Risk Reduction Research Articles

Big Data, Big Insights: Leveraging Data Analytics to Unravel Cardiovascular Exposome Complexities.

The exposome encompasses the full range of environmental exposures throughout a person's lifetime and plays an important role in cardiovascular health. Interactions with the social, natural, and built components of the exposome significantly impact cardiovascular disease prevalence and mortality. Robust data analytics, including machine learning and geospatial analysis, have advanced our understanding of how these factors converge to influence cardiovascular disease risk. The integration of multiomics platforms and advanced computational approaches enhances our ability to characterize the exposome, leading to targeted public health interventions and innovative risk reduction strategies aimed at improving cardiovascular health globally. These multiomics platforms that integrate factors such as genomics, epigenomics, clinical data, social factors, environmental factors, and wearable technology will characterize the exposome in greater detail concerning cardiovascular health. In this review, we aimed to elucidate the components of the exposome and discuss recent literature regarding their relationship to cardiovascular health.

A systematic literature review of risk management research on hydrometeorological hazards-related Natech events

Natech events refer to technological accidents triggered by natural hazards, potentially leading to fires, explosions, and hazardous material (hazmat) releases. Notably, hydrometeorological hazards, exemplified by hurricanes, have led to an escalating frequency of Natech events over recent decades, resulting in significant socio-economic impacts and substantial financial losses. Consequently, Natech has evolved into a critical domain within risk management, garnering heightened scholarly and professional attention. Urgent application of effective strategies for managing and mitigating risks associated with hydrometeorological-related Natech events is crucial, particularly in the context of increasing climate change threats. Thus, A comprehensive review of risk management developments for hydrometeorological Natech events is essential to identify the research gaps and summarize the future direction. Aimed at achieving that purpose, this study was conducted to systematically review literature pertaining to hydrometeorological Natech events, conducting a comprehensive analysis to elucidate research trends, identify current knowledge gaps, and propose future research directions. The findings of this study would support risk managers and multi-stakeholders in developing effective Natech risk reduction strategies and climate change adaptation policies. Meanwhile, this study is expected to promote future research in risk management, causal mechanisms, and preparedness strategies for hydrometeorological Natech events.

Effect of GLP-1 receptor agonists on prostate cancer risk reduction: a systematic review and meta-analysis.

Prostate cancer is one of the most prevalent malignancies among men globally. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), primarily used for type 2 diabetes mellitus (T2DM) management, have been investigated for their potential effects on cancer risks. This systematic review and meta-analysis aimed to assess the association between GLP-1 RA use and risk reduction of prostate cancer. A comprehensive literature search was conducted across PubMed, Embase, and Web of Science up to July 30, 2024. Studies that met the inclusion criteria randomized controlled trials, cohort studies, case-control studies, and observational studies assessing the incidence of prostate cancer in GLP-1 RA-treated patients were included. The quality of studies was evaluated using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool. Meta-analysis was performed using a random effects model. A total of five studies were included, analyzing data from diverse international contexts. The included studies showed a reduced risk of prostate cancer with both adjusted and unadjusted effect estimates with GLP-1 RAs. The meta-analysis revealed an RR of 0.72 (95% CI: 0.610 to 0.832), indicating a statistically significant 28% reduction in prostate cancer risk associated with GLP-1 RA use compared to placebo or other antidiabetic drugs. Moderate heterogeneity was observed (I2 = 51%). Sensitivity analysis confirmed the results. The findings suggest a significant protective association between GLP-1 RA use and reduced prostate cancer risk in men, particularly those with T2DM. This supports the potential of GLP-1 RAs not only in diabetes management but also as a strategy to mitigate cancer risk. Further research is required to confirm these findings and explore the underlying mechanisms, considering different dosages, durations of therapy, and patient subgroups based on demographic and metabolic characteristics.

