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This article reviews cultural and methodological considerations when developing effective preventive interventions among Latino families. A prevention approach guides the discussion of five key issues in prevention science, including (a) the role of risk and protective factors, (b) fidelity and adaptation strategies, (c) program effectiveness, (d) methodological consideration, and (e) bridging prevention research and practice. An annotated bibliography complements our discussion of conceptual and methodological considerations and prevention and intervention practices when working with Latinos.

BACKGROUND: It has been suggested that up to 40% of dementia cases worldwide are associated with modifiable risk factors; however, these estimates are not known in Canada. Furthermore, sleep disturbances, an emerging factor, has not been incorporated into the life-course model of dementia prevention. OBJECTIVE: To estimate the population impact of 12 modifiable risk factors in Canadian adults including sleep disturbances, by sex and age groups, and to compare with other countries. DESIGN: Cross-sectional analysis of Canadian Longitudinal Study on Aging baseline data. SETTING: Community. PARTICIPANTS: 30,097 adults aged 45 years and older. MEASUREMMENTS: Prevalence and Population Attributable Fractions (PAFs) associated with less education, hearing loss, traumatic brain injury, hypertension, excessive alcohol, obesity, smoking, depression, social isolation, physical inactivity, diabetes, and sleep disturbances. RESULTS: The risk factors with the largest PAF were later life physical inactivity (10.2%; 95% CI, 6.8% to 13%), midlife hearing loss (6.5%; 3.7% to 9.3%), midlife obesity (6.4%; 4.1% to 7.7%), and midlife hypertension (6.2%; 2.7% to 9.3%). The PAF of later life sleep disturbances was 3.0% (95% CI, 1.8% to 3.8%). The 12 risk factors accounted for 51.9% (32.2% to 68.0%) of dementia among men and 52.4% (32.5% to 68.7%) among women. Overall, the combined PAF of all risk factors was 49.2% (31.1% to 64.9%), and it increased with age. CONCLUSION: Nearly up to 50% of dementia cases in Canada are attributable to 12 modifiable risk factors across the lifespan. Canadian risk reduction strategies should prioritize targeting physical inactivity, hearing loss, obesity, and hypertension.

IntroductionWith Alzheimer's disease and related dementias (ADRD) representing an enormous public health challenge, there is a need to support individuals in learning about and addressing their modifiable risk factors (e.g., diet, sleep, and physical activity) to prevent or delay dementia onset. However, there is limited availability for evidence-informed tools that deliver both quality education and support for positive behavior change such as by increasing self-efficacy and personalizing goal setting. Tools that address the needs of Latino/a, at higher risk for ADRD, are even more scarce.MethodsWe established a multidisciplinary team to develop the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia (HALT-AD) program, a bilingual online personalized platform to educate and motivate participants to modify their risk factors for dementia. Grounded in social cognitive theory and following a cultural adaptation framework with guidance from a community advisory board, we developed HALT-AD iteratively through several cycles of rapid prototype development, user-centered evaluation through pilot testing and community feedback, and refinement.ResultsUsing this iterative approach allowed for more than 100 improvements in the content, features, and design of HALT-AD to improve the program's usability and alignment with the interests and educational/behavior change support needs of its target audience. Illustrative examples of how pilot data and community feedback informed improvements are provided.DiscussionDeveloping HALT-AD iteratively required learning through trial and error and flexibility in workflows, contrary to traditional program development methods that rely on rigid, pre-set requirements. In addition to efficacy trials, studies are needed to identify mechanisms for effective behavior change, which might be culturally specific. Flexible and personalized educational offerings are likely to be important in modifying risk trajectories in ADRD.

Because alcohol consumption is an established cause of female breast cancer, understanding whether cessation affects risk is of public health importance. In a recent meta-analysis, compared with continuing consumption, the relative risk (RR) for cessation was 0.95 (95% confidence interval [CI] 0.88–1.01). Because intake of alcohol is more consistently associated with estrogen receptor positive (ER+) than negative (ER-) subtypes, we conducted a meta-analysis of alcohol cessation for ER-specific breast cancer risk using data from three cohort studies and one population-based case-control study (ER + n = 3,793; ER- n = 627) with information reported on cessation and ER status. Compared with continuing consumption, cessation was associated with lower risk of ER+ (RR = 0.88, 95%CI, 0.79–0.98) but not ER- (RR = 1.23, 95%CI, 0.98–1.55) breast cancer. These results suggest that, compared with continuing consumption, alcohol cessation may reduce ER + but not ER- breast cancer risk. However, research that considers duration of cessation is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To describe the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence‐based lifestyle intervention known as the Diabetes Prevention Program (DPP). Data Sources and Study Setting: 2012–2024 VA administrative and survey data. Study Design: This is a summary of findings and impacts from four effectiveness‐implementation projects focused on in‐person and/or online DPP across VA sites. Data Collection/Extraction Methods: Patient demographics, participation data, and key findings and impacts were summarized across reports from the VA Diabetes‐Mellitus Quality Enhancement Research Initiative (QUERI‐DM) Diabetes Prevention Program (VA DPP) Trial, QUERI‐DM Online DPP Trial, the Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI DPP Project, and EMPOWER 2.0 QUERI Program. Principal Findings: Between 2012 and 2024, four VA QUERI studies enrolled 963 Veterans in DPP across 16 VA sites. All participants had overweight/obesity with one additional risk factor for type 2 diabetes (i.e., prediabetes, elevated risk score, or history of gestational diabetes) and 56% (N = 536) were women. In addition to enhancing the reach of and engagement in diabetes prevention services among Veterans, these projects resulted in three key impacts as follows: (1) informing the national redesign of VA MOVE! including recommendations to increase the number of MOVE! sessions and revise guidelines across 150+ VA sites, (2) enhancing the national evidence base to support online DPP delivery options with citations in national care guidelines outside VA, and (3) demonstrating the importance of gender‐tailoring of preventive care services by and for women Veterans to enhance engagement in preventive services. Conclusions: Over the past decade, the evolution of VA QUERI DPP projects increased the reach of and engagement in diabetes prevention services among Veterans, including women Veterans who have been harder to engage in lifestyle change programs in VA, and resulted in three key impacts informing type 2 diabetes and obesity prevention efforts within and outside of VA. [ABSTRACT FROM AUTHOR]

• This research explores public perceptions of reportable safety incidents. • Falls were incorrectly identified as nonreportable by a plurality of respondents. • Ascope of practice intervention was incorrectly identified as a safety incident. • Research is vital to test strategies that enhance perception of reportable safety risks. Introduction: Patients may not feel responsible for reporting safety events, and social norms may prevent patients from questioning health care providers' judgment. There is a paucity of research regarding public awareness of reportable safety events/risks. Educating the public about reporting is paramount in error prevention. Because more than 70% of errors (e.g., errors in diagnosis, communication errors, unsafe medication practices, and care fragmentation) occur in primary care settings, the purpose of this study was to explore public perceptions of when to report safety events/risks in these settings. Method: System-level primary and outpatient facility safety incident scenarios conducive to safety events/risk reporting were developed and administered via online survey methodology. Following completion of the scenario questions, participants were asked a single open-text item: "As you were reading the scenarios above, what did you think makes an event/risk 'reportable'?" Results: At least one-third of participants responded incorrectly in 70% of the scenarios. The percentage of incorrect responses ranged from 5.2% to 62.3% with "unwitnessed falls" and "nursing scope of practice" queries incorrectly reported at 44.5% and 53.9%, respectively. Rationales for inappropriate events/risk reporting included "risk prediction at the management/system level," "legal repercussions/protection (e.g., negligence, legal responsibility to patient)," "violations of scope of practice/professional expectations," "degree of potential/actual lethality," and "personnel errors." Conclusion: This study revealed a gap between understanding why to report an event/risk and when to correctly report (or not report) an actual healthcare issue. Practical applications: Awareness of reasons for correctly reporting incidents and how correct reporting builds a culture of safety needs to be strengthened. [ABSTRACT FROM AUTHOR]

Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multimodal lifestyle intervention yielded cognitive and other health benefits in older adults at risk of cognitive decline. The two-year multinational randomized controlled LETHE trial evaluates the feasibility of a digitally supported, adapted FINGER intervention among at-risk older adults. Technology is used to complement in-person activities, streamline the intervention delivery, personalize recommendations, and collect digital biomarkers. Methods: Trial includes older adults (60–77 years) with digital readiness/experience with smart devices and increased dementia risk but without substantial cognitive impairment. Participants are enrolled at four sites (Austria, Finland, Italy, Sweden). At baseline, participants were randomized 1:1 ratio to 1) intervention i.e., structured multimodal lifestyle program (including diet, exercise, cognitive training, vascular/metabolic risk management, social stimulation, sleep/stress management) where in-person activities led by professionals are supported with an Android mobile phone application developed by the consortium (the LETHE App); or 2) control i.e., self-guided program (regular health advice; simplified App with no personalized/interactive content). All participants wear smartwatches to gather passive data (e.g., physical activity, sleep). Primary outcomes are retention, adherence, and change in validated dementia risk scores. Secondary outcomes include changes in lifestyle, cognition, stress, sleep, health-related quality of life, and health literacy. Additional outcomes (exploratory) include e.g. participant experiences and dementia-related biomarkers (Alzheimer’s disease blood markers, neuroimaging). A sub-study explores the feasibility of novel interactive technology (audio glasses, social robot). Results: Recruitment began in September 2022, and the last participant was randomized in June 2023. In total, 156 individuals were randomized (mean age 69 years, 65% women; balanced recruitment across the four sites). Vascular and lifestyle risk factors were common (e.g., 65% with hypertension, 69% with hypercholesterolemia, 39% physically inactive), indicating successful recruitment of a population with risk reduction potential. Trial will be completed by summer 2025. Retention until the first post-baseline visit at 6 months is high (n = 2 discontinued, retention 98.7%). Conclusion: LETHE provides crucial information about the feasibility of technology and a digitally supported FINGER lifestyle program to promote brain health. Digital tools specifically designed for older adults could offer potential for large-scale, cost-effective prevention programs. Trial registration: ClinicalTrials.gov (NCT05565170). [ABSTRACT FROM AUTHOR]

Previous studies identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment at baseline. Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing, who completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke's Cognitive Examination–Revised, adapted for culturally acceptable use in Aotearoa New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes. The analysis included 783 participants without cognitive impairment at baseline (54.7% female, mean age 62.7 years, 25.0% Māori, the Indigenous people of Aotearoa New Zealand). There was an association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p =.050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p =.013) over two years, while controlling for covariates. The findings emphasise the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities. [ABSTRACT FROM AUTHOR]

With the intensification of global warming and sea level rise, extreme weather and climate events occur frequently, increasing the probability and destructive power of marine disasters. The purpose of this paper is to propose the specific application of artificial intelligence (AI) in marine disaster risk reduction. First, this paper uses computer vision to assess the vulnerability of the target and then uses CNN-LSTM to forecast tropical cyclones. Second, this paper proposes a social media communication mechanism based on deep learning and a psychological crisis intervention mechanism based on AIGC. In addition, the rescue response system based on an intelligent unmanned platform is also the focus of this research. Third, this paper also attempts to discuss disaster loss assessment and reconstruction based on machine learning and smart city concepts. After proposing specific application measures, this paper proposes three policy recommendations. The first one is improving legislation to break the technological trap of AI. The second one is promoting scientific and technological innovation to break through key technologies of AI. The third one is strengthening coordination and cooperation to build a disaster reduction system that integrates man and machine. The purpose of this paper is to reduce the risk of marine disasters by applying AI. Furthermore, we hope to provide scientific references for sustainability and human adaptation to climate change. [ABSTRACT FROM AUTHOR]

Postoperative complications related to anastomosis, including postoperative anastomotic bleeding and anastomotic leakage, remain a serious issue. The effect of anastomotic devices on suture complications during intestinal anastomosis remains unclear. The present study examined the utility of automated anastomotic devices for reducing anastomotic complication risks. A retrospective cohort study of colorectal cancer surgeries in which an anastomosis device was used at Osaka University Hospital (Suita, Japan) between January 2018 and December 2022 was conducted. Cases of emergency surgery, inflammatory bowel disease and simultaneous surgery for other cancers were excluded. Experienced gastrointestinal surgeons performed manual anastomosis using the ETHICON Circular Stapler CDH or EEA Circular Stapler, and automatic anastomosis using the ECHELON CIRCULAR Powered Stapler, with no observed operator bias. Additionally, a meta-analysis that included other study results was performed. The outcomes included postoperative complications, mainly anastomotic leakage. The study included 414 patients: 231 in the manual circular stapler group and 183 in the powered circular stapler (PCS) group. Although this retrospective study found no statistically significant association between the anastomotic device used and anastomotic complications, an increased risk ratio was observed in the manual group compared with the automatic group when restricted to elderly patients. Similarly, a meta-analysis found a significantly higher anastomotic complication risk in the manual group compared with the automatic group (random-effects model; odds ratio, 0.376; 95% confidence interval, 0.232-0.610; P<0.0001). The findings of the present study suggested that a PCS is useful for reducing the anastomotic complication risk in patients undergoing colorectal cancer surgery. [ABSTRACT FROM AUTHOR]

Background: Coronary calcification is a well-established risk factor for cardiovascular events. This retrospective study sought to determine the predictive value of coronary calcification in a specific group of patients with chronic kidney disease. Methods: We included 1094 asymptomatic patients (724 males, 370 females, age 62 ± 9.3 years) referred for cardiological examination. Patents were divided into two groups depending on their renal function. Coronary calcification was determined with a multi-slice computer tomography (CT) scanner. For quantification of coronary calcification the Agatston score was calculated. Over a mean follow up period of 6.2 ± 1.3 years we observed the rate of cardiovascular events (185 events, 61 myocardial infarctions, 103 revascularizations, 21 cardiac deaths). Results: The calcium score was significantly higher in patients with severe kidney disease (glomerular filtration rate (GFR) =30 mL/min/1.72 m²) compared with those with normal to moderate reduced renal function (GFR =30 mL/min/1.72 m²) (207 ± 190 vs.121 ± 169, p = 0.001). The event rate in patients with severe impaired renal function was significantly higher compared to patients with normal to moderate reduced renal function (20.6% vs. 14.8%, p = 0.0001). The hazard ratio for cardiovascular events increased constantly with the calcium score in both groups. The hazard ratio in patients with severe kidney disease was significantly lower compared to patients in corresponding groups with regular to moderate reduced renal function (7.3 vs. 9.3, p = 0.01). No cardiac events were observed in patients with a calcium score of 0. Conclusions: We could demonstrate that risk prediction with the calcium score is possible in patients with severe chronic kidney disease even if the calcium score overestimates the risk for future cardiovascular events compared to patients with normal to moderate reduced renal function. [ABSTRACT FROM AUTHOR]

Purpose: Falls among older adults are a growing public health concern in Saudi Arabia. The Otago Exercise Program (OEP) is an evidence-based intervention aimed at reducing fall risk in this population. This study assessed the knowledge and attitudes of Saudi Arabian physical therapists toward the OEP and examined potential gender-based differences. Patients and Methods: A cross-sectional survey was conducted between November 2023 and April 2024, involving 120 licensed physical therapists from Saudi Arabia, recruited via Email and social media. The survey captured sociodemographic data, knowledge, and attitudes regarding the OEP. Responses were analyzed using descriptive statistics, chi-square tests, and Cramér's V to assess the strength of associations, with a significance level set at p < 0.05. Results: Most physical therapists reported knowledge of the OEP's clinical effectiveness (36.7%), cultural compatibility (35.0%), and fall prevention benefits (28.3%). Gender was not significantly associated with knowledge of clinical effectiveness (χ² = 3.84, p = 0.57), contraindications (χ² = 4.44, p = 0.48), cost-effectiveness (χ² = 4.15, p = 0.52), or fall prevention in older adults (χ² = 2.44, p = 0.78), with moderate effect sizes observed (Cramer's V = 0.233 to 0.467). Attitudes toward the OEP were generally positive, with 51.7% supporting its use in regular aging care and 45.0% expressing confidence in delivering the program. There were no significant gender differences in understanding the OEP's recommendations (χ² = 7.45, p = 0.11) or confidence in program delivery (χ² = 7.62, p = 0.10), although strong association effects were noted (Cramer's V = 0.696 and 0.680, respectively). Conclusion: This study highlights the strong knowledge and positive attitudes of Saudi physical therapists toward the OEP, underscoring its potential for integration into national healthcare strategies to improve geriatric care and reduce fall-related risks. The findings emphasize the importance of continuous professional development to address knowledge gaps and optimize the implementation of evidence-based fall prevention programs. [ABSTRACT FROM AUTHOR]

