Risk Analysis Research Articles

Tail risk driven by investment losses and exogenous shocks

AbstractConsider a company whose business carries the potential for investment losses and is additionally vulnerable to exogenous shocks. The unpredictability of the shocks makes it challenging for both the company and the regulator to accurately assess their impact, potentially leading to an underestimation of solvency capital when employing traditional approaches. In this paper, we utilize a stylized model to conduct an extreme value analysis of the tail risk of the company under a Fréchet-type and a Gumbel-type shock. Our main results explicitly demonstrate the different roles of investment risk and shock risk in driving large losses. Furthermore, we derive asymptotic estimates for the value at risk and expected shortfall of the total loss. Numerical studies are conducted to examine the accuracy of the obtained estimates.

401.7: Utilizing large language models for predictive analysis of intraoperative hemorrhage risks in lung transplant recipients.

401.7: Utilizing large language models for predictive analysis of intraoperative hemorrhage risks in lung transplant recipients.

The differential impact of early graft dysfunction in kidney donation after brain death and after circulatory death: Insights from the Dutch National Transplant Registry

Kidneys donated after circulatory death (DCD) perform similarly to kidneys donated after brain death (DBD). However, the respective incidences of delayed graft function (DGF) differ. This questions the donor type-specific impact of early graft function on long-term outcomes. Using competing risk and Cox-regression analysis, we compared death-censored graft loss between types of early graft function: DGF (temporary dialysis dependency started within 7 days after transplantation), slow graft function (3-day plasma creatinine decline less than 10% per day), and immediate graft function. In 1061 DBD and 1605 DCD graft recipients (January 2014 until January 2023), graft survival was similar. DGF was associated with death-censored graft loss in DBD and DCD (adjusted hazard ratios: DGF in DBD: 1.79 [1.04-2.91], P = .027, DGF in DCD: 1.84 [1.18-2.87], P = .008; Reference: no DGF). Slow graft function was associated with death-censored graft loss in DBD, but not significantly in DCD (adjusted hazard ratios DBD: 2.82 (1.34-5.93), P = .007, and DCD: 1.54 (0.72-3.35), P = .262; Reference: immediate graft function). Early graft dysfunction has a differential impact on graft outcome in DBD and DCD. The differences between DBD and DCD should be accounted for in research and the clinic.

TCL-760 Hemophagocytic Lymphohistiocytosis in COVID-19: A Retrospective Analysis of Risks, Outcomes, and Health Care Burden in US Hospitals

TCL-760 Hemophagocytic Lymphohistiocytosis in COVID-19: A Retrospective Analysis of Risks, Outcomes, and Health Care Burden in US Hospitals

Enhancing resilience by considering climate change influenced bushfire in slope risk analysis

Enhancing resilience by considering climate change influenced bushfire in slope risk analysis

Beyond the Dikes: Flood Scenarios for Financial Stability Risk Analysis

Beyond the Dikes: Flood Scenarios for Financial Stability Risk Analysis

Mortality follow-up of Fernald Feed Materials Production Center workers exposed to uranium from 1951 to 1985

ObjectiveThis follow-up study of uranium processing workers at the Fernald Feed Materials Production Center examines the relationship between radiation exposure and cancer and non-cancer mortality among 6403 workers employed for...

Posterior assessment of occupational risks associated with work hardness based on workers’ subjective perception of their health