Retrofitting through the loss-Based Earthquake engineering

AbstractThe novelty of the research is the development of closed-from equations to assess the effective capacity of retrofitting interventions to reduce the seismic risk of existing buildings. The goal of the proposed procedure is to provide decision-making in the context of the Loss-Based Earthquake Engineering, whose purpose is the reduction of the seismic risk, which is herein computed through a monetary loss. The procedure consists of specifying performance targets (e.g. acceptable monetary losses, capital to invest, reduction of expected annual loss) and deriving engineering parameters, specifically the target fragility curves to achieve the established performance target. The identification of required fragility curves, in turn, allows to identify proper retrofitting interventions to mitigate the expected seismic loss. The method allows for estimating the maximum reduction of the annual average loss and the recommended capital to invest, accounting for the actual cost of the retrofitting alternatives and the nominal life of the building. In addition, it can be used to identify the payback period. With the aim of promoting the design procedure in the common practice, an existing reinforced concrete moment-resisting frame, retrofitted with three strengthening methods, is explored as case-study.

In-hospital bioimpedance-derived total body water predicts short-term cardiovascular mortality and re-hospitalizations in acute decompensated heart failure patients.

Hospital re-admissions in heart failure (HF) patients are mostly caused by an acute exacerbation of their chronic congestion. Bioimpedance analysis (BIA) has emerged as a promising non-invasive method to assess the volume status in HF. However, its correlation with clinically assessed volume status and its prognostic value in the acute intra-hospital setting remains uncertain. In this single-center observational study, patients (n = 49) admitted to the cardiology ward for acute decompensated HF (ADHF) underwent a daily BIA-derived volume status assessment. Median hospital stay was 7 (4-10) days. Twenty patients (40%) reached the composite endpoint of cardiovascular mortality or re-hospitalization for HF over 6months. Patients at discharge displayed improved NYHA class, lower body weight, plasma and blood volume, as well as lower NT-proBNP levels compared to the admission. Compared to patients with total body water (TBW) less than or equal to that predicted by body weight, those with higher relative TBW levels had elevated NT-proBNP and E/e´ (both p < 0.05) at discharge. In the Cox multivariate regression analysis, the BIA-derived delta TBW between admission and discharge showed a 23% risk reduction for each unit increase (HR = 0.776; CI 0.67-0.89; p = 0.0006). In line with this finding, TBW at admission had the highest prediction importance of the combined endpoint for a subgroup of high-risk HF patients (n = 35) in a neural network analysis. In ADHF patients, BIA-derived TBW is associated with the increased risk of HF hospitalization or cardiovascular death over 6months. The role of BIA for prognostic stratification merits further investigation.

Gaps in and Opportunities for Disaster Risk Reduction in Urban Areas Through International Standardization of Smart Community Infrastructure

Global communities are becoming increasingly vulnerable to natural hazards and climate change, and the rapid pace of urbanization exacerbates these risks. According to the World Bank, approximately 50% of the world’s population lives in areas exposed to natural hazards, making the need to overcome the challenges to sustainable urban development pressing. The increasing frequency of heavy rain, flooding, landslides, and wildfires underscores the urgent need for disaster risk mitigation strategies, aligned with sustainable development goals. Infrastructure plays a crucial role in cultivating resilient cities that can withstand, recover from, and adapt to disasters, while promoting long-term sustainability, by minimizing environmental degradation and encouraging responsible development. International standards for smart community infrastructure provide significant advantages, including cost reductions, technology transfer, and enhanced innovation through improved global competitiveness. This paper investigates how these standards can empower community stakeholders to strengthen both the resilience and sustainability of urban areas, facilitating balanced growth that addresses environmental and social demands.

Disparities in Genetic Management of Breast and Ovarian Cancer Patients.

Hereditary breast and ovarian cancer syndrome (HBOC) is most often caused by pathogenic variants in the BRCA1 or BRCA2 genes. Guidelines exist for genetic testing in patients at high risk, yet significant disparities in genetic testing and management remain. These disparities result in missed opportunities for cancer prevention and treatment. This review details the multiple layers of disparities in genomic knowledge, testing referral, completion, and posttesting risk reduction for at-risk populations. A comprehensive search of the PubMed database was conducted in September 2023 for studies addressing disparities at all points of HBOC risk assessment and risk reduction. Disparities in genomic knowledge, referral and testing, and in cancer risk reduction exist by race, ethnicity, insurance status, socioeconomic status, age, and care setting in the United States. Many mitigation strategies have been explored with some success. Each component contributes to a "leaky pipe" in BRCA testing and management whereby patients eligible for intervention trickle out of the pipe due to inequities at each step. Implementation of proven strategies aimed at disparity reduction in this setting is essential, as well as additional strategy development. This review provides clinicians with a comprehensive understanding of disparities in the identification and management of individuals at risk for or diagnosed with HBOC and strategies to reduce disparities in their own practice.

