively, in patients treated with anthracyclines. We have derived quantitative estimates of HF risk in patients treated for HL following radiotherapy with or without anthracycline-containing chemotherapy. Our results enable estimation of HF risk for patients before treatment, during radiotherapy planning, and during follow-up.

Model-based approach for quantitative estimates of skin, heart, and lung toxicity risk for left-side photon and proton irradiation after breast-conserving surgery

Background: Proton beam therapy represents a promising modality for left-side breast cancer (BC) treatment, but concerns have been raised about skin toxicity and poor cosmesis. The aim of this study is to apply skin normal tissue complication probability (NTCP) model for intensity modulated proton therapy (IMPT) optimization in left-side BC.Material and methods: Ten left-side BC patients undergoing photon irradiation after breast-conserving surgery were randomly selected from our clinical database. Intensity modulated photon (IMRT) and IMPT plans were calculated with iso-tumor-coverage criteria and according to RTOG 1005 guidelines. Proton plans were computed with and without skin optimization. Published NTCP models were employed to estimate the risk of different toxicity endpoints for skin, lung, heart and its substructures.Results: Acute skin NTCP evaluation suggests a lower toxicity level with IMPT compared to IMRT when the skin is included in proton optimization strategy (0.1% versus 1.7%, p < 0.001). Dosimetric results show that, with the same level of tumor coverage, IMPT attains significant heart and lung dose sparing compared with IMRT. By NTCP model-based analysis, an overall reduction in the cardiopulmonary toxicity risk prediction can be observed for all IMPT compared to IMRT plans: the relative risk reduction from protons varies between 0.1 and 0.7 depending on the considered toxicity endpoint.Conclusions: Our analysis suggests that IMPT might be safely applied without increasing the risk of severe acute radiation induced skin toxicity. The quantitative risk estimates also support the potential clinical benefits of IMPT for left-side BC irradiation due to lower risk of cardiac and pulmonary morbidity. The applied approach might be relevant on the long term for the setup of cost-effectiveness evaluation strategies based on NTCP predictions.

Natural hazards and risk in rice cultivation along the upper Amazon River

Farmers along the Amazon River each year face multiple natural hazards that threaten crop production and limit the potential for agricultural development of the expansive floodplain and active channel. In this paper we report the findings of a study of natural hazard-related risk associated with rice production on silt bars in the active channel of the Amazon River near Iquitos, Peru. Data were gathered in four rice producing communities in 2014 using household surveys (n = 83 households), focus group discussions, surveying of land elevations along the Amazon River, and interpretation of remote sensing imagery. The probability, extent, and severity of rice crop shortfalls were estimated for recent production years and the economic losses to farming households were also assessed. Our findings point to a very high risk of crop shortfalls due to natural hazards, suggesting that a good year brings rice farmers bounty and a bad year, near penury. River stage reversals (repiquetes) and edaphic conditions were found to be more problematic than the often cited hazard of high and/or early floods. Also surprisingly, farmers’ perceptions of hazards and risk diverged markedly from actual shortfalls experienced during the production years studied. Our results provide the first quantitative estimates of risk due to the multiple natural hazards along the Amazon River and point to the need to assist lowland farmers with risk mitigation so as to unlock the considerable potential of Amazon floodlands for agricultural production.

다중 센서들을 이용한 다양한 화재 상황의 위험도 추정 시스템 개발

In this paper, a fire detection system based on quantitative risk estimation is presented. Multiple sensors are used to build a comprehensive indicator that represents the risk of fire quantitatively. The proposed fire risk estimation method consists of two stages which determines the occurrence of fire and estimates the toxicity of the surveillance area. In the first stage, fire is reliably detected under diverse fire scenarios. The risk of fire is estimated in the second stage. Applying Purser's Fractional Effective Dose (FED) model which quantitates harmfulness of toxic gases, the risk of the surveillance area and evacuation time are calculated. A fire experiment conducted using four different types of combustion materials for the verification of the system resulted in a maximum error rate of 12.5%. By using FED calculation and risk estimation methods, the proposed system can detect various signs of fire faster than conventional systems.