Work hardness causes health impairments in workers of some occupations. Posterior assessment should be considered priority one in health risk analysis instead of relying solely on results obtained by prior assessment based on descriptions of working condition. This paper presents the results obtained by posterior occupational risk (OR) assessment associated with work hardness; the assessment is based on analyzing workers’ subjective perception of their health (workers employed at a bearing production were used as an example). A survey was accomplished within this study followed by analyzing subjective perception of one’s health. It gave an opportunity to accomplish quantitative posterior OR assessment (that considered both likelihood of diseases and their severity) at the group and individual levels. Work hardness creates unacceptable group health risks associated with diseases of the musculoskeletal system and connective tissue (1.93•10-2–2.56•10-2), nervous system (4.03•10-2–6.77•10-2), genitourinary system (2.04•10-2–2.7•10-2) and cardio-vascular system (1.47•10-2–1.69•10-2). Such indicators as ‘weight of constantly lifted cargo and cargo moved by hand’ (35–58 %) and ‘uncomfortable working posture / working upright’ (29–54 %) make major contributions to the integral risk. Risk categories were adjusted at the individual level (considering parameters of the relationship that describe how likelihood of disease is influenced by work hardness, age and working records). This allowed establishing that OR was predominantly caused by diseases of the musculoskeletal system and connective tissue (‘medium risk’ for 19–83 % of the workers and ‘high risk’ for 75–81 %), nervous system (‘high risk’ for 84–85 % and ‘extremely high risk’ for 15–16 % of the workers) and genitourinary system (‘moderate risk’ for 1 %, ‘medium risk’ for 8 %, and ‘high risk’ for 87 %). Occupational health risk assessment allowed identifying priority indicators of work hardness (‘weight of constantly lifted cargo and cargo moved by hand’ and ‘uncomfortable working posture / working upright’) and establishing proper scope of relevant prevention activities at the group and individual level.

A Reliability-Based Risk Analysis of a Hollow Buttress Gravity Concrete Dam

A Reliability-Based Risk Analysis of a Hollow Buttress Gravity Concrete Dam

Competing risk analysis to estimate amputation incidence and risk in lower-extremity peripheral artery disease.

Background: Patients with peripheral artery disease face high amputation and mortality risk. When assessing vascular outcomes, consideration of mortality as a competing risk is not routine. We hypothesize standard time-to-event methods will overestimate major amputation risk in chronic limb-threatening ischemia (CLTI) and non-CLTI. Methods: Patients undergoing peripheral vascular intervention from 2017 to 2018 were abstracted from the Vascular Quality Initiative registry and stratified by mean age (⩾ 75 vs < 75 years). Mortality and amputation data were obtained from Medicare claims. The 2-year cumulative incidence function (CIF) and risk of major amputation from standard time-to-event analysis (1 - Kaplan-Meier and Cox regression) were compared with competing risk analysis (Aalen-Johansen and Fine-Gray model) in CLTI and non-CLTI. Results: A total of 7273 patients with CLTI and 5095 with non-CLTI were included. At 2-year follow up, 13.1% of patients underwent major amputation and 33.4% died without major amputation in the CLTI cohort; 1.3% and 10.7%, respectively, in the non-CLTI cohort. In CLTI, standard time-to-event analysis overestimated the 2-year CIF of major amputation by 20.5% and 13.7%, respectively, in patients ⩾ 75 and < 75 years old compared with competing risk analysis. The standard Cox regression overestimated adjusted 2-year major amputation risk in patients ⩾ 75 versus < 75 years old by 7.0%. In non-CLTI, the CIF was overestimated by 7.1% in patients ⩾ 75 years, and the adjusted risk was overestimated by 5.1% compared with competing risk analysis. Conclusions: Standard time-to-event analysis overestimates the incidence and risk of major amputation, especially in CLTI. Competing risk analyses are alternative approaches to estimate accurately amputation risk in vascular outcomes research.

Reconstruction of the Dynamics of a Catastrophic Crater Lake Outburst Flood, Changbaishan‐Tianchi Volcano

AbstractReconstruction of the catastrophic drainage following the Millennium Eruption (ME) of Changbaishan‐Tianchi volcano in 946 ± 20 CE is of great significance, as it contributes to improving the regional maximum flood record and develop rare flood risk analysis. However, limited knowledge exists concerning the failure mode, magnitude, and transport processes of the outburst flooding. In this work, we present a whole system model that describes the paleohydrology of catastrophic drainage using geological records along the downstream valley. The model encompasses the crater lake dynamics, an approximation of the breach erosion process and flood propagation downstream. The boulder competence method was used to constrain by reasonable flow parameters, while mitigating the uncertainty caused by the ambiguous geological paleostage indicators. Paleohydrologic analysis indicates that at least 1 km3 of water was released from the caldera, with the vertical breach erosion rates as high as 34 m/hr. Volcanic activity during the ME II may have directly contributed to triggering of the flood event. The local hydrodynamic response of the downstream riverbed captures the dynamic migration patterns of sediments across spatio‐temporal scales, offering a comprehensive interpretation of the specific scouring surfaces observed in the geological profile. The analysis of simulated inundation boundaries reveals that not all recorded inundations can be attributed to the crater lake outburst event. Reconstructions of megafloods based on downstream constraints on flood stage, velocity and discharge can help to infer and constrain the dynamics of dam failure mechanisms, and also contribute to our understanding of these complex paleohydrologic events.