Background Infectious complications of substance use are increasingly encountered in infectious diseases (ID) clinical care. In this study, we surveyed ID fellows in the United States to assess training experiences, clinical practices, and perspectives in caring for people who use drugs (PWUD). Methods An 18-item survey was distributed to ID fellows via email and social media platforms. Four focus groups were conducted with a subset of participants to elucidate themes in fellowship experiences and training needs. Results Among 196 survey respondents (estimated 24% response rate), all reported caring for PWUD in ID fellowship. Forty-nine percent received some formal fellowship-based didactics around care of PWUD, and 64% worked with faculty seen as advocates for PWUD. Integrated care practices for PWUD were infrequently employed: 50% offered risk reduction counseling, and 33% discussed medications for opioid use disorders, naloxone, or HIV preexposure prophylaxis. Risk reduction counseling was felt to be "extremely" within scope of ID practice (69%), although comfort level with this skill was low; fellows' likelihood of offering counseling was significantly associated with their comfort (P ≤.0001). Common themes in caring for PWUD included an expanded role for ID consultants, a lack of formalized training, and benefits of developing dedicated opportunities in this field. Conclusions ID fellows frequently care for PWUD but may have gaps in knowledge or comfort that affect care practices. Increased fellowship training in the care of PWUD has potential to improve clinical practices and support growing interest in this field among current and prospective ID fellows. [ABSTRACT FROM AUTHOR]

Abstract Because alcohol consumption is an established cause of female breast cancer, understanding whether cessation affects risk is of public health importance. In a recent meta-analysis, compared with continuing consumption, the relative risk (RR) for cessation was 0.95 (95% confidence interval [CI] 0.88–1.01). Because intake of alcohol is more consistently associated with estrogen receptor positive (ER+) than negative (ER-) subtypes, we conducted a meta-analysis of alcohol cessation for ER-specific breast cancer risk using data from three cohort studies and one population-based case-control study (ER + n = 3,793; ER- n = 627) with information reported on cessation and ER status. Compared with continuing consumption, cessation was associated with lower risk of ER+ (RR = 0.88, 95%CI, 0.79–0.98) but not ER- (RR = 1.23, 95%CI, 0.98–1.55) breast cancer. These results suggest that, compared with continuing consumption, alcohol cessation may reduce ER + but not ER- breast cancer risk. However, research that considers duration of cessation is warranted.

Abstract Background The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multimodal lifestyle intervention yielded cognitive and other health benefits in older adults at risk of cognitive decline. The two-year multinational randomized controlled LETHE trial evaluates the feasibility of a digitally supported, adapted FINGER intervention among at-risk older adults. Technology is used to complement in-person activities, streamline the intervention delivery, personalize recommendations, and collect digital biomarkers. Methods Trial includes older adults (60–77 years) with digital readiness/experience with smart devices and increased dementia risk but without substantial cognitive impairment. Participants are enrolled at four sites (Austria, Finland, Italy, Sweden). At baseline, participants were randomized 1:1 ratio to 1) intervention i.e., structured multimodal lifestyle program (including diet, exercise, cognitive training, vascular/metabolic risk management, social stimulation, sleep/stress management) where in-person activities led by professionals are supported with an Android mobile phone application developed by the consortium (the LETHE App); or 2) control i.e., self-guided program (regular health advice; simplified App with no personalized/interactive content). All participants wear smartwatches to gather passive data (e.g., physical activity, sleep). Primary outcomes are retention, adherence, and change in validated dementia risk scores. Secondary outcomes include changes in lifestyle, cognition, stress, sleep, health-related quality of life, and health literacy. Additional outcomes (exploratory) include e.g. participant experiences and dementia-related biomarkers (Alzheimer’s disease blood markers, neuroimaging). A sub-study explores the feasibility of novel interactive technology (audio glasses, social robot). Results Recruitment began in September 2022, and the last participant was randomized in June 2023. In total, 156 individuals were randomized (mean age 69 years, 65% women; balanced recruitment across the four sites). Vascular and lifestyle risk factors were common (e.g., 65% with hypertension, 69% with hypercholesterolemia, 39% physically inactive), indicating successful recruitment of a population with risk reduction potential. Trial will be completed by summer 2025. Retention until the first post-baseline visit at 6 months is high (n = 2 discontinued, retention 98.7%). Conclusion LETHE provides crucial information about the feasibility of technology and a digitally supported FINGER lifestyle program to promote brain health. Digital tools specifically designed for older adults could offer potential for large-scale, cost-effective prevention programs. Trial registration ClinicalTrials.gov (NCT05565170).

Abstract Previous studies identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment at baseline. Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing, who completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke’s Cognitive Examination–Revised, adapted for culturally acceptable use in Aotearoa New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes. The analysis included 783 participants without cognitive impairment at baseline (54.7% female, mean age 62.7 years, 25.0% Māori, the Indigenous people of Aotearoa New Zealand). There was an association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p = .050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p = .013) over two years, while controlling for covariates. The findings emphasise the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities.

International research attention on evacuation issues has increased significantly following the human and natural disasters at the turn of the century, such as 9/11, Hurricane Katrina, Cyclones Idai and Kenneth, the Black Saturday forest fires and tsunamis in Japan. The main problem concerning when a disaster can occur involves studying the risk reduction. Risk, following all the theoretical and experimental studies, is determined by the product of three components: occurrence, vulnerability and exposure. Vulnerability can be improved over time through major infrastructure actions, but absolute security cannot be achieved. When the event will occur with certainty, only exposure remains to reduce the risk to people before the effect hits them. Exposure can be improved, under fixed conditions of occurrence and vulnerability, by improving evacuation. The main problem in terms of evacuating the population from an area is the available transport system, which must be used to its fullest. So, if the system is well managed, the evacuation improves (shorter times), meaning the exposure is reduced, and therefore, the risk is reduced. A key factor in the analysis of transport systems under emergency conditions is the behavior of the user, and therefore, the study of demand. This work identifies the main research lines that are useful for studying demand under exposure-related risk conditions. The classification of demand models that simulate evacuation conditions in relation to the effect on the transportation system is summarized. The contribution proposes a model for updating choice in relation to emergency conditions and utility. The contribution of emerging ICTs to actualization is formally introduced into the models. Intelligent technologies make it possible to improve user decisions, reducing exposure and therefore risk. The proposed model moves within the two approaches of the literature: it is an inter-period dynamic model with the probability expressed within the discrete choice theory; furthermore, it is a sequential dynamic model with the probability dependent on the previous choices. The contribution presents an example of application of the model, developing a transition matrix considering the case of choice updating under two extreme conditions.