Factors that affect the intention of consumers to buy food products online

Internet purchases are no longer a new form of purchase, but they are successfully complementing conventional product sales channels. This study aims to understand factors, such as: product performance risk, distance, trust and risk reduction that affect consumer's intention to buy food products online. The following data was collected through a structured questionnaire.Confirmatory Factor Analysis was used to develop measures and Structural Equation Modelling was used to test hypotheses. The results show that trust and risk reduction have a positive effect on the consumers' intention to buy food products online.Product performance risk has a negative effect on the intention to buy food products online, meanwhile distance does not show any significance on their intention to buy food products online. These findings provide significant insights into what limits consumers to consider the online channel as a complementary alternative of shopping for food products.

Prediabetes and cardiovascular risk factors: the effectiveness of a guided self-determination counselling approach in primary health care, a randomized controlled trial

BackgroundIdentify individuals who are at risk of Type 2 diabetes, who also are at a greater risk of developing cardiovascular disease is important. The rapid worldwide increase in diabetes prevalence call for Primary Health Care to find feasible prevention strategies, to reduce patient risk factors and promote lifestyle changes. Aim of this randomized controlled trial was to investigate how a nurse-lead Guided Self-Determination counselling approach can assist people at risk of type 2 diabetes to lower their coronary heart disease risk.MethodsIn this randomized controlled study, 81 people at risk of developing type 2 diabetes were assigned into an intervention group (n = 39) receiving Guided Self-Determination counselling from Primary Health Care nurses over three months and a control group (n = 42) that received a diet leaflet only. Measurements included the Finnish Diabetes Risk Score questionnaire and biological measurements of Hemoglobin A1c protein, Body Mass Index, fasting blood glucose, Blood pressure, Cholesterol, High-density lipoprotein, and triglycerides, at baseline (time1), 6 (time2) and 9 months (time 3).ResultsA total of 56 participants, equal number in intervention and control groups, completed all measurements. A significant difference between the intervention and control groups, in coronary heart disease risk was not found at 6 nor 9-months. However, within-group data demonstrated that 55.4% of the participants had lower coronary heart disease risk in the next ten years at the 9-month measurement. Indicating an overall 18% relative risk reduction of coronary heart disease risk by participating in the trial, with the number needed to treat for one to lower their risk to be nine. Within the intervention group a significant difference was found between time 1 and 3 in lower body mass index (p = 0.046), hemoglobin A1c level (p = 0.018) and diastolic blood pressure (p = 0.03).ConclusionsAlthough unable to show significant group differences in change of coronary heart disease risk by this 12-weeks intervention, the process of regular measurements and the guided self-determination counselling seem to be beneficial for within-group measures and the overall reduction of coronary heart disease risk factors.Trial registrationThis study is a part of the registered study ‘Effectiveness of Nurse-coordinated Follow-Up Programme in Primary Care for People at Risk of T2DM’ at www.ClinicalTrials.gov (NCT04688359) (accessed on 30 December 2020).

Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data

ObjectiveTo estimate the effectiveness of vaccination with a monovalent covid-19 mRNA vaccine containing the omicron XBB.1.5 subvariant against severe covid-19 disease in Denmark, Finland, and Sweden.DesignTarget trial emulation based on registry data.SettingDenmark, Finland, and Sweden, 1 October 2023 to 21 April 2024.ParticipantsSource population of 3 898 264 individuals eligible for vaccination with the XBB.1.5 containing covid-19 mRNA vaccine at the start of the study on 1 October 2023. Study cohort comprised 1 876 282 recipients of an XBB.1.5 containing vaccine during the study period matched with 1 876 282 non-recipients. Individuals were aged ≥65 years (mean age 75.4 years, standard deviation 7.4 years) and had received at least four doses of a previous covid-19 vaccine.Main outcome measuresCumulative incidences of hospital admissions and deaths related to covid-19 in a follow-up period of 24 weeks after immunisation (defined as one week after vaccination) in recipients of an XBB.1.5 containing covid-19 mRNA vaccine and matched non-recipients. Cumulative incidences were used to calculate comparative vaccine effectiveness (1−risk ratio) and risk differences.ResultsThe associated comparative vaccine effectiveness was 57.9% (95% confidence interval (CI) 49.9% to 65.8%) against hospital admission for covid-19 (1085 v2635 events) and 75.2% (70.6% to 79.9%) against deaths related to covid-19 disease (348 v1458 events) after 24 weeks of follow-up. This result corresponded to 154.7 (95% CI 78.3 to 231.0) hospital admissions for covid-19 and 120.3 (110.5 to 130.2) deaths prevented per 100 000 individuals who were vaccinated with an XBB.1.5 containing vaccine. The associated comparative vaccine effectiveness was similar irrespective of sex, age group (65-74v≥75 years), number of doses of previous covid-19 vaccines, subgroup of co-administered seasonal influenza vaccines, and period of when either the omicron XBB or BA.2.86 sublineage was predominant. Although the observed reduction in risk was highest during the first weeks after vaccination, comparative vaccine effectiveness was well maintained after 24 weeks of follow-up.ConclusionsIn this study, in adults aged ≥65 years, vaccination with a monovalent XBB.1.5 containing covid-19 mRNA vaccine was associated with reduced rates of hospital admissions for covid-19 and deaths related to covid-19, during the autumn and winter of 2023-24 in Denmark, Finland, and Sweden.

The effect of peri- and postoperative antibiotic prophylaxis on surgical site infection in surgeries with elective antibiotic administration.

The aim of this study was to investigate the effect of peri- and postoperative antimicrobial prophylaxis (AMP) on surgical site infection (SSI) in surgeries with elective antibiotic administration in a large university hospital with a high volume of people in the operating room. In this retrospective study, 1060 cats and dogs belonging to private owners were analysed for the occurrence of SSI over a period of almost 5 years, except during the COVID pandemic. Both the patient files were included, and the patient owners were contacted by questionnaire. The type of surgery, the use and type of AMP, as well as the occurrence, time, type and treatment of an SSI were documented. The overall SSI rate was 7.8% (66/841). The use of an AMP did not lead to a significant reduction in risk in any of the surgeries analysed. Postoperative continuation of antibiotic prophylaxis showed no significant difference compared to perioperative prophylaxis alone. When interpreting the results, the retrospective nature of the study should be considered, as well as the fact that some of the results are based on a survey of patient owners.

A sequential study of Chikungunya fever cases notified in the urban setup of India

ABSTRACT Context: Chikungunya’s resurgence highlights reporting and awareness challenges. Aims: To analyze trends in 170 laboratory-confirmed Chikungunya cases in Urban Surat’s Central Sentinel Surveillance (2016-2020), supplemented by a subset (n = 30) examining perceptions, attitudes, and risk reduction practices based on notification level. Results: Notification rates peaked in 2017 (1.14 cases/100,000). A high House Index (&gt;1) was observed in 59% (2018) and 58% (2019) of cases. Seasonal peaks occurred in November (31%) and December (24.7%), with no private sector notifications. Highest case rates were in South (9.2) and Southeast (8.1) zones. Over half of the cases in Central (69.2%), Southeast (67.2%), and South (52.8%) zones had a House Index &gt;1 (P = 0.001), indicating significant indoor mosquito breeding. Median age was 37 years (30-43), with females comprising 65.3% of cases. Awareness of mosquitoes as vectors (40%) and their day-biting behavior (26.7%) was low, despite familiarity with Abate larvicide (60%). Prevention methods included mosquito coils (76%) and fumigation (73%), with less emphasis on water change (40%) and container maintenance (23%). Only 13% perceived Chikungunya as preventable, with low readiness for community engagement (13%). Misconceptions included considering chemical fogging sufficient (63%) and neglecting water-logging as a health concern (40%). Few implemented risk reduction measures (23% removing stagnant water, 20% weekly water change). Conclusion: Fluctuating notifications and unnoticed surges in 2019-2020 underscore the need for continuous, standardized surveillance. Higher case rates in southern and central regions were linked to high indoor breeding. The lack of private sector reporting and underreporting indicate a need for integrated surveillance. Awareness and adoption of Aedes-specific risk reduction practices remain low, with persistent misconceptions and poor attitudes.

