Risk Reduction Research Articles

Effect of ESG performance on stock price crash risk: evidence from China

ABSTRACT This study investigates the impact of ESG performance on stock price crash risk using a dataset of Chinese-listed firms in the period 2015 – 2020. Empirical evidence reveals a negative association between ESG performance and stock price crash risk, particularly under high product market competition conditions. Mechanism analysis suggests that ESG performance reduces stock price crash risk by alleviating maturity mismatch and optimizing debt maturity in investment and financing, but only when market competition is intense. These findings align with the resource dependence theory, indicating that strong ESG performance enhances a firm’s ability to acquire resources and mitigate stock price crash risk in highly competitive environments. Consequently, ESG performance not only augments a firm’s competitive advantage but also serves as a risk reduction tool, enabling investors to construct more sustainable investment portfolios.

Statins in the Cause and Prevention of Cancer: Confounding by Indication and Mediation by Rhabdomyolysis and Phosphate Toxicity.

Statins are drugs used in cardiovascular pharmacotherapy to decrease hypercholesterolemia and lower the risk of atherosclerosis. Statins also increase the risk of rhabdomyolysis, which is often minimized in comparison with large relative risk reductions of cardiovascular disease reported in clinical trials. By contrast, absolute risk reductions of cardiovascular disease are often clinically insignificant and unreported in statin clinical trials. Additionally, cytotoxic effects of statins inhibit cancer cell proliferation and reduce cancer risk, but other studies found that statins are carcinogenic. Due to an inverse association between incidence of cancer and atherosclerosis, the indication to prescribe statins likely biases the association of statins with cancer prevention. Dietary patterns associated with atherosclerosis and cancer contain inverse amounts of cholesterol and phosphate, an essential mineral that stimulates tumorigenesis. Accordingly, lower cancer risk is associated with high dietary cholesterol intake and increased risk of atherosclerosis. Furthermore, serum is exposed to excessive inorganic phosphate that could increase cancer risk as rhabdomyolysis induced by statins releases phosphate from skeletal muscle breakdown. Increased risk of comorbid conditions associated with statins may share the mediating factor of phosphate toxicity. More research is warranted on statins in the cause and prevention of cancer.

Abstract B103: Friend-to-friend: Culturally tailored health education for East African communities

Abstract Purpose: The Mayo Clinic Comprehensive Cancer Center (MCCCC) serves its communities through every pillar of the cancer continuum from prevention to survivorship. To effectively educate our communities along this continuum, MCCCC partnered with a trusted community partner, leveraged the stories of survivors, and addressed stigma in a safe space for community members to ask vulnerable questions. Methods: The MCCCC partnered with Pamoja Women on the Friend-to-Friend initiative. Pamoja Women is a trusted community partner supporting East African women and their families, some of whom are refugees. They provided the space to hold each event, an environment where the women were comfortable with support from their community. The program highlighted cancer education, screening, and risk reduction through culturally appropriate discussions between friends. Topics were identified based on community interest and the cancer incidence in the community. Survivors shared their personal stories and medical experts discussed prevention, risk reduction, screening, addressed myths, answered questions, and showcased discoveries in research and treatment methods. Results: We have held 3 events covering breast, cervical, and HPV vaccination. Each event saw an increase in participation with almost 50 participants attending the series. Furthermore, there was an increase in awareness of screening methods, prevention, and risk reduction. Pamoja Women provided navigation to screening through transportation to and advocacy during appointments. This continuity from education to screening led to heading the call to action for screening. Due to its success, the four-part series has been expanded to include the topics of endometrial, prostate cancer, and breast cancer for a second time. Conclusion: Partnering with trusted community organizations has led to safe spaces for cancer education with friends. This approach has led to successful education and navigation to screening in communities that do not always have access to this essential information. Citation Format: Adeline Abbenyi, Manal Abbadi, Khadija Ali, Fatuma Ahmed. Friend-to-friend: Culturally tailored health education for East African communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B103.