The effects of global warming, coupled with the continuing expansion of urbanization, have significantly increased vulnerability to urban flooding, widespread erosion risks, and related phenomena such as shallow landslides and mudflows. These challenges are particularly evident in both lowland and hill/foothill environments of urbanized regions. Improving resilience to urban flooding has emerged as a top priority at various levels of governance. This paper aims to perform an initial analysis with the goal of developing an early warning system to efficiently manage intense convective rainfall events in urban areas. To address this need, the paper emphasizes the importance of analyzing different hazard scenarios. This involves examining different hydro-meteorological conditions and exploring management alternatives, as a fundamental step in designing and evaluating interventions to improve urban flood resilience. The Turin Metropolitan Area (TMA), located in north-western Italy, represents a unique case due to its complex orography, with a mountainous sector in the west and a flat or hilly part in the east. During the warm season, this urban area is exposed to strong atmospheric convection, resulting in frequent hailstorms and high-intensity rainfall. These weather conditions pose a threat to urban infrastructure, such as drainage systems and road networks, and require effective management strategies to mitigate risks and losses. The TMA’s urban areas are monitored by polarimetric Doppler weather radars and a dense network of rain gauges. By examining various summer precipitation events leading to urban flooding between 2007 and 2021, this study assesses the practicability of deploying a weather-radar early-warning system. The focus is on identifying rainfall thresholds that distinguish urban flooding in lowland areas and runoff erosion phenomena in urbanized hills and foothills.

Abstract The occurrence of debris flow events in small-scale watersheds with dense vegetation in mountainous areas that result in significant loss of life and missing individuals challenges our understanding and expertise in investigating and preventing these disasters. This has raised concerns about the occurrence of large debris flow disasters from small watersheds. This study focused on a catastrophic debris flow that took place in Longtou Gully (0.45 km2) in Tianquan County, Ya’an City on 25 September 2021, which resulted in 14 deaths and missing individuals. Through comprehensive field investigations, high-precision remote sensing data analyses, and numerical simulations, we analyzed the triggering mechanisms and dynamic processes of this event. Our results indicate that the convergence hollow at the channel head exhibited higher hydraulic conditions during rainfall compared to gentle slopes and convex terrains, leading to the instability of colluvial soil due to the expansion of the saturated zone near the soil–bedrock interface. The entrainment of material eroded from the channel resulted in an approximately 4.7 times increase in volume, and the channel scarp with a height of about 200 m amplified the destructive power of the debris flow. We emphasize the need to take seriously the possibility of catastrophic debris flows in small-scale watersheds, with colluvial deposits in hollows at the channel head under vegetation cover that serve as precursor material sources, and the presence of channel scarps formed by changes in the incision rate of the main river, which is common in the small watershed on both sides. This study provides insights for risk assessment of debris flows in small-scale catchments with dense vegetation cover in mountainous areas, highlighting the importance of vigilance in addressing disasters in small-scale catchments, particularly in regions with increasing human–environment conflicts.

Meteorological information and forecasts are of great importance to reduce agro-meteorological hazards. However, the gap between production and application of these forecasts is one of the most ambiguous issues of crop management at the farmers' level. In this regard, investigating the factors influencing Iranian farmers willingness to use meteorological information and predictions was selected as the main aim of the present study. To this end, an extended version of Theory of Planned Behavior (TPB) was employed and modeled. The results revealed that attitude towards the use of meteorological information and predictions, subjective norms in the use of meteorological information and predictions, perceived behavioral control and self-identity in the use of meteorological information and prediction, and moral norm variables regarding the use of meteorological information and predictions positively and significantly affected willingness to use meteorological information and predictions. These variables could account for 46% of willingness to use meteorological information and predictions variance. According to the results, it was suggested that by creating multimedia programs, the agricultural community become aware of the benefits and consequences of using meteorological information in their activities. Furthermore, it was recommended that social cooperation and research groups be formed on the use of meteorological information in agricultural activities. This can contribute to examine the various dimensions (strengths, weaknesses, threats, and opportunities) of using meteorological information from a collective perspective. Making a social decision in this regard can have a profound effect on a person's subjective norms and dramatically increase the speed of using meteorological information. The results of this study can help policymakers and decision-makers in the field of agriculture to design suitable intervention programs for the effective use of meteorological information by farmers. Also, the results of this study help farmers to effectively reduce the impacts of meteorological hazards. [ABSTRACT FROM AUTHOR]

On 1 September 2022, a landslide in Hongya Village, Weiyuan Town, Huzhu Tu Autonomous County, Qinghai Province, caused significant casualties and economic losses. To mitigate such risks, InSAR technology is employed due to its wide coverage, all-weather operation, and cost-effectiveness in detecting landslides. In this study, focusing on the landslide in Hongya Village, SBAS-InSAR and Sentinel-1A satellite data from July 2021 to September/October 2022 were used to accurately identify the areas of active landslides and to analyze the landslide deformation trends, in combination with the geological characteristics of the landslides and rainfall data. The results showed that strong deformation was detected in the middle and back of the landslide in Hongya Village, with a maximum deformation rate of approximately -13 mm/year. The surface of the landslide consisted of mainly Upper Pleistocene wind-deposited loess, which is extremely sensitive to water. The deformation of the landslide was closely related to the rainfall, and the deformation of the landslide increased with the increase in rainfall. The research results prove that the combination of ascending and descending orbit data based on SBAS-InSAR technology is highly feasible in the field of landslide deformation monitoring and is of great practical significance for landslide disaster prevention and mitigation. [ABSTRACT FROM AUTHOR]

Simple Summary: For more than a decade, researchers have been gathering evidence suggesting pregnancy may alter the resistance of women to the development of diseases later in life. We wondered if parity—pregnancy resulting in live offspring—could enhance or diminish resistance of bitches to subsequent non-reproductive disease conditions, a hypothesis previously untested in domestic dogs. To pursue this goal, we constructed detailed lifetime reproductive and medical histories from 65 purebred Rottweiler bitches enrolled in an exceptional longevity study. An advantage of studying these bitches was that we could conduct a long-term evaluation of the relationship between parity and the lifelong occurrence of a commonly diagnosed degenerative disease, cranial cruciate ligament (CCL) rupture. Notably, we found parous bitches had a significantly lower likelihood of CCL rupture than nulliparous bitches. This 5.5-fold lower incidence of CCL rupture among parous females could not be explained by differences in diet, physical activity, overweight body condition, or reason for nulliparity. Our work may guide future mechanistic studies on the apparent association between parity and CCL rupture resistance. The research may also stimulate investigations into other non-reproductive health outcomes, such as autoimmune diseases, whose occurrence later in life may be impacted by parity. Emerging evidence in women supports the notion that pregnancy may reset disease resistance, thereby providing protection against subsequent adverse health outcomes, but this hypothesis has not been adequately explored in domestic dogs. Cranial cruciate ligament (CCL) rupture is a degenerative orthopedic disease that frequently affects pet dogs, and its risk has been associated with disruption of the reproductive hormone axis. Our research team is conducting a lifetime cohort study of purebred Rottweilers in North America that have lived 30% longer than breed-average. Detailed medical and reproductive histories of 33 nulliparous and 32 parous Rottweilers were generated from questionnaires and review of medical records. Interviews with owners of bitches in the nulliparous group served to limit selection bias, confirming that in no instance was the reason for nulliparity based upon the owner's suspicion that a bitch had a heightened risk for CCL rupture. The risk of CCL rupture associated with parity and other exposure variables was estimated using multivariate logistic regression. Overall, CCL rupture was diagnosed in 17 of 65 (26%) bitches. Median age at first litter and CCL rupture were 3.6 and 6.5 years, respectively. Compared to nulliparous, parous bitches had a significant 94% reduction in CCL rupture risk adjusted for duration of ovary exposure, overweight body condition, dietary pattern, habitual physical activity, and work/sport activity [ORadjusted (95% CI) = 0.06 (0.01–0.46); (p = 0.006)]. The observed parity-associated CCL rupture risk reduction remained robust in sensitivity analysis excluding six nulliparous bitches for which decision not to breed was based on diagnosis of hip or elbow dysplasia, conditions which may be genetically linked to CCL rupture [ORadjusted (95% CI) = 0.08 (0.01–0.58); (p = 0.01)]. This work sets the stage for replication studies in other canine populations that should begin to explore the mechanistic basis for parity-associated CCL rupture risk reduction and to pursue other non-reproductive health outcomes in bitches whose incidence or severity may be parity-sensitive. [ABSTRACT FROM AUTHOR]