Pattern Anlysis of Risk-Reducing Strategies in Unaffected Korean BRCA1/2 Mutation Carriers

The lifetime risk of breast and ovarian cancer increases substantially for individuals with mutations in BRCA1/2. The evidence indicates that BRCA1/2 mutation carriers benefit from early cancer detection and prevention strategies. However, data on the patterns of risk-reducing interventions are lacking. This study investigated the patterns of surveillance and risk-reducing interventions among unaffected BRCA1/2 mutation carriers. A cohort of unaffected BRCA1/2 mutation carriers was identified from the Korean Hereditary Breast cAncer (KOHBRA) study database, and a telephone survey was conducted. The survey included questions on the incidence of new cancers, patterns of cancer (breast, ovarian, prostate, other) surveillance, chemoprevention, risk-reducing surgery, and reasons for participating in risk-reducing strategies. Between November 2016 and November 2020, 192 BRCA1/2 mutation carriers were contacted, of which 83 responded. After excluding 37 responders who refused to participate, 46 participants (15 males, 31 females) were included in the analysis. The mean ± SD follow-up time was 103 ± 17 months (median 107, range 68~154), and the mean ± SD age was 31 ± 8 years. Ten BRCA1/2 mutation carriers developed breast cancer, one developed ovarian cancer, and three developed other cancers. Six BRCA1/2 mutation carriers (19.4%) underwent annual breast cancer surveillance as recommended by guidelines, while none underwent ovarian or prostate cancer surveillance. Three carriers (9.7%) used chemoprevention for breast cancer. Risk-reducing salpingo-oophorectomy was performed on only one BRCA1/2 mutation carrier. The rates of breast/ovarian cancer surveillance, chemoprevention, and risk-reducing surgery were low among unaffected Korean BRCA1/2 mutation carriers. Given this cohort’s relatively high risk of developing breast cancer, strategies to encourage active participation in risk reduction are needed.

Design of a mindfulness intervention to reduce risk factors for colorectal cancer among at-risk Black women in Chicago.

Chronic stress can directly and indirectly promote carcinogenesis through immune, metabolic, and microbial pathways. Our overarching hypothesis is that reducing chronic stress will have important implications for colorectal cancer (CRC) risk reduction among vulnerable and high-risk populations. A promising approach for reducing chronic stress is mindfulness. Mindfulness is a meditation-based technique that achieves a state of mind that is used to experience higher awareness or consciousness. Existing small studies suggest mindfulness can positively regulate stress response in a way that translates to anticancer effects, including reduced systemic inflammation. We propose to evaluate an 8-wk mindfulness intervention delivered in a hybrid format (synchronous and asynchronous sessions) among 40 Black women at elevated risk of CRC who reside in vulnerable communities and who report moderate to high perceived stress. At baseline and postintervention, participants will provide blood, hair, and stool; undergo body composition analysis; and complete mood and lifestyle-related surveys. The specific aims are to assess the feasibility and acceptability of the intervention and explore changes on stress, weight, fasting glucose, inflammation markers, and the gut microbiota-risk markers and risk pathways associated with CRC. The data generated through this project will inform if mindfulness is a feasible option for CRC risk reduction among high-risk individuals.NEW & NOTEWORTHY We propose to evaluate an 8-wk mindfulness intervention delivered in a hybrid format (synchronous and asynchronous sessions) among 40 Black women at elevated risk of CRC who reside in vulnerable communities and who report moderate to high perceived stress. The specific aims are to assess the feasibility and acceptability of the intervention and explore changes on stress, weight, fasting glucose, inflammation markers, and the gut microbiota-risk markers and risk pathways associated with CRC.