Abstract B002: Cancer health equity and research advocacy program among immigrant communities

Abstract Introduction: In an effort to ensure an all-inclusive initiative that would close the disparity gap among the immigrant communities in Florida, we developed a pilot project under the Inclusive Cancer Care Research Equity (iCCaRE) for Black Men Consortium with generous support from the Mayo Clinic Comprehensive Cancer Center (MCCCC). The objective is to train cancer advocates to engage their communities and develop and implement cancer prevention and screening navigation programs. The central hypothesis for this program is that community-driven cancer advocacy will significantly improve cancer awareness, knowledge, prevention, risk reduction, screening uptake, and early detection among Black immigrants. Methods: We collaborated with immigrant communities’ leaders to brainstorm on the current state of healthcare access and disparities experienced by Black immigrants and to set program and research priorities through listening sessions. Cancer advocates were trained to engage their communities to (1) develop and implement cancer risk reduction and education programs using train-the-trainer approach, (2) mobilize the resources within the community for cancer health promotion, prevention, and screening strategies, (3) partner with key stakeholders to accomplish targeted objectives; (4) raise funds to support advocacy activities; and (5) develop and successfully organize community-centered programs. Results: We are currently working with 10 Black immigrant organizations, including immigrant churches across different ethnicities, including Nigeria, Ghana, Cameroon, Liberia, South Africa, Haiti, Jamaica, and across different cities in the United States. Eighteen community cancer advocates, including breast and prostate cancer survivors, caregivers, and community influencers, were trained to engage the immigrant communities in cancer risk reduction and research in Florida using multiple channels, including in-person community programs and online engagement approaches. We have engaged 720 immigrants in cancer risk reduction education and the need to participate in research during advocate-led in-person community outreaches. We currently have 26 immigrants who have volunteered in the Mayo Clinic Community Research Registry. The program is ongoing, and we anticipate that more than 750 will be engaged, and 100 will volunteer to be registered in the Mayo Clinic Community Research Registry. Conclusion: Advocate-led advocacy in immigrant communities will provide evidence for compelling arguments about the feasibility and availability of the Black immigrant population for robust and sustainable research and program engagements to eliminate disparity and advance cancer health equity. Citation Format: Opeyemi O. Bolajoko, Caleb Ramirez, Shannon Pressey, Noreen A. Stephenson, Vinessa A. Gordon, Binta Onyibe, Kingsley Efe, Austin Okaiwele, Mubo Oloruntobo, Brittany M. Norris, Folakemi T. Odedina. Cancer health equity and research advocacy program among immigrant communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B002.

Abstract C125: Improving access to genetic counseling and testing for underserved populations through telehealth

