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This is a commentary on the manuscript by Mpody C, Arends J, Aldrink J, et al., titled "Prognostic Profiling of Children with Serious Post-Operative Complications: A Novel Probability Model for Failure to Rescue".

Background: Prediction of patient outcomes following allogeneic hematopoietic stem cell transplantation (HSCT) remains a tenacious problem. An important limitation of current prediction models is the heterogeneity in outcome even among similar cases. We introduce a novel approach to individualizing estimates of leukemia-free survival (LFS) in acute leukemia patients undergoing haploidentical (haplo) HSCT. Methods: Data were obtained from the registry of the European Society for Blood and Marrow Transplantation for all cases of haplo HSCT for acute leukemia performed between 2011 and 2017. Patients receiving ex-vivo T-cell depleted grafts were excluded. Acute myeloid leukemia patients were classified by clinical disease ontogeny (de novo vs. secondary), cytogenetics, and FLT3-ITD/NPM1mut status; acute lymphoblastic leukemia patients by disease status and the presence of the Philadelphia chromosome. Common patient and transplantation parameters including recipient age, Karnofsky performance status (KPS), time from diagnosis to transplantation, conditioning and graft-versus-host disease (GvHD) prophylaxis were included. Data were split into training and geographic validation sets. Results: A total of 2,001 patients was included in the training set and another 270 in the validation cohort. In the training set, the median age was 50 years; 68% of patients were in complete remission, and 69% had a KPS ≥ 90; 87% received post-transplant cyclophosphamide and 13% antithymocyte globulin for GvHD prophylaxis. To provide the clinician insight on outcomes of similar patients, we developed a descriptive tool to visually explore outcomes of cases with comparable features. We next generated 50 random survival forest models for the prediction of 1-year LFS. In contrast to single point-estimates, the ensemble of 50 models generates a prediction interval accounting for predictive uncertainty. There was heterogeneity of variable importance between models, with either disease status or KPS leading in all models (Figure A). The model was well calibrated (Figure B); the median c-statistic was 0.64 on the validation set. An online interface presents the individual outcomes of the fifteen patients most similar to the index case, the prediction interval, and a visualization of all 50 survival forest predictions. Predictions for a sample patient are shown in Figure (C). Conclusions: We present the first system for individualized prediction of leukemia-free survival following T-cell replete haplo transplantation. A key, novel component of the model, distinguishing it from standard risk scores, is that it provides a measure of predictive certainty. This is essential for judging the robustness of prediction. Our approach is applicable to other clinical settings and can be used for designing risk-guided interventions and for informing patients and clinicians. Figure Disclosures Labopin: Jazz Pharmaceuticals: Honoraria. Blaise:Jazz Pharmaceuticals: Honoraria. Sica:F. Hoffmann-La Roche Ltd: Other: All authors received support for third-party writing assistance, furnished by Scott Battle, PhD, provided by F. Hoffmann-La Roche, Basel, Switzerland., Research Funding. Mohty:Stemline: Consultancy, Honoraria, Research Funding, Speakers Bureau; Takeda: Consultancy, Honoraria, Research Funding, Speakers Bureau; Jazz Pharmaceuticals: Consultancy, Honoraria, Research Funding, Speakers Bureau; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Sanofi: Consultancy, Honoraria, Research Funding, Speakers Bureau; Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau; BMS: Consultancy, Honoraria, Research Funding, Speakers Bureau; Celgene: Consultancy, Honoraria, Research Funding, Speakers Bureau; Amgen: Consultancy, Honoraria, Research Funding, Speakers Bureau; GSK: Consultancy, Honoraria, Research Funding, Speakers Bureau.

The study aimed to investigate the waste characteristics and management activities in the iron and steel industry in Southern Africa based on a case study in South Africa. A four-phased decision-support framework (DSF) has been suggested to approach industrial waste management in Southern Africa’s iron and steel industry, consisting of a desktop-based waste management audit, waste generation investigation, waste streams sampling and analysis, and waste risk profiling. Results indicate that the global average of 0.3 tons of waste generated per ton of crude steel produced is exceeded. Annual average process waste generation amounted to 1510 million tons, and general waste generation amounted to 872 tons, with respective recycling rates of 22% for process waste and 40% for general waste. Furthermore, 54% of the waste streams were found to have a moderate to high-risk profile, where the rest of the waste streams were found to have a low-risk profile. The suggested DSF, as a guide, can lead to decision outcomes to position industrial waste management in the iron and steel industry in Africa towards a circular economy.