Estimates of Radiation Effects on Cancer Risks in the Mayak Worker, Techa River and Atomic Bomb Survivor Studies.

For almost 50 y, the Life Span Study cohort of atomic bomb survivor studies has been the primary source of the quantitative estimates of cancer and non-cancer risks that form the basis of international radiation protection standards. However, the long-term follow-up and extensive individual dose reconstruction for the Russian Mayak worker cohort (MWC) and Techa River cohort (TRC) are providing quantitative information about radiation effects on cancer risks that complement the atomic bomb survivor-based risk estimates. The MWC, which includes ~26 000 men and women who began working at Mayak between 1948 and 1982, is the primary source for estimates of the effects of plutonium on cancer risks and also provides information on the effects of low-dose rate external gamma exposures. The TRC consists of ~30 000 men and women of all ages who received low-dose-rate, low-dose exposures as a consequence of Mayak's release of radioactive material into the Techa River. The TRC data are of interest because the exposures are broadly similar to those experienced by populations exposed as a consequence of nuclear accidents such as Chernobyl. In this presentation, it is described the strengths and limitations of these three cohorts, outline and compare recent solid cancer and leukemia risk estimates and discussed why information from the Mayak and Techa River studies might play a role in the development and refinement of the radiation risk estimates that form the basis for radiation protection standards.

Characteristics of cigarette smoking without alcohol consumption and laryngeal cancer: overall and time-risk relation. A meta-analysis of observational studies.

Tobacco smoking was one of the risk factors for upper aerodigestive tract cancer, but exclusive quantification of the impact of cigarette smoking on laryngeal cancer had not been investigated. A meta-analysis of researches that had reported quantitative estimates of cigarette smoking and risk of laryngeal cancer by March 2016 was performed. Pooled estimates of relative risks and their 95% confidence intervals were obtained and summarized. Sensitivity analysis and subgroup analysis were implemented to find out sources of research heterogeneity and the effect of potential confounders. Publication bias was investigated and corrected if found to be present through Egger's and Begg's test, and trim and fill algorithm. Thirty researches based on a total of 14,292 cases from three cohort and fifteen case-control studies were included and pooled estimate for the correlation between cigarette smoking and the risk of laryngeal cancer was 7.01 (95% confidence interval 5.56-8.85), with moderate heterogeneity across the researches (I 2=56.7%, p=0.002). The RRs were 5.04 (95% CI 3.09-8.22) for cohort studies (p=0.121), 7.59 (95% CI 5.86-9.82) for case-control studies (p=0.005). The risk kept elevated within thefirstfifteen yearsofquittingsmoking(RR 3.62, 95% CI 1.88-7.00) but dropped in the 16years and more after smoking cessation(RR 1.88, 95% CI 1.16-3.05). Individuals who smoked with 40 or more pack-years had nine times the risk of laryngeal cancer(RR 9.14; 95% CI 6.24-13.39). Subjects who smoked 30 or more cigarettes a day had sevenfolds the risk of laryngeal cancer (RR 7.02; 95% CI 4.47-11.02) and who smoked 40 or more years had five times the risk versus never smokers (RR 5.76; 95% CI 3.69-8.99). Evidence of publication bias was not detected for the correlation between current cigarette smoking and risk of laryngeal cancer (p=0.225 with Begg's test, p=0.317 with Egger's test). The results demonstrated strong correlation referring to dose-response and time-response between cigarette smoking and risk of laryngeal cancer for both men and women. The probability of developing laryngeal cancer was decreased by quitting smoking, particularly among former cigarette smokers who had stopped smoking for 15 or more years. The subgroup analysis demonstrated that study type influenced the RRs estimates of the studies.

Warfarin use and stroke, bleeding and mortality risk in patients with end stage renal disease and atrial fibrillation: a systematic review and meta-analysis.