Abstract Introduction: A lack of access to genetic counseling for hereditary cancer risk in rural and underserved areas is well-documented and can exacerbate disparities in cancer risk reduction and early detection. Telehealth has the potential to bridge this gap, providing remote access to specialized care. The COVID-19 pandemic accelerated telehealth availability, allowing estimation of the causal effects of shifting to a model of virtual care delivery for genetic counseling services. Methods: The Stanford Cancer Genetic Counseling Clinic provided solely in-person care at two clinical sites (Palo Alto and San Jose, CA) until March 2020, and solely virtual care from April 2020 onward. We performed a regression discontinuity design, allowing outcomes comparison before and after the threshold of early 2020, to evaluate the impact of telehealth genetic counseling on access to care for patients living in areas of higher deprivation. The assignment variable (the exposure measured before versus after the threshold) was the three-month period during which the patients were seen, with the March-May 2020 quarter excluded because of disruption of care during the early COVID-19 pandemic. The primary endpoint was proportion of patients whose primary residence zip code had a state area deprivation index of at least 4. Secondary endpoints included driving distance to the primary clinic location in Palo Alto, CA, insurance type, race/ethnicity, and primary language. Results: The study included N=5,957 patients seen in the Stanford Cancer Genetics Program between January 2017 and February 2020, and N=9,469 patients seen between June 2020 and April 2024. The regression discontinuity analysis revealed a significant discontinuity at the threshold for telehealth in access for patients living in areas of higher deprivation, who accounted for 22% of patients seen just prior to telehealth implementation and 27% just after telehealth implementation, a proportional increase of 21% (p=0.006). Mean driving distance to Palo Alto, CA also increased, from 49 minutes just prior to the threshold to 56 minutes just after (p=0.003). There were no significant differences in insurance type, race/ethnicity, or primary language across the threshold. Conclusion: The implementation of telehealth services at the Stanford Cancer Genetic Counseling Clinic significantly improved access to genetic counseling for patients from areas with higher deprivation, as evidenced by a 21% increase in the proportion of such patients among those seen. These results quantify the effectiveness of telehealth in reducing geographical and socioeconomic barriers to specialized genetic counseling and testing services. Citation Format: Jennifer L. Caswell-Jin, Hao Tang, Mina Satoyoshi, Kerry Kingham, Allison W. Kurian. Improving access to genetic counseling and testing for underserved populations through telehealth [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C125.

Abstract A111: Leveraging African American women as change agents to reduce obesity-related breast cancer risk: An evaluation of a network-based pilot intervention promoting the Mediterranean diet

Abstract BACKGROUND: Obesity is a key risk factor for breast cancer (BC) incidence, recurrence, and mortality among post-menopausal African American (AA) women. Many older AA women are likely to report fewer healthy dietary behaviors, and those who are overweight or obese are likely to share similar dietary patterns as their social networks (SNs). AA women are also likely to receive information on BC risk from their SNs. Thus, AA women who share information on healthy dietary behaviors are well-positioned to become change agents toward reducing obesity and improving BC outcomes among their SNs. This presents a novel opportunity to increase the impact of evidence-based (EB) interventions focused on reducing obesity-related BC risk. This study aimed to assess the effects of the MedDiet-SN pilot intervention among participants trained as change agents to improve obesity-related BC risk reduction behaviors for themselves and their SNs through EB information sharing. Methods: MedDiet-SN was a 10-week, pre-/post- pilot intervention promoting the uptake of the Mediterranean diet, with participant training on effective EB information sharing. A community-based participant advisory board informed the pilot. Study procedures were IRB approved. Eligible participants were AA women, ≥60 years old, overweight or obese, Chicago area residents, and with no severe health conditions. Sixteen women participated, and 30 of their SN members (age ≥18 years) were recruited through participant referral. Predictors included time from pre- to post-study and session dosage for participants, and participant EB information sharing on healthy eating for SN members. Outcomes for both groups included BC and diet knowledge, dietary change attitudes (motivation, self-efficacy), dietary behavior change, and BMI. EB information sharing on healthy eating was an additional outcome for participants. Bivariate and multivariate analyses were performed to assess outcomes. Results: In crude and adjusted time models, participants showed improved knowledge, behavior change, BMI, and EB information sharing (p<0.05). In adjusted dosage models, participants showed improved knowledge, attitudes, and EB information sharing (p<0.05). SN members showed improved attitudes and behavior change based on participant EB information sharing on healthy eating (p<0.05). In addition, there was a high concordance between participant EB information sharing and SN EB information learned (>70%). CONCLUSION: This research is innovative in that it 1) shows the effectiveness of a network-based intervention promoting healthy dietary behaviors for obesity-related BC risk reduction among AA women, 2) supports the value of scaling up interventions by leveraging participants as change agents for EB information sharing among SNs, and 3) provides a contribution to emerging research on positive intervention spillover effects to SNs. It is anticipated that results from this study will inform the development of future network-based interventions that aim to reduce obesity-related BC risk and improve health outcomes for AA women. Citation Format: Nyahne Bergeron, Mona Strahan, Patricia Hardmon, Marja Stanford- Leak, Anita Stevens, Annie Young, Devyanne Ward, Lois White, Eunhye Lee, Lisa Tussing-Humphreys, Marian Fitzgibbon, Yamilé Molina. Leveraging African American women as change agents to reduce obesity-related breast cancer risk: An evaluation of a network-based pilot intervention promoting the Mediterranean diet [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A111.