It has been assumed that the greater the number of flying hours, the better the pilot is at solving problems. The studies suggest, however, that this issue is more complex. What is important is not only a pilot’s experience but also their personality traits such as temperament, aggression, and risk-taking tendencies, which all influence how the pilot reacts under stress. After examining 112 pilots of passenger planes, we found that individuals characterized by a high need for stimulation seek situations, consciously or not, of excessive or unnecessary risk to achieve the right level of stimulation. In terms of their psychological characteristics, the study also revealed that some pilots are less predisposed to be airline pilots.

Soil-transmitted helminth infections propagate poverty and slow economic growth in low-income countries. As with many other neglected tropical diseases, environmental conditions are important determinants of soil-transmitted helminth transmission. Hence, remotely sensed data are commonly utilised in spatial risk models intended to inform control strategies. In the present study, we build upon the existing modelling approaches by utilising fine spatial resolution Landsat 8 remotely sensed data in combination with topographic variables to predict hookworm prevalence in a hilly tribal area in southern India. Hookworm prevalence data collected from two field surveys were used in a random forest model to investigate the predictive capacity of 15 environmental variables derived from two remotely sensed images acquired during dry and rainy seasons. A variable buffer radius (100–1000 m) was applied to the point-prevalence locations in order to integrate environmental conditions around the village centroids into the modelling approach and understand where transmission is more likely. Elevation and slope were the most important variables in the models, with lower elevation and higher slope correlating with higher transmission risk. A modified normalised difference water index was among other recurring important variables, likely responsible for some seasonal differences in model performance. The 300 m buffer distance produced the best model performance in this setting, with another spike at 700 m, and a marked drop-off in R2 values at 1000 m. In addition to assessing a large number of environmental correlates with hookworm transmission, the study contributes to the development of standardised methods of spatial linkage of continuous environmental data with point-based disease prevalence measures for the purpose of spatially explicit risk profiling.

The Council for Scientific and Industrial Research (CSIR) has recently launched a state-of-the-art online climate risk profiling and adaptation tool to assist municipalities across South Africa to assess their risk and vulnerabilities, and respond by adapting settlements to climate change. The Green Book looks forwards to the year 2050 by projecting settlement growth combined with quantitative, scientific evidence of the likely impacts that climate change will have on South African towns and cities and its key resources. The tool provides appropriate adaptation measures to be considered for implementation towards the development of climate resilient settlements. The ultimate goal of the Green Book is to contribute to resilient, sustainable and liveable South African settlements through climate change adaptation. Co-funded by the Canadian International Development Research Centre and the CSIR and produced in collaboration with South Africa’s National Disaster Management Centre, the Green Book is the result of a 3-year initiative. More than 50 researchers and numerous stakeholders and reviewers were involved in producing the Green Book and reviewing its findings.

Demand is growing for data-driven tools which can provide greater understanding of societal challenges. Synthetic populations generated from publicly-held microdata offer potential for policymakers to gain insight into pressing policy issues while respecting the right to privacy of the citizen. This paper offers an example of an application of synthetic populations to generate a social profile of primary school children in rural Ireland. A spatially explicit school population is developed using a novel approach; employing combinatorial optimisation techniques on full coverage census microdata, and information on school location and enrolment. The resulting population provides a realistic portrait of rural educational risk across Ireland and can be used for spatial risk profiling, as the basis for an agent-based model, and to simulate the possible impact of a variety of policy initiatives aimed at improving equity in the education system.

[The Research Foundation Review 2018 summarizes the offerings from the CFA Institute Research Foundation over the past year—books, literature reviews, workshop presentations, and other relevant material.