BackgroundPatients with end stage renal disease (ESRD), including stage 5 chronic kidney disease (CKD), hemodialysis (HD) and peritoneal dialysis (PD), are at high risk for stroke-related morbidity, mortality and bleeding. The overall risk/benefit balance of warfarin treatment among patients with ESRD and AF remains unclear.MethodsWe systematically reviewed the associations of warfarin use and stroke outcome, bleeding outcome or mortality in patients with ESRD and AF. We conducted a comprehensive literature search in Feb 2016 using key words related to ESRD, AF and warfarin in PubMed, Embase and Cochrane Library without language restriction. We searched for randomized trials and observational studies that compared the use of warfarin with no treatment, aspirin or direct oral anticoagulants (DOACs), and reported quantitative risk estimates on these outcomes. Paired reviewers screened articles, collected data and performed qualitative assessment using the Cochrane Risk of Bias Assessment Tool for Non-randomized Studies of Interventions. We conducted meta-analyses using the random-effects model with the DerSimonian - Laird estimator and the Knapp-Hartung methods as appropriate.ResultsWe identified 2709 references and included 20 observational cohort studies that examined stroke outcome, bleeding outcome and mortality associated with warfarin use in 56,146 patients with ESRD and AF. The pooled estimates from meta-analysis for the stroke outcome suggested that warfarin use was not associated with all-cause stroke (HR = 0.92, 95 % CI 0.74–1.16) or any stroke (HR = 1.01, 95 % CI 0.81–1.26), or ischemic stroke (HR = 0.80, 95 % CI 0.58–1.11) among patients with ESRD and AF. In contrast, warfarin use was associated with significantly increased risk of all-cause bleeding (HR = 1.21, 95 % CI 1.01–1.44), but not associated with major bleeding (HR = 1.18, 95 % CI 0.82–1.69) or gastrointestinal bleeding (HR = 1.19, 95 % CI 0.81–1.76) or any bleeding (HR = 1.21, 95 % CI 0.99–1.48). There was insufficient evidence to evaluate the association between warfarin use and mortality in this population (pooled risk estimate not calculated due to high heterogeneity). Results on DOACs were inconclusive due to limited relevant studies.ConclusionsGiven the absence of efficacy and an increased bleeding risk, these findings call into question the use of warfarin for AF treatment among patients with ESRD.

Association between vitamin D and development of otitis media: A PRISMA-compliant meta-analysis and systematic review.

Background:Nutrients related to serum vitamin D level were previously shown to be significantly associated with the risk of many chronic diseases. This study aimed to assess potential relationships between serum vitamin D level and otitis media (OM) risk.Methods:PubMed, EMBASE, and Cochrane Library databases were searched till Aug 18, 2015 for studies of quantitative OM risk estimates in relation to serum vitamin D level. The odds ratio and weighted mean difference, with 95% confidence intervals (CIs), were used to measure the relationship between serum vitamin D level and OM risk.Results:Of the 89 articles identified by database search, 5 studies reported data of 16,689 individuals were included in our meta-analysis. We noted participants with OM was associated with lower level of plasma vitamin D when compared with patients without OM (weighted mean difference −5.67; 95% CI −8.08 to −3.26, P < 0.001). Furthermore, as compared with control group, serum vitamin D level was not associated with the risk of OM (odds ratio 0.80, 95% CI 0.47–1.38, P = 0.425). Subgroup analyses suggested that participants with acute OM might associate with lower serum vitamin D level.Conclusions:Plasma vitamin D level might play an important role on the progression of acute OM, whereas no significant impact in patients with chronic OM.

Preparing for the unprecedented — Towards quantitative oil risk assessment in the Arctic marine areas

The probability of major oil accidents in Arctic seas is increasing alongside with increasing maritime traffic. Hence, there is a growing need to understand the risks posed by oil spills to these unique and sensitive areas. So far these risks have mainly been acknowledged in terms of qualitative descriptions. We introduce a probabilistic framework, based on a general food web approach, to analyze ecological impacts of oil spills. We argue that the food web approach based on key functional groups is more appropriate for providing holistic view of the involved risks than assessments based on single species. We discuss the issues characteristic to the Arctic that need a special attention in risk assessment, and provide examples how to proceed towards quantitative risk estimates. The conceptual model presented in the paper helps to identify the most important risk factors and can be used as a template for more detailed risk assessments.