Tools to briefly assess diet among US Spanish-speaking adults are needed to identify individuals at risk for cardiometabolic disease (CMD) related to diet. Two registered dietitian nutritionists (RDNs) recruited bilingual medical students to translate the validated Diet Risk Score (DRS) into Spanish (DRS-S). Participants were recruited from a federally qualified health center. Students administered the DRS-S and one 24-h recall (Automated Self-Administered 24-Hour (ASA24®) Dietary Assessment Tool) on one day; a second recall was administered within 1 week. Recalls were scored using the Healthy Eating Index (HEI)-2015, a measure of adherence to the Dietary Guidelines for Americans. Spearman correlations, weighted kappa, and ANOVA were conducted using SAS 9.4 to assess the relative validity of the DRS-S. Thirty-one Spanish-speaking adults (female: n = 17, 53%; mean age: 58 (42–69)) completed assessments. The mean DRS-S was 9 (SD = 4.2) (max: 27; higher score = higher risk) and the mean HEI-2015 score was 65.7 (SD = 9.7) (max: 100; higher score = lower risk), with significant agreement between measures (r: −0.45 (p = 0.01)), weighted kappa: −0.3 (p = 0.03). The DRS-S can be used in resource-constrained settings to assess diet for intervention and referral to RDNs. The DRS-S should be tested in clinical care to assess the impact of dietary changes to reduce CMD risk. [ABSTRACT FROM AUTHOR]

The effects of global warming, coupled with the continuing expansion of urbanization, have significantly increased vulnerability to urban flooding, widespread erosion risks, and related phenomena such as shallow landslides and mudflows. These challenges are particularly evident in both lowland and hill/foothill environments of urbanized regions. Improving resilience to urban flooding has emerged as a top priority at various levels of governance. This paper aims to perform an initial analysis with the goal of developing an early warning system to efficiently manage intense convective rainfall events in urban areas. To address this need, the paper emphasizes the importance of analyzing different hazard scenarios. This involves examining different hydro-meteorological conditions and exploring management alternatives, as a fundamental step in designing and evaluating interventions to improve urban flood resilience. The Turin Metropolitan Area (TMA), located in north-western Italy, represents a unique case due to its complex orography, with a mountainous sector in the west and a flat or hilly part in the east. During the warm season, this urban area is exposed to strong atmospheric convection, resulting in frequent hailstorms and high-intensity rainfall. These weather conditions pose a threat to urban infrastructure, such as drainage systems and road networks, and require effective management strategies to mitigate risks and losses. The TMA's urban areas are monitored by polarimetric Doppler weather radars and a dense network of rain gauges. By examining various summer precipitation events leading to urban flooding between 2007 and 2021, this study assesses the practicability of deploying a weather-radar early-warning system. The focus is on identifying rainfall thresholds that distinguish urban flooding in lowland areas and runoff erosion phenomena in urbanized hills and foothills. [ABSTRACT FROM AUTHOR]

International research attention on evacuation issues has increased significantly following the human and natural disasters at the turn of the century, such as 9/11, Hurricane Katrina, Cyclones Idai and Kenneth, the Black Saturday forest fires and tsunamis in Japan. The main problem concerning when a disaster can occur involves studying the risk reduction. Risk, following all the theoretical and experimental studies, is determined by the product of three components: occurrence, vulnerability and exposure. Vulnerability can be improved over time through major infrastructure actions, but absolute security cannot be achieved. When the event will occur with certainty, only exposure remains to reduce the risk to people before the effect hits them. Exposure can be improved, under fixed conditions of occurrence and vulnerability, by improving evacuation. The main problem in terms of evacuating the population from an area is the available transport system, which must be used to its fullest. So, if the system is well managed, the evacuation improves (shorter times), meaning the exposure is reduced, and therefore, the risk is reduced. A key factor in the analysis of transport systems under emergency conditions is the behavior of the user, and therefore, the study of demand. This work identifies the main research lines that are useful for studying demand under exposure-related risk conditions. The classification of demand models that simulate evacuation conditions in relation to the effect on the transportation system is summarized. The contribution proposes a model for updating choice in relation to emergency conditions and utility. The contribution of emerging ICTs to actualization is formally introduced into the models. Intelligent technologies make it possible to improve user decisions, reducing exposure and therefore risk. The proposed model moves within the two approaches of the literature: it is an inter-period dynamic model with the probability expressed within the discrete choice theory; furthermore, it is a sequential dynamic model with the probability dependent on the previous choices. The contribution presents an example of application of the model, developing a transition matrix considering the case of choice updating under two extreme conditions. [ABSTRACT FROM AUTHOR]

The occurrence of debris flow events in small-scale watersheds with dense vegetation in mountainous areas that result in significant loss of life and missing individuals challenges our understanding and expertise in investigating and preventing these disasters. This has raised concerns about the occurrence of large debris flow disasters from small watersheds. This study focused on a catastrophic debris flow that took place in Longtou Gully (0.45 km2) in Tianquan County, Ya'an City on 25 September 2021, which resulted in 14 deaths and missing individuals. Through comprehensive field investigations, high-precision remote sensing data analyses, and numerical simulations, we analyzed the triggering mechanisms and dynamic processes of this event. Our results indicate that the convergence hollow at the channel head exhibited higher hydraulic conditions during rainfall compared to gentle slopes and convex terrains, leading to the instability of colluvial soil due to the expansion of the saturated zone near the soil–bedrock interface. The entrainment of material eroded from the channel resulted in an approximately 4.7 times increase in volume, and the channel scarp with a height of about 200 m amplified the destructive power of the debris flow. We emphasize the need to take seriously the possibility of catastrophic debris flows in small-scale watersheds, with colluvial deposits in hollows at the channel head under vegetation cover that serve as precursor material sources, and the presence of channel scarps formed by changes in the incision rate of the main river, which is common in the small watershed on both sides. This study provides insights for risk assessment of debris flows in small-scale catchments with dense vegetation cover in mountainous areas, highlighting the importance of vigilance in addressing disasters in small-scale catchments, particularly in regions with increasing human–environment conflicts. [ABSTRACT FROM AUTHOR]

Disasters and climate-related events, including tropical storms, droughts, coastal erosion, and ocean acidification, threaten small island nations. Given the urgency of reducing disaster risks and the effects of climate change on vulnerable populations, this reflection essay pursues three objectives. First, it highlights the role of anthropology, ethnography, and multi-sited research in exploring disaster impacts, climate crises, and public policy in island communities. It then highlights national planning and inter-regional activities to build awareness of various risk reduction efforts by island nations and multi-governmental organizations. This article concludes with discussion prompts to engage researchers, scholars, students, and practitioners studying and working in small island nations. Due to the growing interest in climate equity and justice, this paper argues that anthropologists can offer valuable methodologies and approaches to develop transdisciplinary and nuanced insights into researching disaster risk reduction efforts and climate policy networks in and across island nations. [ABSTRACT FROM AUTHOR]

Relay cropping allows soybean to overlap with wheat for a period, reducing the production risks associated with wheat and enabling earlier sowing and harvesting of soybean. This study aimed to evaluate the technical and economic feasibility of a wheat-soybean relay cropping system and the cultivation of corn as a third crop within the same agricultural year. The experiment was conducted using a randomized block design with a 4 x 3 factorial arrangement, featuring three repetitions during the 2019/2020 and 2020/2021 growing seasons. Four wheat inter-row spacings, with configurations of 17 and 22 cm in single and double rows, resulted in soybean row spacings of 51 and 66 cm. Soybean was sown at the wheat's milk and dough grain stages, and a control was sown after wheat harvest with 45 cm inter-row spacing. The best wheat-soybean relay cropping arrangement was 17D, where wheat produced 2,812 and 2,267 kg ha-1, or 69.41 and 64.82% of the total produced by the control treatment in the first and second evaluated years, respectively. In the first year, soybean in the 51-cm arrangement sown during the second sowing season (09/23/19) produced 6,029.42 kg ha-1, which was 32.5% higher than the first season on 09/13/19 and 11.8% lower than the control on 10/03/19. In the second year, the same treatment sown on September 29 yielded 4,235.00 kg ha-1, which was 12.58% more than the first sowing period on September 14 and 7.4% lower than the control sown on October 23, 2020. Although its yield was 1,239 kg ha-1 less than the control (17S), relay cropping allowed corn sowing to be advanced by 15 days, which resulted in a grain yield increase of 1,956 kg ha-1 compared to corn sown after soybean harvest in the conventional system. The trade-off between wheat yield losses and corn yield gains indicates that wheat-soybean relay cropping has a positive balance and can be used as a management strategy to reduce crop risks and achieve higher grain yields per area. Additionally, wheat-soybean relay cropping provides grain yield gains per area and contributes to the productivity of the system, reducing risks for the three crops and yielding higher economic returns in both studied years.