Diarrhoeal diseases remain a major public health problem, causing more than half a million child deaths every year, particularly in low- and middle-income countries (LMICs). Despite existing knowledge on the aetiologies and causes of diarrhoeal diseases, relatively little is known about its spatial patterns in LMICs, including Senegal. In the present study, data from a cross-sectional survey carried out in 2016 were analysed to describe the spatial pattern of diarrhoeal prevalence in children under the age of 5 years in the secondary city of Mbour in the south-western part of Senegal. Bayesian conditional autoregressive (CAR) models with spatially varying coefficients were employed to determine the effect of sociodemographic, economic and climate parameters on diarrhoeal prevalence. We observed substantial spatial heterogeneities in diarrhoea prevalence. Risk maps, stratified by age group, showed that diarrhoeal prevalence was higher in children aged 25-59 months compared to their younger counterparts with the highest risk observed in the north and south peripheral neighbourhoods, especially in Grand Mbour, Médine, Liberté and Zone Sonatel. The posterior relative risk estimate obtained from the Bayesian CAR model indicated that a unit increase in the proportion of people with untreated stored drinking water was associated with a 29% higher risk of diarrhoea. A unit increase in rainfall was also associated with an increase in diarrhoea risk. Our findings suggest that public health officials should integrate disease mapping and cluster analyses and consider the varying effects of sociodemographic factors in developing and implementing areaspecific interventions for reducing diarrhoea.

An emerging objective in the IBD community is to gear the findings from genome-wide association studies towards achieving precision medicine. The main goal of this new model of disease management is to adapt clinical practice to the needs of each patient. This includes, among others, obtaining more detailed characterizations of disease presentation at diagnosis, better prediction of disease prognosis that permits to anticipate and adapt management to variations in symptomatology, and tailoring treatment to individual needs. In this chapter, we will introduce the methodology for estimation of disease risk using genetic data from individuals and discuss the potential and main challenges for using genomic risk profiling as a predictive tool that can pave the way for adoption of precision medicine-based approaches in the clinical management of IBD.

This chapter focuses on three questions in its quest to better understand the historical and comparative perspectives of charity regulation. Accepting the traditional rationales for such regulation, it first explores the question of ‘how we regulate’ followed by the interrelated question of the associated cost of such regulation. Finally, the chapter examines the important issues concerning how we currently (or could better) measure the success of charity regulatory efforts. The paper draws upon the experiences of charity regulators in a range of common law countries across the UK, Ireland, Australia, New Zealand and Singapore. Ian Potter Foundation Fellowship

AIM Centenarians represent a biological model of successful aging because they escaped/postponed most invalidating age-related diseases, such as cardiovascular diseases. The aim of the present study was to clarify whether a favorable cardiovascular risk profile increases the survival chances in long-lived people. METHODS A total of 355 community-dwelling nonagenarians and centenarians living in Southern Italy were recruited in the study. Patients were classified as at low and high cardiovascular risk on the basis of serum cholesterol, diabetes, hypertension and smoking status. The relationship between cardiovascular risk factors and 10-year mortality was investigated by Cox regression analysis. Splines-based hazard ratio curves were also estimated for total cholesterol, low-density lipoprotein cholesterol, and systolic and diastolic blood pressure. RESULTS Low levels of selected cardiovascular risk factors usually associated with lower mortality in adults do not increase survival chances among oldest-old individuals. In particular, after adjusting for age, sex, and cognitive, functional and nutritional status, serum cholesterol >200 mg/dL increased the survival chances during the follow-up period (hazard ratio 0.742, 95% CI 0.572-0.963). CONCLUSIONS The present results showed that in nonagenarians and centenarians, the clinical and prognostic meaning associated with traditional cardiovascular risk factors is very different from younger populations. Consequently, considering the increase of this population segment, further studies are required to confirm these results and to translate them into clinical practice/primary care. Geriatr Gerontol Int 2019; 19: 165-170.

Summary Accurate prediction of long-term outcomes remains a challenge in the care of cancer patients. Due to the difficulty of serial tumor sampling, previous prediction tools have focused on pretreatment factors. However, emerging non-invasive diagnostics have increased opportunities for serial tumor assessments. We describe the Continuous Individualized Risk Index (CIRI), a method to dynamically determine outcome probabilities for individual patients utilizing risk predictors acquired over time. Similar to “win probability” models in other fields, CIRI provides a real-time probability by integrating risk assessments throughout a patient’s course. Applying CIRI to patients with diffuse large B cell lymphoma, we demonstrate improved outcome prediction compared to conventional risk models. We demonstrate CIRI’s broader utility in analogous models of chronic lymphocytic leukemia and breast adenocarcinoma and perform a proof-of-concept analysis demonstrating how CIRI could be used to develop predictive biomarkers for therapy selection. We envision that dynamic risk assessment will facilitate personalized medicine and enable innovative therapeutic paradigms.