The changing social vulnerability in Shanghai during 2000–2020 and its implications for risk management

Risk dynamics are driven not only by changes in hazard and exposure, but also the changing social vulnerability along with urban development, aging, renewal, and adaptation planning. However, there has been limited research on the spatial and temporal changes in social vulnerability, particularly at a fine scale in urban settings. To bridge this gap, our study developed a framework to consistently evaluate social vulnerability. Using Shanghai as a case study, the framework was applied to assess the social vulnerability at a township level for the years 2000, 2010, and 2020. The results revealed that the social vulnerability index decreased in 99.56 % of the townships in Shanghai from 2000 to 2020. However, there were notable variations among the four primary sub-indexes as demographic sub-index, particularly regarding an aging population, displayed a strong increase aggravating social vulnerability, in contrast to an overall decline trend of the other three sub-indexes of educational, residential, and economic. Therefore, the social vulnerability reduced along with socioeconomic development while an aging society posed a new challenge. Furthermore, 32 townships were identified with a notable rising demographic sub-index, a high flood hazard, and a low capability of disaster reliefs, demonstrating social vulnerability should be comprehensively addressed aligning with other challenges. The study highlighted the need to consider the dynamics of social vulnerability in disaster risk reduction strategies and the importance of addressing emerging challenges, such as an aging population, in urban vulnerability.

Expert systems: an effective tool for risk management – the case of Naftal Skikda

This study aims to investigate the impact of expert systems on improving risk management at Naftal Skikda, a key player in the oil and gas sector in Algeria. It seeks to determine the effectiveness of these advanced technologies in risk detection, real-time decision-making, and overall risk management efficiency. The hypotheses tested aim to assess whether the integration of expert systems can accelerate risk detection and contribute to risk reduction, while enhancing the speed and accuracy of decision-making. This research aims to provide strategic recommendations to strengthen practices for managing risks within the petroleum and natural gas sectors, highlighting the potential of expert systems as a transformative tool.

Indicators of functional state of liver, blood lipid spectrum in patients with steatotic liver disease associated with metabolic dysfunction: modern approaches to complex treatment. Review