In the models developed by probabilistic safety analyses (PSA) and in their applications associated with nuclear power plants (NPPs), the risk importance of a particular feature can be, most generally, divided into two categories: importance with respect to the risk-increase potential and importance with respect to the risk-decrease potential. A representative measure of the first category is risk achievement worth (RAW), while a representative measure of the second category is risk reduction worth (RRW). The present paper discusses the use of RAW and RRW in achieving safe design and points out some implications of their mutual dependency on the selection of a risk-reduction strategy. A simple example is provided to illustrate the differences between the two basic strategies and point out to the main issues and conclusions.

Introduction: Cardiovascular diseases (CVDs) have many risk factors; few can be modified through health education. Traditional patient counselling methods fail to impact health behaviours to prevent or reduce the risk of CVDs. Objectives: This study was conducted to estimate the effect of various risk communication methods on CVD risk reduction and medication adherence. Design: An open-label superiority randomised control trial was conducted where 159 patients were randomised into three groups: Communication of 10-year Framingham CVD risk score, heart age, and routine care. Follow-up was done 3 months after recruitment. The primary outcome was a difference in excess 10-year Framingham CVD risk score in the end-line compared to baseline. The status of modifiable behavioural risk factors at baseline was expressed as ‘yes’ and ‘no’, and follow-up was defined as ‘action’, ‘positive maintenance’, ‘negative maintenance’, and ‘defaulter’. The trial was registered with the Clinical Trials Registry India (CTRI NO. CTRI/2020/10/028614). Setting: The study setting was screening outpatient department (OPD), General Medicine OPD, and Cardiology OPD of a tertiary care hospital in Central India. Participants: Participants aged >30 years, residing in Bhopal for more than 6 months, diagnosed with hypertension or diabetes mellitus or both, and having any of the four CVD behavioural risk factors: tobacco use, alcohol use, physical inactivity, or unhealthy diet. Results: Median excess 10-year Framingham CVD risk scores were 0.945% (CI: 1.275–4.297), –0.850% (–3.932–2.075), and –1.300% (–5.100–0.900) (10-year Framingham CVD risk score vs Heart age vs Routine care) and 0.000% (–3.125–5.925), –1.600% (–3.760–1.475), and –1.400% (–6.600–5.900) before and after intervention, respectively (P > 0.05). Positive maintenance was higher in both intervention groups concerning all modifiable behaviours, with a higher proportion reported in the 10-year Framingham risk score. The action phase was reported higher in intervention groups for medication adherence, addiction, and dietary changes. Conclusion: Systematic risk communication methods reduced the probability of contracting CVD in the future, though this finding was statistically insignificant.

Background: Diabetes inpatient specialist services vary across the country, with limited evidence to guide service delivery. Currently, referrals to diabetes inpatient specialists are usually 'reactive' after diabetes-related events have taken place, which are associated with an increased risk of morbidity/mortality and increased length of hospital stay. We propose that a proactive diabetes review model of care, delivered by diabetes inpatient specialist nurses, may contribute to the prevention of such diabetes-related events and result in a reduction in the risk of harm. Method: We will conduct a cluster randomised feasibility study with process evaluation. The proactive diabetes review model (PDRM) is a complex intervention that focuses on the prevention of potentially modifiable diabetes-related harms. All eligible patients will receive a comprehensive, structured diabetes review that aims to identify and prevent potentially modifiable diabetes-related harms through utilising a standardised review structure. Reviews are undertaken by a diabetes inpatient specialist nurse within one working day of admission. This differs from usual care where patients are often only seen after diabetes-related harms have taken place. The trial duration will be approximately 32 weeks, with intervention delivery throughout. There will be an initial 8-week run-in phase, followed by a 24-week data collection phase. Eight wards will be equally randomised to either PDRM or usual care. Adult patients with a known diagnosis of diabetes admitted to an included ward will be eligible. Data collection will be limited to that typically collected as part of usual care. Data collected will include descriptive data at both the ward and patient level and glucose measures, such as frequency and results of capillary glucose testing, ketonaemia and hypoglycaemic events. The analysis aims to determine the fidelity and acceptability of the intervention and the feasibility of a future definitive trial. Whilst this study is primarily about trial feasibility, the findings of the process evaluation may lead to changes to both trial processes and modifications to the intervention. A qualitative process evaluation will be conducted in parallel to the trial. A minimum of 22 patients, nurses, doctors, and managers will be recruited with methods including direct non-participant observation and semi-structured interviews. The feasibility of a future definitive trial will be assessed by evaluating recruitment and randomisation processes, staffing resources and quality of available data. Discussion: The aim of this cluster randomised feasibility trial with a process evaluation is to explore the feasibility of a definitive trial and identify appropriate outcome measures. If a trial is feasible and the effectiveness of PDRM can be evaluated, this could inform the future development of inpatient diabetes services nationally. Trial registration: UK Clinical Research Network, 51,167. ISRCTN, ISRCTN70402110. Registered on 21 February 2022. [ABSTRACT FROM AUTHOR]

Protected and conserved areas (PCAs) are key ecosystem management tools for conserving biodiversity and sustaining ecosystem services and social cobenefits. As countries adopt a 30% target for protection of land and sea under the Global Biodiversity Framework of the United Nations Convention on Biological Diversity, a critical question emerging is, which 30%? A risk‐based answer to this question is that the 30% that returns the greatest reductions in risks of species extinction and ecosystem collapse should be protected. The International Union for Conservation of Nature (IUCN) Red List protocols provide practical methods for assessing these risks. All species, including humans, depend on the integrity of ecosystems for their well‐being and survival. Africa is strategically important for ecosystem management due to convergence of high ecosystem diversity, intense pressures, and high levels of human dependency on nature. We reviewed the outcomes (e.g., applications of ecosystem red‐list assessments to protected‐area design, conservation planning, and management) of a symposium at the inaugural African Protected Areas Congress convened to discuss roles of the IUCN Red List of Ecosystems in the design and management of PCAs. Recent progress was made in ecosystem assessment, with 920 ecosystem types assessed against the IUCN Red List criteria across 21 countries. Although these ecosystems spanned a diversity of environments across the continent, the greatest thematic gaps were for freshwater, marine, and subterranean realms, and large geographic gaps existed in North Africa and parts of West and East Africa. Assessment projects were implemented by a diverse community of government agencies, nongovernmental organizations, and researchers. The assessments have influenced policy and management by informing extensions to and management of formal protected area networks supporting decision‐making for sustainable development, and informing ecosystem conservation and threat abatement within boundaries of PCAs and in surrounding landscapes and seascapes. We recommend further integration of risk assessments in environmental policy and enhanced investment in ecosystem red‐list assessment to fill current gaps. [ABSTRACT FROM AUTHOR]