Actinic keratoses (AKs) represent in-situ squamous cell carcinomas that potentially invade subepidermal structures and may metastasize. Until now, it is unpredictable to determine which AK lesions show this aggressive behavior. As AKs usually occur in large sun exposed areas, field-directed treatments have become the standard treatment regimen. Among these, conventional photodynamic therapy (cPDT) with 5-aminolaevulinic acid (ALA) or methyl-aminolevulinate (MAL) using red light is particularly effective in the treatment of AKs, but acceptance of the therapy is impaired by severe pain during treatment. Daylight PDT (dPDT) has demonstrated to be an equally effective alternative treatment option which is less painful. Recent attempts to determine the risk of AKs that demonstrate particular aggressive biological behavior by implementation of clinical and histological characteristics of AKs have not lead to conclusive results. Therefore, a look at the molecular biology of AKs could serve as a useful tool to develop a risk profiling for separation of those patients that are of particular risk to develop invasive tumor and, by this, to facilitate a more effective and adapted treatment option.

Introduction The purpose of this study is to determine if the risk of receiving a blood transfusion during hip fracture hospitalization can be predicted by a validated risk profiling score (Score for Trauma Triage in Geriatric and Middle Aged (STTGMA)). Materials and Methods A consecutive series of 1449 patients 55 years and older admitted for a hip fracture at one academic medical center were identified from a trauma database. The STTGMA risk score was calculated for each patient. Patients were stratified into risk groups based on their STTGMA score quantile: minimal risk (0–50%), low risk (50–80%), moderate risk (80–95%), and high risk (95–100%). Incidence and volume of blood transfusions were compared between risk groups. Results There were 562 (38.8%) patients who received a transfusion during their admission. 58.3% of patients in the high risk group received a transfusion during admission compared to 31.2% of minimal risk group patients, 42.6% of low risk group patients, and 50.0% of moderate risk group patients ( p < 0.001). STTGMA was predictive of first transfusion incidence in both the preoperative and postoperative periods. There was no difference in mean total transfusion volume between the four risk groups. Conclusion The STTGMA model is capable of risk stratifying hip fracture patients more likely to receive blood transfusions during hospitalization. Surgeons can use this tool to anticipate transfusion requirements.

Enhanced ways to cope with climate change and environmental change are being made at various levels across the world. In the southern African region, despite the regions’ potential for economic growth, several disasters associated with climate stresses (particularly evidence made for repeated floods and droughts) can retard economic growth, development and livelihood security. In this paper, disaster inventories are argued to be useful ways of revealing nuanced analyses of extreme climate events and other challenges such as the spatial–temporal distribution of events and their impacts, particularly for vulnerable people groups. Despite repeated calls for vigilance about current and future climate variations and environmental change impacts, there are few detailed regional and country-specific inventories of disasters and records of subsequent humanitarian responses that record both impacts and possible implications of disaster events in the region. This paper draws together those data that do exist and offers a review of the occurrences, impacts and past responses to humanitarian crises in the region (for 14 countries over the period of 2000–2012). From this research a number of critical areas are profiled: first, the convergence of compound and complex shocks that occur simultaneously and/or sequentially is compounding disaster risks—including those associated with climate challenges. A review of international and regional UN agency, NGO and governmental reports all illustrates the need to articulate between internationally significant, ‘signature’ events and smaller, sub-national events with a higher recurrence interval that may be just as damaging to local communities. Second, the reach of disaster impacts is changing with the region becoming increasingly more mobile in terms of the movement patterns of people within countries and across borders, which brings with it new compound and complex threats such as cholera and measles outbreaks. Third, the nature of the changing disaster profile is placing strain on countries and the region. Sub-national disaster response due to personnel capacity limitations, at the national and municipal levels, is unable to effectively respond to and reduce risks associated with various shocks. In the paper, by providing an inventory of disasters and humanitarian responses in the southern African region, we point to the changing regional and national dimensions of the region’s disaster risk profile that, we suggest, will require a variety of responses.