Objective — to study the dynamics of indicators of the functional state of the liver, the lipid spectrum of the blood, to evaluate the cardiovascular risk according to SCORE‑2 (Systematic Coronary Risk Estimation 2) scale under the influence of complex pathogenetic treatment of the detected disorders in patients with steatotic liver disease associated with metabolic dysfunction (SLDMD) in combination with obesity. Materials and methods. 46 outpatients with a diagnosis SLDMD were examined: 29 (63.1%) men and 17 (36.9%) women aged 32—55 years. The patients were divided into two groups. The main group included 19 (41.3%) persons who received atorvastatin: 20 mg/day for 90 days. The comparison group consisted of 27 (58.7%) patients who were prescribed ursodeoxycholic acid preparations in combination with atorvastatin: 250 mg (15 mg/kg of body weight) for 90 days. The control group consisted of 12 healthy persons of the appropriate age. The anthropometric criterion of obesity was the Quetelet index. Phenotypic variant of obesity was determined by the ratio of waist circumference/hip circumference (WC/HC). Among the patients of the main group, there were 9 (47.4%) persons with I degree of obesity ((32.6±2.2) kg/m2), 6 (31.5%) persons with II degree ( 35.8±3.6 kg/m2), and 4 (21.1%) persons with III degree (40.0±2.1kg/m2), in the comparison group there were 17 (62.9%), 6 (22.3%) and 4 (14.8%) patients, respectively. All patients received a differentiated diet with the calculation of the energy value, the quota of protein (1.4—1.6 g), fat (1.2—1.4 g), carbohydrates (2—3 g) per 1 kg of ideal body weight and dosed physical activity. For assessing the indicators of the functional state of the disease we determined: the level of general bilirubin and its fractions (direct and indirect), activity of serum aminotransferases, alkaline phosphatase, total cholesterol content in the blood serum, high‑density lipoprotein cholesterol, low‑density lipoprotein cholesterol, very‑low‑density lipoprotein cholesterol, triglycerides. Results. In the majority of patients with SLDMD, a statistically significant (p <0.05) increase in the level of direct bilirubin in the blood, the activity of hepatic transaminases, alkaline phosphatase, and changes in the lipid spectrum of the blood were detected. According to the body mass index (BMI) most of the examined patients had visceral obesity. After the course of the combined therapy positive dynamics was marked in biochemical indices of the blood (p <0.05): decrease of the direct bilirubin level, hepatic transaminases, blood phosphatase. The lipid spectrum of the blood was close to normal (p <0.05). The addition of ursodeoxycholic acid to statin therapy contributes to a statistically significant reduction in total cardiovascular risk according to the SCORE 2 scale compared with atorvastatin monotherapy. All patients were recommended to continue the course of treatment (combination of atorvastatin and ursodeoxycholic acid) for 2 to 3 months. Conclusions. The use of a combination of statin and ursodeoxycholic acid in the treatment of patients with SLDMD and obesity helps to normalise the functional state of the liver and blood lipid parameters, reduce the degree of overall cardiovascular risk, and achieve clinical and biochemical remission of the pathological process in the liver.

Citrus reticulata Olive Oil: Production and Nutraceutical Effects on the Cardiovascular System in an In Vivo Rat Model of Metabolic Disorder.

Recently, there has been significant exploration into the utilization of food by-products as natural reservoirs of bioactive substances, particularly in the creation of functional foods naturally enriched with antioxidants. Citrus peels represent a viable option for formulating enhanced olive oils that contribute to a healthier diet, due to their bioactive compound content. This study aimed to (i) ascertain the compositional characteristics of Citrus reticulata olive oil (CrOO) and (ii) assess its nutraceutical properties in rats with metabolic disorder induced by 3 weeks of feeding with a high-fat diet (HFD). The results showed a peculiar phytochemical composition, thanks to the contribution of citrus peels, which are excellent bio-products. In addition, it demonstrated HFD-induced weight gain (18 ± 2% for HFD vs. 13 ± 0.9% for CrOO) and showed protective effects on fasting blood glucose levels (90.2 ± 3.8 mg/dL for HFD vs. 72.3 ± 2.6 for CrOO). Furthermore, a reduction in cardiovascular risk (total cholesterol/HDL cholesterol = 5.0 ± 0.3 for HFD vs. 3.8 ± 0.3 for CrOO) and an improvement in myocardial tissue function were observed, as well as a significant reduction in inflammatory mediators such as iNOS, COX-2, and mPGES-1 in aortic vessel tissues, thus preserving endothelial function at the vascular level.

The Past and Present of Disaster Risk Reduction in Indonesia

The Past and Present of Disaster Risk Reduction in Indonesia

Body mass index, body satisfaction, and body image discrepancy among Latinx men: Implications for Latinx-centered cancer and diabetes risk reduction interventions.

Body mass index, body satisfaction, and body image discrepancy among Latinx men: Implications for Latinx-centered cancer and diabetes risk reduction interventions.