NNT and NNH: statistics and stochastics in the evaluation of added therapeutic value

Any pharmacological, invasive, surgical health intervention should have an added therapeutic value as well as the requirements of quality, safety, efficacy, to be considered as a medical device based on scientific evidence and of clinical utility for the patient. The intervention should be shared between the doctor and the patient who should have rigorous but simple tools to decide on the best therapy to undertake. Assessment of relative risk reduction is commonly used in the scientific literature to quantify both statistical and clinical significance. The reduction of the relative risk is independent of the baseline risk and is useful for comparing the results of trials conducted on populations at different risk levels. A biased reading of relative risk reduction can be used to emphasize the magnitude of the benefit for market innovation. The absolute risk reduction, on the other hand, is proportional to the magnitude of the baseline risk and is a more useful parameter for physicians and patients to understand the extent of benefit and harm, especially if the parameter is expressed in terms of the number needed to treat (NNT) or to harm (NNH). The mode of scientific communication is important for doctors' choices and patients' trust. Even true data can be fake in communication and perception by resorting to verbose paraphrases. Presenting the results of clinical trials in stochastic as well as statistical terms is useful for doctors and patients to verify whether it is worth practicing a certain treatment whose success sometimes has the probability of winning the lottery, also considering side effects and adverse events. One of the most important challenges in precision medicine will be understanding the relationship between probability and randomness.

Comparison of Time to Next Treatment or Death Between Front-Line Daratumumab, Lenalidomide, and Dexamethasone (DRd) Versus Bortezomib, Lenalidomide, and Dexamethasone (VRd) Among Transplant-Ineligible Patients With Multiple Myeloma.

Daratumumab, lenalidomide, and dexamethasone (DRd) and bortezomib, lenalidomide, and dexamethasone (VRd) are the only preferred treatment regimens for patients with transplant-ineligible (TIE) newly diagnosed multiple myeloma (NDMM). As there are no randomized head-to-head studies of DRd versus VRd, this analysis aimed to compare real-world time-to-next-treatment (TTNT) or death in this population. Patients with NDMM who received front-line (FL) DRd or VRd were identified from the Acentrus database (January 1, 2018 to May 31, 2023). Those with a record of a stem cell transplant or aged < 65 years were excluded to limit analysis to the TIE population. Inverse probability of treatment weighting was used to balance baseline patient characteristics. A doubly robust Cox proportional hazards model was used to compare TTNT or death between cohorts. A total of 149 and 494 patients who initiated DRd and VRd, respectively, were identified. After weighting (weighted NDRd = 302, weighted NVRd = 341), cohorts had similar baseline characteristics. Of these, 98 (32.4%) DRd and 175 (51.2%) VRd patients either received a subsequent line of therapy or died, with a median TTNT or death of 37.8 months in the DRd cohort and 18.7 months in the VRd cohort (hazard ratio: 0.58, 95% confidence interval: 0.35, 0.81; p < 0.001). Treatment of TIE NDMM patients with DRd led to a significantly longer TTNT or death compared to VRd, evidenced by a 42% risk reduction, supporting the effectiveness of DRd over VRd as FL treatment in this patient population.

Agricultural land around river confluences could strongly suppress floods occurrences

Flooding poses a significant threat to socioeconomic systems, with risks expected to escalate in the future due to factors such as climate change and urbanization. Ecosystem-based disaster risk reduction (Eco-DRR) emphasizes the role of natural and seminatural ecosystems, particularly agricultural ecosystems, in disaster impact mitigation such as by flood prevention benefits. This study evaluates the effectiveness of Eco-DRR in agricultural land around river confluences across Japan, where frequent flooding occurs. Using flood occurrence data from 2010 to 2018 in 1,917 municipalities across Japan, statistical models were established incorporating agricultural land, urbanized areas, and the number of dams as explanatory variables to predict flood frequency. Previous studies have demonstrated that agricultural land located in the water storage zone contributes to flood suppression, whereas high land in urbanized areas is associated with increased flooding risk. Therefore, this condition was incorporated into the models. Two patterns were tested: one using all agricultural land and another focusing on agricultural land within a 1-km buffer around river confluences. The results demonstrate that agricultural land near river confluences significantly enhances flood suppression compared to all agricultural land. In contrast, urbanized areas within water storage zones were associated with increased flood risks. The findings suggest that conserving agricultural land in flood-prone confluence areas offers substantial flood mitigation benefits, whereas urban expansion in these areas heightens flood risks. Therefore, prioritizing the preservation of agricultural land around river confluences is crucial for flood risk reduction.