Background and aims: Subclinical atherosclerosis assessed by sonographic intima-media-thickness measurement of the carotid artery (cIMT) is considered to be an early precursor of cardiovascular disease already in childhood. Structural analysis of the carotid intimal layer (carotid intima-media-roughness, cIMR) improves cardiovascular risk profiling for the adult patient and has been shown to be increased also in paediatric patients with elevated cardiovascular risk. To date, normal values for the paediatric age are lacking. Thus, we present normative data for a paediatric age group. Methods: 602 healthy German school children (age 8-18 y) were studied, and cIMT and cIMR calculated;reference values were given for three age groups (group 1: 8-10.99 years;group 2: 11-13.99 years;group 3: 14-17.99 years). Results: cIMT values were: 0.48 +/- 0.03 mm for girls and boys in age group 1, 0.49 +/- 0.03 mm for girls and boys in age group 2;and 0.45 +/- 0.03 mm for girls and 0.49 +/- 0.03 mm for boys in age group 3;cIMR was 0.04 +/- 0.01 mm for both sexes in age group 1 and 3;while in age group 2, both sexes showed a cIMR of 0.03 +/- 0.01 mm. Physical fitness was significantly negatively correlated with cIMR (r = -0.212, p < 0.0001) and a strong predictor for cIMR increase. Conclusions: The normative data of cIMR for a paediatric age group presented here allow for the identification of patients at elevated cardiovascular risk. By including cIMR as surface analysis of the arterial wall, the individual risk stratification may be improved compared to thickness-analysis of the Intima-Media-Layer (cIMT) also at a paediatric age. (C) 2016 Published by ELSEVIER.

This paper addresses the problem of trust in Modeling and Simulation (M&S) technologies, and uncertainty in applications to homeland security. The key goal of this paper is an extension of the notion of trusted M&S techniques for traveler risk assessment in mass-transit applications such as e-borders. Theories of uncertainty suggest that different understandings of uncertainty result in different mechanisms of its reduction. We show that a taxonomy of uncertainty that is accepted in philosophical studies, as well as the NATO methodology of uncertainty assessment (known as the Admiralty Code), can be useful in M&S. This paper overviews various approaches to M&S and focuses on a framework that is based on multi-source fusion mechanisms using Dempster–Shafer (DS) theory. The DS metric is useful for the development of simulators, recommender machines, and risk profilers when expert knowledge is given in an imprecise form. The difference between the Bayesian and DS metrics is introduced via a demonstrative experiment from the area of traveler risk assessment using a biometric-enabled watchlist.

Background Addressing all modifiable risk factors in a composite manner, instead of treating individual risk factors is the current approach in the management of cardiovascular diseases. In patients, attending chronic disease clinic in Urban Health Centre (UHC) functioning under a tertiary care teaching hospital, this study aims to assess 10-year cardiovascular risk using ‘WHO/ISH Cardiovascular Risk Prediction Charts’ and ‘Framingham General Cardiovascular Risk Profile using lipid levels’ and compare the level of agreement between the results obtained. Methodology A retrospective record review was carried out in urban chronic disease clinic during the months of May and June 2013. Records of 280 patients attending the Urban Health Centre were screened using a structured proforma and 180 of them were included subject to selection criteria. The analysis was carried out using IBM SPSS v 21. 10-year cardiovascular risk was calculated using the joint WHO/ISH charts and the General Framingham Cardiovascular Risk Profile charts. Level of agreement between the risk scores was compared using kappa statistics. Institution ethics committee approval was obtained before starting the project. Results 81.7% of the patients were women with a median age of 58 years. Less than half of the patients (45%) had hypertension and another 37.2% had both diabetes and hypertension. 71.6% of the patients had a Conclusion Framingham Risk Profile was found to identify more patients as belonging to the higher risk category as compared to WHO/ISH charts.