315. SHORT-TERM RESULTS OF ROBOT-ASSISTED SURGERY FOR ESOPHAGEAL CANCER IN JAPAN 5 YEARS AFTER INSURANCE COVERAGE

Abstract Background In Japan, robot-assisted surgery (RAMIE) for esophageal cancer surgery was covered by insurance in 2018, and its introduction has been rapidly progressing since then. In our department, RAMIE has been introduced and performed in 250 cases so far. In the process, we have improved the short-term results by introducing the standardization and NIM (neuromonitoring) according to the characteristics of RAMIE. In addition, we have recently expanded the use of RAMIE in advanced cancer patients due to its usefulness in stable operation. In this meeting, we will review the short- and mid-term results and discuss current issues. Methods We analyzed the short-term results of all 213 RAMIE cases performed at our department, and compared them with the short-term results of 51 post-standardization (late) MIE cases previously reported. The mid-term results to date were also reviewed. Results A total of 213 patients were included. 211, 222 mins thoracic operation time. 235, 190 ml blood loss in comparison to MIE (vs. RAMIE). Postoperative outcomes were similar: overall complications (&amp;gt;Grade II) were 49, 54.9%, respiratory complications were 19.6, 23.9%, and recurrent nerve palsy was 15.7, 17.4%. Risk analysis demonstrated that paralysis in RAMIE was significantly related to prolonged thoracic operation time (p=0.021) and NIM (Odds=0.38, p=0.0447). In comparison between patients with early-stage and advanced cancer, pneumonia and anastomotic complications were not different. Prognosis was 81.7/64.2% (UICC 8th) for 3-year survival in cStage II/III patients. Conclusion RAMIE was considered to be highly useful for short-term and medium-term outcomes at this time.

Change and coincidence risk analysis of floods in the Mahanadi River Basin, India

ABSTRACT Coincidence flood risk due to the simultaneous flood occurrences on both mainstream and its tributary results in downstream inundation of a confluence. Therefore, this study was taken up for coincidence flood risk analysis of Mahanadi River basin considering the annual maximum (AM) and the peak over threshold (POT) series. In this study, the Mann–Kendall trend test was performed to analyze the trend in flood magnitudes, while circular statistics was used to analyze the persistence in flood timing. The joint distributions between the streams were established using bivariate copula functions considering flood magnitudes and occurrence dates as variables. The results of MK test revealed a mixture of significant and insignificant trends for AM series for the selected stations, while the trends were insignificant for POT series. Additionally, the flood occurrence dates showed a high level of persistence. It is evident from the results that the coincidence risk is high for Seorinarayan–Bamnidhi confluence point with a risk value of 7.63 × 10−3. The coincidence risk increases mostly from late July to mid-September, and the coincidence risk is high for more frequently occurring flood events. The obtained results will help in prioritizing flood hazard zones for effective flood mitigation strategies in Mahanadi River basin.

Non-conventional endpoints show higher sulfoxaflor toxicity to Chironomus riparius than conventional endpoints in a multistress environment