Flash Floods Hazard to the Settlement Network versus Land Use Planning (Lublin Upland, East Poland)

There has been an increase in the frequency of hazards associated with meteorological and hydrological phenomena. One of them is flash floods occurring episodically in areas of concentrated runoff—valleys without permanent drainage. In the opinion of residents and local authorities, these are potentially safe areas—they are not threatened by floods and are therefore often occupied by buildings. The importance of addressing flash floods in land use planning is essential for sustainable development and disaster risk reduction. The objective of this research was to assess the level of the hazard and to evaluate its presence in land use planning activities. This manuscript fills a research gap, as to date flash flood threats have not been analyzed for individual buildings located in catchments of dry valleys in temperate climates. More than 12,000 first-order catchments were analyzed. The study covered an upland area located in East Poland, which is characterized by high population density and dispersed rural settlement. Within the 10 municipalities, buildings located on potential episodic runoff lines were identified. Qualitative assessment was applied to ascertain the susceptibility of catchments to flash floods. Such criteria as slopes, size, shape of the catchment area, and land cover, among others, were used. Between 10 and 20% of the buildings were located on episodic runoff lines, and about 900 sub-catchments were highly or very highly susceptible to flash floods. The way to reduce the negative effects of these phenomena is to undertake proper land use planning based on knowledge of geohazards, including flash floods. However, an analysis of available planning documents shows that phenomena of this type are not completely taken into account in spatial management processes.

Association between Multi-Domain Lifestyle and Objective Cognitive Impairment in Elderly People with SCD and MCI in Chinese Communities.

Controlling the lifestyle associated with dementia risk can delay the process of cognitive decline. Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early states in the development of dementia and are also the window period for early intervention in dementia. The purpose of this study was to explore the association between multi-domain lifestyle and objective cognitive impairment in elderly people with SCD and MCI in Chinese communities and to provide reference for effective implementation of precise health management measures to reduce the risk of dementia. A total of 265 middle-aged and elderly volunteers recruited from the community were divided into SCD group (107 cases), MCI group (80 cases), and healthy control (HC) group (78 cases). All participants received clinical interview, examination, and cognitive assessments. The total Dementia Risk Reduction Lifestyle Scale (DRRLS) scores in the HC, SCD, and MCI groups [110.00 (11.25) vs. 101.00 (10.00) vs. 79.50 (20.75)] exhibited statistically significant differences among them. The total score of the DRRLS showed a significant negative correlation with the Trail-Making Test (TMT), and significant positive correlations with both the Verbal Fluency Test (VFT) and Auditory Verbal Learning Test (AVLT) scores (p < 0.05). After adjusting for confounding factors, such as age and years of education, multiple linear regression analysis revealed several points. In the SCD group, brain-strengthening exercise and interpersonal relationship scores were negatively correlated with TMT scores (β = -11.257, -15.077; all p < 0.05), while health responsibility, smoking control behavior, and interpersonal relationship scores were positively correlated with AVLT scores (β = 0.485, 0.344, and 0.406; all p < 0.05). In the MCI Group, brain-strengthening exercise, brain-healthy diet, and interpersonal relationship were negatively correlated with TMT (β = -22.011, -16.206, -11.696; all p < 0.01), whereas health responsibility, mental activity, smoking control behavior, interpersonal relationship, and stress management were positively correlated with AVLT (β = 0.450, 0.435, 0.308, 0.256, 0.607; all p < 0.05). In Chinese communities, the unhealthy lifestyle of elderly individuals with SCD and MCI is significantly associated with cognitive function impairment. The greater their unhealthy lifestyle habits, the more pronounced the scope and severity of cognitive function impairment becomes. Furthermore, different dimensions of lifestyle have varying impacts on cognitive domains.