Background Goal-oriented communication of risk of hazards is necessary in order to reduce risk of workers' exposure to chemicals. Adequate training of workers and enterprise priority setting are essential elements. Cleaning enterprises have many challenges and the existing paradigms influence the risk levels of these enterprises. Methods Information on organization and enterprises' prioritization in training programs was gathered from cleaning enterprises. A measure of enterprises' conceptual level of importance of chemical health hazards and a model for working out the risk index (RI) indicating enterprises' conceptual risk level was established and used to categorize the enterprises. Results In 72.3% of cases, training takes place concurrently with task performances and in 67.4% experienced workers conduct the trainings. There is disparity between employers' opinion on competence level of the workers and reality. Lower conceptual level of importance was observed for cleaning enterprises of different sizes compared with regional safety delegates and occupational hygienists. Risk index values show no difference in risk level between small and large enterprises. Conclusion Training of cleaning workers lacks the prerequisite for suitability and effectiveness to counter risks of chemical health hazards. There is dereliction of duty by management in the sector resulting in a lack of competence among the cleaning workers. Instituting acceptable easily attainable safety competence level for cleaners will conduce to risk reduction, and enforcement of attainment of the competence level would be a positive step. Copyright 2015, Occupational Safety and Health Research Institute. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Purpose – The purpose of this paper was to determine factors that could be used to create different authentication requirements for diverse online banking customers based on their risk profile. Online security remains a challenge to ensure safe transacting on the Internet. User authentication, a human-centric process, is regarded as the basis of computer security and hence secure access to online banking services. The increased use of technology to enforce additional actions has the ability to improve the quality of authentication and hence online security, but often at the expense of usability. The objective of this study was to determine factors that could be used to create different authentication requirements for diverse online banking customers based on their risk profile. Design/methodology/approach – A web-based survey was designed to determine online consumers’ competence resecure online behaviour, and this was used to quantify the online behaviour as more or less secure. The browsers used by consumers as well as their demographical data were correlated with the security profile of respondents to test for any significant variance in practice that could inform differentiated authentication. Findings – A statistical difference between behaviours based on some of the dependant variables was evident from the analysis. Based on the results, a case could be made to have different authentication methods for online banking customers based on both their browser selected (before individual identification) as well as demographical data (after identification) to ensure a safer online environment. Originality/value – The research can be used by the financial services sector to improve online security, where required, without necessarily reducing usability for more “security inclined” customers.

Ma, L.; Li, Y.; Li, D.; Li, H.; Wang, Y., and Ren, C., 2020. Risk identification and decision making for P2P companies: An empirical study in the Bohai Coast regions. In: Gong, D.; Zhang, M., and Liu, R. (eds.), Advances in Coastal Research: Engineering, Industry, Economy, and Sustainable Development. Journal of Coastal Research, Special Issue No. 106, pp. 191–196. Coconut Creek (Florida), ISSN 0749-0208.This paper takes risk identification and risk profiling of new types of peer-to-peer (P2P) companies as the theme, efficiently integrates multidimensional variables, and builds a corporate risk identification model. On the basis of this model, it describes the risk profiling of P2P companies, thereby helping investors better identify corporate risks and reduce potential loss. This paper takes the data of 633 P2P platforms in the Bohai Coast regions extracted from the two authoritative websites of Wdzj and Tianyancha as examples, uses logistic regression models to analyze 16 variables in five dimensions, and draws the following conclusions: change log and platform transfer fees are significantly positively related to platform operating risks; platform background, platform management fees, and automatic bidding are significantly negatively related. Finally, it provides relevant recommendations on how investors choose a platform.