Evidence grows that standard toxicity testing might underestimate the environmental risk of neurotoxic insecticides. Behavioural endpoints such as locomotion and mobility have been suggested as sensitive and ecologically relevant additions to the standard tested endpoints. Possible interactive effects of chemicals and additional stressors are typically overlooked in standardised testing. Therefore, we aimed to investigate how concurrent exposure to environmental stressors (increased temperature and predation cues) and a nicotinic acetylcholine receptor (nAChR)-modulating insecticide (‘sulfoxaflor’) impact Chironomus riparius across a range of conventional and non-conventional endpoints. We used a multifactorial experimental design encompassing three stressors, sulfoxaflor (2.0–110 µg/L), predation risk (presence/absence of predatory cues), and elevated temperature (20 °C and 23 °C), yielding a total of 24 distinct treatment conditions. Additional stressors did not change the sensitivity of C. riparius to sulfoxaflor. To assess potential additive effects, we applied an Independent Action (IA) model to predict the impact on eight endpoints, including conventional endpoints (growth, survival, total emergence, and emergence time) and less conventional endpoints (the size of the adults, swimming abilities and exploration behaviour). For the conventional endpoints, observed effects were either lower than expected or well-predicted by the IA model. In contrast, we found greater than predicted effects of predation cues and temperature in combination with sulfoxaflor on adult size, larval exploration, and swimming behaviour. However, in contrast to the non-conventional endpoints, no conventional endpoints detected interactive effects of the neurotoxic insecticide and the environmental stressors. Acknowledging these interactions, increasing ecological context of ecotoxicological test systems may, therefore, advance environmental risk analysis and interpretation as the safe environmental concentrations of neurotoxic insecticides depend on the context of both the test organism and its environment.

Association between complementary use of Goreisan (a Japanese herbal Kampo medicine) and heart failure readmission: A nationwide propensity score-matched study

BackgroundGoreisan, a Japanese herbal medicine, possesses aquaretic properties to regulate body fluid homeostasis and may therefore be effective as a complement to standard therapy in improving outcomes in patients with heart failure (HF). MethodsWe retrospectively identified 431,393 patients (mean age 79.2 ± 12.6 years; male 52.3 %) who were admitted for HF for the first time and were discharged alive with standard HF medications between April 2016 and March 2022, using the Japanese Diagnosis Procedure Combination database. We divided patients into two groups according to the prescription of Goreisan at discharge: patients who received standard HF medications plus Goreisan and those who received standard medications alone. We compared the incidence of HF readmission within 1 year after discharge between the groups using propensity score matching. ResultsOverall, Goreisan was prescribed in 1957 (0.45 %) patients at discharge. Patients who received Goreisan were older and received diuretics more frequently than those who did not. One-to-four propensity score matching created a cohort of 1957 and 7828 patients treated with and without Goreisan, respectively. No significant difference was found in the incidence of 1-year HF readmission between the groups [22.1 % vs. 21.7 %; hazard ratio (HR) = 1.02, 95 % confidence interval (CI) = 0.92–1.13]. This result was consistent with that from competing risk analysis (subdistribution HR = 1.02, 95 % CI = 0.92–1.13) and across clinically relevant subgroups except for renal disease. Goreisan use was associated with a lower incidence of HF readmission among patients with renal disease (HR = 0.77, 95 % CI = 0.60–0.97), but not among those without (HR = 1.09, 95 % CI = 0.97–1.23; p for interaction = 0.009). ConclusionsThis nationwide propensity score-matched analysis did not demonstrate that complementary Goreisan use at discharge was associated with a lower incidence of 1-year HF readmission in patients with HF receiving standard medications. An ongoing randomized trial is awaited to establish the effectiveness of Goreisan use in patients with HF.

Optimizing Market Efficiency through Blue Economy: Supply Chain and Risk Analysis of Tuna Fisheries in South Coastal East Java

Optimizing Market Efficiency through Blue Economy: Supply Chain and Risk Analysis of Tuna Fisheries in South Coastal East Java

Security Risk Analysis in Accounting Information Systems Based on Data Dashboard from the Palo Alto Network PA-820 UTM

This study analyzes security risks in accounting information systems using data from the Palo Alto Network PA-820 UTM dashboard, which monitors various aspects such as network activity, user activity, and application usage. The data includes information on data transfers, source and destination IP activities, and system rule usage. The study aims to identify potential threats that could affect the integrity and security of accounting information systems. Keywords: Accounting Information Systems, Security, Risk, Dashboard, Network Activity.