Influence of Studies Published by the Journal of the American Geriatrics Society: Top 20 Articles from 2000-2015.

Influence of Studies Published by the Journal of the American Geriatrics Society: Top 20 Articles from 2000-2015.

Qualitative and Quantitave Risk Evaluation on the Basis of Military Aviation Event Analysis

Abstract Risk management is understood as a process supporting decision making through systemic assessment of possible courses of action, identification of hazards and benefits, and indication of the best way to carry out aviation tasks. The article presents a method of qualitative and quantitative risk assessment on the basis of military aviation incident analysis. The procedure of the suggested approach is contained in a probability and severity degree estimation algorithm and in subsequent steps: of identifying the risk factor (CZN) of a given category, analysis of risk associated with a given CZN, determination of risk, defining correcting actions, risk forecasting and its verification over the following assessment period. A simplified block diagram presents a proposal of the implementation of a qualitative and quantitative risk estimation procedure with the use of the TURAWA IT system, which function in the air forces.

Cryptosporidium risk from swimming pool exposures.

Infection risk estimates from swimming in treated recreational water venues are lacking and needed to prioritize public health interventions in swimming pools. Quantitative infection risk estimates among different age groups are needed to identify vulnerable populations. High risk populations can be targeted during public health interventions, like education campaigns and pool operation improvements. This study estimated per-swim and annual Cryptosporidium infection risks in adults (>18) and children (≤18) using new experimental data collected in the U.S. on swimmer behavior. Risks were estimated using oocyst concentration data from the literature, and data collected in this study on pool water ingestion, swim duration and pool use frequency. A sensitivity analysis identified the most influential model variables on infection probability. The average estimated risk of Cryptosporidium infection was 2.6×10-4 infections/swim event. The per-swim risk estimate in the present study differed from others because behavior data (ingestion rates, swim duration, and visit frequency) were collected in different countries and varied from U.S. estimates. We found swimmer behaviors influence infection risk. This is the first study to report annual risk of Cryptosporidium infection among swimmers by age group. Using U.S. exposure data, annual risk was estimated at 2.9×10-2 infections/year for children and 2.2×10-2 infections/year for adults. Annual risk for all swimmers was estimated at 2.5×10-2 infections/year from swimming in treated recreational water venues. Due to increased ingestion and swim duration, child swimmers had the highest annual risk estimate. Cryptosporidium concentration is the most influential variable on infection probability. Results suggest the need for standardized pool water quality monitoring for Cryptosporidium, education, development of interventions to reduce ingestion, consideration of behaviors unique to swimming populations in future risk assessments and improvement of oocyst removal from pool water. Child swimmers were the most vulnerable sub-population, and should be targeted in healthy swimming education campaigns.

Incidence of adverse events in paediatric procedural sedation in the emergency department: a systematic review and meta-analysis

Objective and designWe conducted a systematic review and meta-analysis to evaluate the incidence of adverse events in the emergency department (ED) during procedural sedation in the paediatric population. Randomised controlled...

Computer simulation could be used to make patient-specific osteoarthritis prognoses.

Current imaging methods such as MRI and X-ray provide information about cartilage thickness and composition, but give no quantitative estimate of patient-specific risk of osteoarthritis.

Contribution of dynamic experience feedback to the quantitative estimation of risks for preventing accidents: A proposed methodology for machinery safety

This paper proposes a methodological approach for designing a dynamic risk identification and estimation support tool for machinery safety. Based on a comprehensive literature review and by updating the risks through dynamic experience feedback integrated into quantitative risk estimation, the methodology makes it possible to better equip machinery safety practitioners to intervene effectively. The methodology combines dynamic risk identification and Logical Analysis of Data (LAD) as two potential methods applied in machinery safety. LAD is an artificial intelligence technique introduced to extract information from accident reports in order to analyze machinery-related accidents in the workplace, which has not been covered in previous studies of machinery safety. The practical relevance and feasibility of the proposed methodology are explained using an example involving two accidents that occurred on the same machine in the same sawmill.