Recent studies propose fallopian tubes as the tissue origin for many ovarian epithelial cancers. To further support this paradigm, we assessed whether salpingectomy for treating ectopic pregnancy had a protective effect using the Taiwan Longitudinal National Health Research Database. We identified 316 882 women with surgical treatment for ectopic pregnancy and 3 168 820 age- and index-date-matched controls from 2000 to 2016. In a nested cohort, 91.5% of cases underwent unilateral salpingectomy, suggesting that most surgically managed patients have salpingectomy. Over a follow-up period of 17 years, the ovarian carcinoma incidence was 0.0069 (95% confidence interval [CI] = 0.0060 to 0.0079) and 0.0089 (95% CI = 0.0086 to 0.0092) in the ectopic pregnancy and the control groups, respectively (P  < .001). After adjusting the events to per 100 person-years, the hazard ratio (HR) in the ectopic pregnancy group was 0.70 (95% CI = 0.61 to 0.80). The risk reduction occurred only in epithelial ovarian cancer (HR = 0.73, 95% CI = 0.63 to 0.86) and not in non-epithelial subtypes. These findings show a decrease in ovarian carcinoma incidence after salpingectomy for treating ectopic pregnancy. [ABSTRACT FROM AUTHOR]

Objective: In Athletics (Track and Field), athletes can be affected by injuries, especially in their quest for top performance. Therefore, we aim to provide an overview of the current knowledge about the problem of injuries in Athletics. Main findings: It is necessary to maintain a clear definition of "injury" when stakeholders in Athletics discuss clinical, administrative, and/or research perspectives. There are several possible methodological approaches to collect injury data in Athletics depending on the context, population, and injury definition. In general, about two thirds of Athletics athletes sustain at least one injury during an Athletics season, and there are about 100 injuries per 1000 registered athletes during an international championship. The injury rates and characteristics vary by sex and discipline. The injuries can affect athletes physically, psychologically, and socially, with short- and long-term consequences for musculoskeletal function, athletics performance and athletics career. Although it is logical to try to reduce the injury risk, little scientific evidence is currently available to help Athletics-related stakeholders. Conclusions: Injury can currently be considered as an omnipresent problem in Athletics, which affects their practice, with consequences on performance and health. Injury risk is today an undeniable part of the life of Athletics athletes, which implies that there is a pressing need to continue the development of injury risk reduction strategies, to scientifically evaluate their efficacy, and to implement them in sports practice. [ABSTRACT FROM AUTHOR]

Integrated disaster risk reduction in schools represents a key component of safety strategies within the educational sector of every country. The aim of this study is to comprehensively explore the impact of various demographic and socio-economic factors on the perceptions of students and teachers regarding disaster risk reduction and safety in schools. This study is distinguished by its extensive empirical approach, employing a multistage random sampling method to conduct 850 face-to-face interviews (650 with students and 200 with teachers) throughout 2023 in 10 out of the total 18 municipalities in the Western Morava Basin of the Republic of Serbia. Two structured survey instruments were developed, incorporating a mix of qualitative (closed-ended) multiple-choice questions and five-point Likert scales. The research proposes two central hypotheses regarding school-based disaster risk reduction. Firstly, it suggests that gender, age, parent's employment, academic achievement, living situation, parental education levels, and engagement with social media collectively influence students' perspectives on this matter (H1–H8). Secondly, it posits that gender, age, marital status, parenthood, and educational background significantly impact teachers' viewpoints on school-based disaster risk reduction (H1–H5). Multivariate linear regression was used to explore predictors of students' and teachers' insights on school-based disaster risk reduction. Various statistical tests, including Chi-square, t-tests, one-way ANOVA, and Pearson's correlation, were employed to investigate the influence of demographic and socioeconomic factors on these insights. The results of multivariate regression analyses indicate that age, gender, and marital status emerge as the primary predictors across various facets of students' and teachers' insights on school-based disaster risk reduction, including awareness of disasters, disaster education activities, attitudes toward disaster risk reduction education, and enhancement of disaster information accessibility. The findings of this study provide comprehensive insights into the key factors influencing students' and teachers' perceptions of disaster risk reduction in schools. This research not only contributes to the academic discourse on disaster education but also serves as a foundational basis for improving educational programs, developing policies and strategies, refining normative educational frameworks, guiding teacher training, and informing further research in disaster education. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular diseases (CVDs) have many risk factors; few can be modified through health education. Traditional patient counselling methods fail to impact health behaviours to prevent or reduce the risk of CVDs. Objectives: This study was conducted to estimate the effect of various risk communication methods on CVD risk reduction and medication adherence. Design: An open‑label superiority randomised control trial was conducted where 159 patients were randomised into three groups: Communication of 10‑year Framingham CVD risk score, heart age, and routine care. Follow‑up was done 3 months after recruitment. The primary outcome was a difference in excess 10‑year Framingham CVD risk score in the end‑line compared to baseline. The status of modifiable behavioural risk factors at baseline was expressed as ‘yes’ and ‘no’, and follow‑up was defined as ‘action’, ‘positive maintenance’, ‘negative maintenance’, and ‘defaulter’. The trial was registered with the Clinical Trials Registry India (CTRI NO. CTRI/2020/10/028614). Setting: The study setting was screening outpatient department (OPD), General Medicine OPD, and Cardiology OPD of a tertiary care hospital in Central India. Participants: Participants aged >30 years, residing in Bhopal for more than 6 months, diagnosed with hypertension or diabetes mellitus or both, and having any of the four CVD behavioural risk factors: tobacco use, alcohol use, physical inactivity, or unhealthy diet. Results: Median excess 10‑year Framingham CVD risk scores were 0.945% (CI: 1.275–4.297), –0.850% (–3.932–2.075), and –1.300% (–5.100–0.900) (10‑year Framingham CVD risk score vs Heart age vs Routine care) and 0.000% (–3.125–5.925), –1.600% (–3.760–1.475), and –1.400% (–6.600–5.900) before and after intervention, respectively (P > 0.05). Positive maintenance was higher in both intervention groups concerning all modifiable behaviours, with a higher proportion reported in the 10‑year Framingham risk score. The action phase was reported higher in intervention groups for medication adherence, addiction, and dietary changes. Conclusion: Systematic risk communication methods reduced the probability of contracting CVD in the future, though this finding was statistically insignificant. [ABSTRACT FROM AUTHOR]

Background: Breast cancer remains the most frequently diagnosed cancer in female population worldwide. However, germline mutations are responsible for a small proportion of these cases. The aim of our study is to assess how germline mutations influence the management and outcome of these patients taken into consideration both their cancer diagnosis and genetic assessment. Methods: We performed a retrospective analysis in a women's single-center during a period of six years to assess the contribution of germline mutation in the treatment, prognosis and survival of breast cancer patients. Statistics were collected from both the patients' medical records and genetics department. Results: From the total number of patients treated for breast cancer in our department between 2017 and 2022, 243 were eligible for genetic testing, comprising either BRCA1/2 or extended panel, taking into consideration their personal and family history. Of all subjects included in our study cohort, 5% were carriers of a pathogenic(P) or likely pathogenic(LP) variant of cancer susceptibility gene, of which 78% were diagnosed before the age of 50; triple negative disease was diagnosed in the majority of cases, and therefore, 62% of patients started treatment with systemic neoadjuvant chemotherapy and 32% of subjects underwent upfront surgery. Prophylactic surgery for contralateral breast and bilateral salpingo-oophorectomy was considered and performed for 20% of patients. Less than 2% of cases had metastatic disease and received PARP inhibitors, with excellent treatment response and a very low rate of mortality in the study group. Conclusion: Carriers of pathogenic variants with breast cancer diagnosis may have a greater benefit from a tailored approach, including both surgical and oncological treatment, with better long-term outcomes. [ABSTRACT FROM AUTHOR]

For this special issue, sustainability and safety are discussed through the tropes of both material and work process substitution. As an architecture and industrial design team, we examine the potential of William McDonough's and Michael Braungart's "cradle to cradle" material methodology, and David Pye's "the workmanship of certainty" as relevant to the construction industry. Locating and revisiting the tenets of Gottfried Semper's Stoffwechseltheorie, alongside contemporary critiques, demonstrates that if historically, material and technique substitution led to architectural innovation, the same conditions exist today. To demonstrate a contemporary Stoffwechsel (material substitution) a formwork prototype was constructed at the University of Canberra's Workshop 7, by substituting timber with plastic, and 3D-printing the formwork. This prototype demonstrates a type of "technical nutrient" that is both recyclable as plastic, and reusable as formwork. This reveals the potential of substituting materials and processes not only to achieve material recovery, but rather, aiming for material recycling, reuse, or upcycling, therefore reducing socio-environmental risks in construction. [ABSTRACT FROM AUTHOR]