Impact of the grade and jet-flow direction of residual aortic regurgitation after valve-sparing root replacement

ObjectivesTo investigate the impact of the grade and jet direction of residual aortic regurgitation (rAR) after valve-sparing root replacement (VSRR). MethodsThe study enrolled 248 adult patients who underwent VSRR between 1995 and 2021. The patients were divided into groups based on the postoperative rAR. Patients with rAR were further categorized according to rAR grade and jet direction. The primary endpoint was the development of aortic regurgitation of moderate or greater (≥moderate) severity and/or the need for valve replacement during the follow-up, analyzed by a multivariable competing risk analysis. The secondary endpoints included the occurrence of rAR and overall survival. ResultsThe median age of the patients was 36.5 years, and 79.8% had been diagnosed with connective tissue disease. After VSRR, 146 patients did not present with rAR; however, 102 had rAR (77 with minimal central, 18 with minimal eccentric, and 7 with mild rAR). The 5-year and 8-year incidence rates of the primary endpoint were 14.6% and 17.9%, respectively. rAR was a significant risk factor (P = .001), and eccentricity and mild rAR seemed to have important roles. The risk factors for rAR included dilated root, preoperative moderate regurgitation, and redo sternotomy. Overall survival was influenced only by age. ConclusionsrAR after VSRR operation could be a risk factor for AR progression. Minimal central rAR generally has a tolerable clinical course; however, patients with even minimal eccentric AR may develop AR progression, so active surveillance and timely management might be required. Furthermore, early VSRR can help reduce the rAR.

Optimisation of decision-making on risk management strategy for the hydromelioration systems in biosphere reserves

The field of nature conservation in Ukraine is currently experiencing a profound crisis. In light of the mounting risks to Ukraine’s ecosystems, it is of paramount importance that conservation planning incorporates risk management strategies. In the aftermath of the Chernobyl disaster, the management of water bodies in the Exclusion Zone assumed paramount importance, given that the rivers had become the primary conduit for the transportation of radioactive substances. It is therefore imperative to evaluate the risks and vulnerabilities of climate change on Ukraine’s most developed economic sectors, population, and natural ecosystems. This will facilitate comprehension of the prospective consequences of climate change, ascertain the extent of potential losses, and inform decision-making aimed at reducing or preventing such losses in a timely manner. One of the primary challenges facing specialists at the Chornobyl Radiation and Ecological Biosphere Reserve, in addition to other organisations and enterprises of the State Agency of Ukraine on Exclusion Zone Management and scientific institutions, is the assessment of the feasibility of hydromelioration systems. It is of the utmost importance that a scientifically sound methodological approach be employed in order to ensure the reliability and validity of the results obtained through the assessment of risks and vulnerabilities to climate change. In this context, the utilisation of adaptive methodologies is of paramount importance for the development of risk management strategies. One such methodology is the Methodology for Risk Analysis and Information Management for Strategic Ecosystems (MARISCO). This article considers the potential deployment of the MARISCO adaptive method as a universal methodology for the analysis of environmental issues, with a view to informing decision-making on risk management strategies in the Chornobyl Radiation and Ecological Biosphere Reserve.

Analyse de risques appliquée au suivi des concentrations des immunosuppresseurs chez les patients transplantés pulmonaire

Mastering and monitoring immunosuppressant concentrations is central to the care of lung transplant patients and involves multiple stakeholders. The objective is to conduct a risk analysis to evaluate the impact of various actions taken. The lung transplantation team was convened to carry out a failure mode effect analysis. The process was divided into stages where different risks were identified. The risk priority number (RPN) (severity, frequency, detectability) and risk level of criticality (frequency, severity) were established before implementation of actions (before 2009) and then after (in 2022) to classify risks according to four levels of criticality. The implemented actions included the establishment of a quality assurance process, computerization of monitoring, and double analysis by a physician/pharmacist pair. Thirty-two risks were identified during the four stages of the process: biological sampling (n=13), reception (n=3), analysis and treatment of levels (n=5), transmission of information/prescriptions to the patient (n=11). The total raw RPN (before 2009) was 839, with 12 major risks. The current total RPN (in 2022) was 452 (a decrease of 46.1%), with 7 major risks identified. The analysis enabled the objective evaluation of the effectiveness of the actions taken. The most secure stage of the process is the reception of residual level results. Efforts should focus on empowering and involving patients, as well as engaging local stakeholders in collaboration with the specialized transplantation team.