Veterinary Evidence: moving forward

Unrecognised and unknown information needs can significantly impact on the quality of decision making, advice, and patient care. In the practice of veterinary medicine, additional information may be required in one or more of epidemiology, diagnosis, treatment, prognosis, control (risk reduction), and prevention (risk avoidance), in order to optimise patient care. Veterinary Evidence publishes Knowledge Summaries, which aim to answer a specific and focused clinical query by appraising the best available evidence published in peer-reviewed scientific journals. By presenting the evidence in a structured and easily digestible format, Knowledge Summaries enable veterinary professionals to stay informed and apply the best available evidence to their decision-making. To assist in the identification of unrecognised deficits and the generation of clinical queries Veterinary Evidence has developed a list of common conditions for each species, alongside the different categories of information. The aim is to prompt and support the generation of new clinical queries in a more systematic format. This resource sits alongside our species-based lists of clinical queries that have already been suggested by practicing veterinarians, veterinary nurses, and other paraprofessionals (see veterinaryevidence.org/index.php/ve/clinical-queries). We hope readers and prospective authors will use these resources to generate new clinical queries or as a starting point for writing their own Knowledge Summaries. Most of the papers published in Veterinary Evidence are Knowledge Summaries, but the journal has always accepted and will continue to accept and encourage other types of reviews and original research that provide evidence to inform clinical practice. For example, in this issue we have published a commentary paper by Professor Jonathan Elliott regarding the processes and evidence required for the registration of veterinary medicinal products which provides some important insights and debate into the publication of evidential information (Elliott, 2024). A Knowledge Summary may not always be the best format to synthesise and summarise evidence on a multifaceted topic; scoping reviews, systematic reviews, or narrative reviews maybe more appropriate. Munn et al. (2018) provide a useful account of scoping reviews and how they differ from traditional literature and systematic reviews. In particular, we are keen to receive articles on artificial intelligence applications, sustainability, and quality improvement in clinical practice, as the impact and importance of these topics grows. We are also making some changes to the presentation of Knowledge Summaries in Veterinary Evidence, to help readers more easily understand the details and context of the summarised evidence. In order to support everyone in appraising and understanding quantitative clinical studies, we will be publishing a glossary and guidance on basic statistical terms and tests on the journal website.

Endometriosis as a risk factor for ovarian cancer: an update on screening, risk reduction, treatment and prognosis

Key content Endometriosis affects up to 10% of women. While many regard endometriosis as a benign (non‐cancerous) disease, there are well‐established links to epithelial ovarian cancer (EOC). Proposed mechanisms for malignant transformation include chronic inflammation, hyperestrogenism and oxidative stress. Mutations in the tumour suppressor gene ARID1A have also been implicated in the development of endometriosis‐associated ovarian cancer (EAOC). Endometriosis is reported to almost double a woman's background risk of ovarian cancer. Risk reduction strategies are effective in reducing the incidence of EAOC. These include tubal ligation, excision of endometriosis and combined hormonal contraception. Novel therapies targeting tumour suppressor gene mutations present in EAOC are undergoing phase I &amp; II clinical trials. Learning objectives To increase knowledge of the association between endometriosis and EOC. To understand the updated evidence for screening, risk and risk reduction strategies. To be informed of potential novel therapies currently in the clinical trial stage of development. Ethical issues Increased public awareness and improved clinician knowledge may lead to more and earlier‐stage disease detection. Women are more informed, necessitating clinicians to deliver evidence‐based counselling to meet their informational needs.

Efficacy versus effectiveness: The HORIZON Pivotal Fracture Trial and its emulation in Claims Data.