Meteorological information and forecasts are of great importance to reduce agro-meteorological hazards. However, the gap between production and application of these forecasts is one of the most ambiguous issues of crop management at the farmers’ level. In this regard, investigating the factors influencing Iranian farmers willingness to use meteorological information and predictions was selected as the main aim of the present study. To this end, an extended version of Theory of Planned Behavior (TPB) was employed and modeled. The results revealed that attitude towards the use of meteorological information and predictions, subjective norms in the use of meteorological information and predictions, perceived behavioral control and self-identity in the use of meteorological information and prediction, and moral norm variables regarding the use of meteorological information and predictions positively and significantly affected willingness to use meteorological information and predictions. These variables could account for 46% of willingness to use meteorological information and predictions variance. According to the results, it was suggested that by creating multimedia programs, the agricultural community become aware of the benefits and consequences of using meteorological information in their activities. Furthermore, it was recommended that social cooperation and research groups be formed on the use of meteorological information in agricultural activities. This can contribute to examine the various dimensions (strengths, weaknesses, threats, and opportunities) of using meteorological information from a collective perspective. Making a social decision in this regard can have a profound effect on a person’s subjective norms and dramatically increase the speed of using meteorological information. The results of this study can help policymakers and decision-makers in the field of agriculture to design suitable intervention programs for the effective use of meteorological information by farmers. Also, the results of this study help farmers to effectively reduce the impacts of meteorological hazards.

Salmonella in raw cocoa beans (n = 870) from main sourcing areas over nine months was analyzed. It was detected in 71 (ca. 8.2%) samples, with a contamination level of 0.3–46 MPN/g except for one sample (4.1 × 104 CFU/g). Using prevalence and concentration data as input, the impact of thermal treatment in cocoa processing on the risk estimate of acquiring salmonellosis by a random Belgian chocolate consumer was calculated by a quantitative microbiological risk assessment (QMRA) approach. A modular process risk model from raw cocoa beans to cocoa liquor up to a hypothetical final product (70–90% dark chocolate tablet) was set up to understand changes in Salmonella concentrations following the production process. Different thermal treatments during bean or nib steam, nib roasting, or liquor sterilization (achieving a 0–6 log reduction of Salmonella) were simulated. Based on the generic FAO/WHO Salmonella dose–response model and the chocolate consumption data in Belgium, salmonellosis risk per serving and cases per year at population level were estimated. When a 5 log reduction of Salmonella was achieved, the estimated mean risk per serving was 3.35 × 10−8 (95% CI: 3.27 × 10−10–1.59 × 10−7), and estimated salmonellosis cases per year (11.7 million population) was 88 (95% CI:

Dear Editor, We write to express a pressing concern about the health-seeking behaviour of asthma patients. As healthcare professionals, we have observed a troubling trend among individuals with asthma who often neglect their lung health and fail to seek appropriate treatment. This is concerning, since a chronic condition like asthma requires careful risk reduction management and improved quality of life.

Abstract The application of risk management strategies is a common approach in emergency response scenarios. However, scant knowledge exists regarding its utilization in the specific context of an outbreak, both theoretically and practically. This study delves into the realm of risk management during the COVID-19 pandemic, focusing on four key measurements: risk avoidance (RA), risk reduction (RD), risk transfer (RT), and risk retention (RR). Using 800 valid responses collected from 31 provinces across China between August 1 and September 30, 2020, this study investigates spatial disparities in individuals’ intentions towards risk management. To achieve this, an extended version of the Theory of Planned Behavior (E-TPB) is applied. The Structural Equation Model’s path analyses revealed several findings: (1) discernible spatial disparities in RR, RA, and RD intentions between large and small cities; (2) RD and RR intentions were significantly associated with attitude, subjective norm, perceived behavioral control, and risk perception; (3) RA and RT intentions were significantly associated with attitude and risk perception; (4) risk perception exihibiting both direct and indirect effects on RA and RR intentions. This study contributs to the urban studies literature by extending the theoretical framework of risk management in the context of COVID-19. It enhances the measurement tools employed in the TPB model and scrutinizes spatial disparities in the adoption of preventative measures against COVID-19. The findings underscore the importance for local policymakers to consider geographical differences when formulating effective strategies for COVID-19 prevention.

Artificial Intelligence (AI) models can predict patient readmission probabilities, aiding discharge decisions and preventing early discharges, which can lead to rehospitalization and related increased costs. EXplainable AI (XAI) methods, like SHAP, can identify important features for the predicted risk. However, the readmission risk and features importance are often considered not informative enough, as they lack in providing suggestions on how to reduce the risk when it is too high to discharge the patient. Our proposed method addresses this gap by using historical medical records of patients with profiles similar to the current case. It generates suggestions for modifying feature values to reduce the AI-predicted rehospitalization risk. By analyzing the historical data distribution of these features, our method infers optimal values and provides targeted suggestions to align current values with these ideals, offering a strategy for situations where discharge risk is deemed too high. In our approach, we explore different definitions of patient similarity to select historical cases and evaluate the effectiveness of the derived suggestions. This is compared with suggestions generated using random historical cases to determine the most effective case selection criteria. Using the MIMIC-III electronic health record dataset, our method demonstrated that two specific sets of historical cases achieved an 80% precision in suggestions, surpassing random case selections by 3%. Ultimately, this method provides recommendations to reduce the readmission risks, serving as a valuable tool in discharge planning. This contributes significantly to reducing premature discharges and the associated costs of rehospitalization.

Background: Coronary calcification is a well-established risk factor for cardiovascular events. This retrospective study sought to determine the predictive value of coronary calcification in a specific group of patients with chronic kidney disease. Methods: We included 1094 asymptomatic patients (724 males, 370 females, age 62 ± 9.3 years) referred for cardiological examination. Patents were divided into two groups depending on their renal function. Coronary calcification was determined with a multi-slice computer tomography (CT) scanner. For quantification of coronary calcification the Agatston score was calculated. Over a mean follow up period of 6.2 ± 1.3 years we observed the rate of cardiovascular events (185 events, 61 myocardial infarctions, 103 revascularizations, 21 cardiac deaths). Results: The calcium score was significantly higher in patients with severe kidney disease (glomerular filtration rate (GFR) ≤30 mL/min/1.72 m2) compared with those with normal to moderate reduced renal function (GFR ≥30 mL/min/1.72 m2) (207 ± 190 vs.121 ± 169, p ≤ 0.001). The event rate in patients with severe impaired renal function was significantly higher compared to patients with normal to moderate reduced renal function (20.6% vs. 14.8%, p = 0.0001). The hazard ratio for cardiovascular events increased constantly with the calcium score in both groups. The hazard ratio in patients with severe kidney disease was significantly lower compared to patients in corresponding groups with regular to moderate reduced renal function (7.3 vs. 9.3, p = 0.01). No cardiac events were observed in patients with a calcium score of 0. Conclusions: We could demonstrate that risk prediction with the calcium score is possible in patients with severe chronic kidney disease even if the calcium score overestimates the risk for future cardiovascular events compared to patients with normal to moderate reduced renal function.

IntroductionFew resources address steps clinicians can take to help patients reduce their risk of dementia, despite growing recognition that brain health can be optimized and that risk reduction for cognitive decline can be accomplished by lifestyle modifications.MethodsTo address this gap, UsAgainstAlzheimer's convened a risk reduction workgroup (RRWG) to review existing evidence and develop recommendations for primary care clinicians discussing cognitive decline and risk reduction with their patients.  RESULTS: The RRWG produced 11 consensus-based recommendations and implementation strategies across six topics: neurovascular risk management, physical activity, sleep, nutrition, social isolation, and cognitive stimulation.  DISCUSSION: These recommendations are a first step for clinicians to address brain health with patients and potentially help them prevent cognitive decline. To ensure there is routine care for brain health, proper incentives and policies must be instituted and more education for consumers should be provided.