How to Promote Data Sharing of Financial Service Providers Based on Federated Learning Technology

Data sharing between financial service providers (FSPs) can promote the reduction of financial risks, but the reality is that the FSPs may be unwilling to share data with each other due to data security problems. The emergence of federated data technology provides a convenient way to address this issue. In this article, the author proposes using a federated data sharing model for FSPs and two dynamic evolutionary games for evaluating influencing factors. Cooperation results when both FSPs reach a certain level of mutual payoff. The reward and punishment mechanisms are important means by which FSPs actively implement real data sharing. The interaction between the FSP and the federated technology service provider (FTSP) demonstrates the practicality of this new technology. The results show that the data sharing improved the data trust and supported regulatory mechanisms.

Agricultural innovation for climate change: limited but positive impacts of commercialized drought-tolerant corn

Abstract The extent to which new technologies can countervail the risks posed by climate change is a critical element for designing adaptation strategies. This study uses new experimental data spanning 17 US states from 2008 to 2023 to examine the potential impact of recently commercialized drought tolerant (DT) traits on both yield and yield resilience in US corn production. We find that there is no yield advantage for DT hybrids under average weather conditions, but they improve yield resilience, particularly with respect to precipitation. These effects are spatially heterogeneous, such that DT has a positive yield impact in the droughty, western US, but a small, or even negative, impact in the central and eastern US. In addition, the presence of DT reduces yield variance and kurtosis, and increases skewness, all of which imply a reduction in yield risk. Using the statistical model estimates, we project the impact of DT on corn yields under future climate conditions obtained from 20 general circulation models with two representative concentration pathways. The projected ensemble means of yield gains are 6.34 bu/acre and 5.39 bu/acre under moderate and extreme warming scenarios, respectively, by the mid-twenty-first century. These gains compensate for 23% and 13.5% of total yield loss due to climate change. Our results indicate that current commercial DT hybrids reduce yield risk, improve resilience with respect to precipitation, and have the potential to offer moderate benefits under climate change warming scenarios.

Efficacy and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation and Liver Cirrhosis.

Comparing direct oral anticoagulants (DOACs) and warfarin's efficacy and safety in patients with nonvalvular atrial fibrillation (AF) and liver cirrhosis (LC). Evidence of the pharmacodynamics of DOACs is limited in patients with AF and LC. A retrospective cohort study was conducted in the largest hospital system in Taiwan, involving patients with AF and LC for the years 2012 to 2021. Hazards of thromboembolic events (ischemic stroke, transient ischemic attack, and systemic embolism), intracranial hemorrhage, gastrointestinal, major bleeding, and all-cause mortality were investigated with a new-user, active comparator design. Inverse probability of treatment weighting was applied to balance potential confounders between treatment groups. In total, 478 DOAC users and 247 warfarin users were included. DOACs and warfarin demonstrated similar trends in preventing thromboembolic events, namely ischemic stroke [adjusted hazard ratio (aHR), 1.05 (95% CI: 0.42-2.61)], transient ischemic attack [aHR, 1.36 (95% CI: 0.18-10.31)], and systemic embolism [aHR, 0.49 (95% CI: 0.14-1.70)]. DOAC use was associated with a similar risk of intracranial hemorrhage [aHR, 0.65 (95% CI: 0.26-1.59)] and gastrointestinal bleeding [aHR, 0.64 (95% CI: 0.39-1.03)], a decreased risk of major bleeding [aHR, 0.64 (95% CI: 0.42-0.99)], and a reduction in mortality [aHR, 0.73 (95% CI: 0.54-0.99)]. DOAC users exhibited a significant reduction in major bleeding risk in patients with Child-Pugh class A (aHR, 0.48; 95% CI: 0.33-0.70). DOACs showed potential safety advantages over warfarin for patients with nonvalvular AF and LC, particularly in reducing major bleeding risk in those with Child-Pugh class A.