To evaluate the concordance of results between the HORIZON-Pivotal Fracture Trial (PFT) and a non-randomized database study designed to emulate the trial. HORIZON-PFT evaluated the efficacy of zoledronic acid vs placebo in reducing the risk of hip fractures and found a 41% risk reduction over a 3-year treatment period (HR = 0.59; 95% CI 0.42 to 0.83). Using two U.S. claims databases from 08/2007 to 12/2020 or 06/2021 we applied eligibility criteria from HORIZON-PFT and identified women with osteoporosis who initiated zoledronic acid or raloxifene as a proxy for placebo. The study protocol was registered on ClinicalTrials.gov (NCT04736693) before inferential analyses. We compared HORIZON-PFT and database study results using prespecified metrics. Due to low adherence in clinical practice, on-treatment follow up was truncated at 18 months in the database study. The hip fracture risk after 18 months was 9.3/1000 in the trial and 8.3/1000 in the database analysis. In the database study, zoledronic acid was associated with a 28% reduction in hip fractures risk compared to raloxifene (HR = 0.72; 95% CI 0.51 to 0.92). The attenuated effect of zoledronic acid in the database study may be explained by its shorter follow-up, as the interpolated estimate of the effect in HORIZON-PFT at 18 months was HRRCT 0.74, nearly identical to the observational estimate HRdatabase 0.72. Real-world emulation of the HORIZON-PFT found that zoledronic acid reduced hip fractures risk over an 18-month follow-up period. Limited adherence in clinical practice diminished the magnitude of its preventive effect and precluded long-term estimation of effectiveness in this setting.

Relationship between cumulative silica exposure and silicosis: a systematic review and dose-response meta-analysis

BackgroundSilicosis, a chronic respiratory disease caused by crystalline silica exposure, is a persistent global lung health issue. No systematic review of the relationship between cumulative respirable crystalline silica (RCS) exposure...

Metabolic Surgery and Chronic Traumatic Encephalopathy: Perceptions of Former NFL Players.

Chronic traumatic encephalopathy (CTE) has been diagnosed in 91.7% of retired United States National Football League (NFL) players at postmortem. There is no treatment or cure for CTE. Most living former NFL athletes with probable CTE suffer from obesity and its comorbidities. Our previous reviews document the improvement in cognition following metabolic/bariatric surgery (MBS) (e.g., gastric bypass, sleeve gastrectomy). These operations might reduce microglial maladaptive states, thereby attenuating neurodegeneration and CTE-like neurocognitive impairment. The study evaluated former NFL players' views on metabolic surgery in relation to reduction of obesity and CTE risk. An online multiple-choice questionnaire (30 items, 125 response options, 10-min completion) developed in the Research Electronic Data Capture (REDCap) system was sent to 1,014 athletes screened in 2017-2022 by the Living Heart Foundation. From 2/2022 to 7/2023, of 700 surveys opened, 72 (10.3%) of the retired players responded. Mean age was 61.6 ± 12.6years; 45.0% had the disease of obesity with a mean BMI 35.5 ± 4.6kg/m2. Thirty-three percent reported ≥ 2 obesity-related comorbidities; 40.3% memory-related TBI symptoms; 66.7% ≥ 1 cognitive symptom; 85.0% believed MBS was safe and effective but were unlikely to elect MBS for weight management. Yet, 57.0% of the entire cohort, and 68.8% of players with obesity were more likely to elect MBS if it could also reduce CTE risk. Results of the study bode well for future research recruitment. Most surveyed retired NFL players with obesity believed MBS to be effective and would be more likely to undergo MBS if it also reduced CTE risk.

Investigating Hallucinations in Pruned Large Language Models for Abstractive Summarization

Abstract Despite the remarkable performance of generative large language models (LLMs) on abstractive summarization, they face two significant challenges: their considerable size and tendency to hallucinate. Hallucinations are concerning because they erode reliability and raise safety issues. Pruning is a technique that reduces model size by removing redundant weights, enabling more efficient sparse inference. Pruned models yield downstream task performance comparable to the original, making them ideal alternatives when operating on a limited budget. However, the effect that pruning has upon hallucinations in abstractive summarization with LLMs has yet to be explored. In this paper, we provide an extensive empirical study across five summarization datasets, two state-of-the-art pruning methods, and five instruction-tuned LLMs. Surprisingly, we find that hallucinations are less prevalent from pruned LLMs than the original models. Our analysis suggests that pruned models tend to depend more on the source document for summary generation. This leads to a higher lexical overlap between the generated summary and the source document, which could be a reason for the reduction in hallucination risk.1