Despite modern therapeutics and treatment strategies, a subset of rheumatoid arthritis (RA) patients remains insufficiently responsive to multiple therapies. Here, we identify predictors of such refractory RA ("reRA").Patients from a longitudinal academic clinical database with reRA (defined as failing to reach the treatment target of at least low disease activity with ≥3 DMARD courses, including ≥1 biological, over a total of ≥18 months) were compared to patients who did respond within the first two treatments (treatment amenable RA, "taRA"). We performed logistic regression analysis to identify risk factors for refractory disease, and several sensitivity analyses concerning different potential definitions for reRA to confirm the robustness of the results; key findings were also validated in an independent community cohort.We enrolled 412 patients, of whom 70 were reRA and 102 taRA; 240 patients fulfilled neither definition. ReRA patients were more frequently female (92.9 vs. 70.6%, p 0.001), younger (44.37 vs. 51.14 years, p = 0.002), and had higher CDAI levels at first presentation (26.06 vs. 15.39, p 0.001). Treatment delay was significantly longer for reRA than for taRA (3.17 vs. 1.45 years, p = 0.001). In multivariable analyses, treatment delay, female gender and higher disease activity remained as independent predictors of refractory disease. Based on the identified predictors, we developed a matrix model for risk of future reRA.Our data identified delay to initial treatment, female gender and higher disease activity as important predictors of a later refractory course of RA. Delay of treatment initiation is the single most important modifiable risk factor of refractory disease.

The number of accidents and victims in the construction sector has not decreased significantly despite the increasingly stricter laws and regulations. The analysis of accidents, as well as their root causes and determinants can certainly contribute to the development of more effective preventive interventions. The present study proposes a methodology for the analysis and synthesis of data provided by accidents statistics with the goal of defining specific risk profiles based on the accidents determinants, their variables, and how they interact with one another in influencing the occurrence of an accident. For this purpose, a procedure capable of extracting this type of information from the European Statistics on Accidents at Work (ESAW) database was developed. In particular, data processing and aggregation are performed by means of the synergic use of the Matrix of Descriptors (MoD) and cluster analysis. To validate such a procedure, the analysis of fatalities due to electrical shocks was carried out. The results achieved allowed us to elicit valuable information for both safety managers and decision makers. The proposed methodology can facilitate a systemic analysis of accidents databases reducing the difficulties in managing reports and accident statistics.

Purpose of Review Hypertension affects more than 30% of the world’s adult population and thiazide (and thiazide-like) diuretics are amongst the most widely used, effective, and least costly treatments available, with all-cause mortality benefits equivalent to angiotensin-converting enzyme inhibitors or calcium channel antagonists. A minority of patients develop thiazide-induced hyponatremia (TIH) and this is largely unpredictable at the point of thiazide prescription. In some cases, TIH can cause debilitating symptoms and require hospital admission. Although TIH affects only a minority of patients exposed to thiazides, the high prevalence of hypertension leads to TIH being the most common cause of drug-induced hyponatremia requiring hospital admission in the UK. This review examines current clinical and scientific understanding of TIH. Consideration is given to demographic associations, limitations of current electrolyte monitoring regimens, clinical presentation, the phenotype evident on routine clinical blood and urine tests as well as more extensive analyses of blood and urine in research settings, recent genetic associations with TIH, and thoughts on management of the condition. Recent Findings Recent genetic and phenotyping analysis has suggested that prostaglandin E2 pathways in the collecting duct may have a role in the development of TIH in a subgroup of patients. Greater understanding of the molecular pathophysiology of TIH raises the prospect of pre-prescription TIH risk profiling and may offer novel insights into how TIH may be avoided, prevented and treated. Summary The rising prevalence of hypertension and the widespread use of thiazides mean that further understanding of TIH will continue to be a pressing issue for patients, physicians, and scientists alike for the foreseeable future.

This paper is an investigation into the issues related to introducing automation to portfolio optimisation for risk matching. Three main aspects are discussed. First, the South African legal context, which determines what is permissible and what is required in terms of automated decision making. Secondly, the risk profiling aspect discusses problems in the design and use of risk profiler questionnaires. As a solution we propose a standardised risk profiler which addresses the issues identified in traditional risk profilers. Finally, the portfolio optimisation section discusses different models of risk and proposes a constrained multi-objective model for retirement portfolio optimisation suited to the South African context.

In this chapter, the book investigates how the Fire and Rescue Services (FRS) develop risk profiles which outline the people, and the places that they live in, that are most vulnerable to fire risk. The chapter reveals in detail how these risk profiles are assembled in a way that draws on both information supplied by software called MOSAIC that is designed and sold by the credit-checking company Experian and anonymised information that has been generated through investigations where fatalities have resulted from fires. I argue that risk profiling allows for an elaboration on the processes of subjectification and forms of subjectivity that emerge where massive sets of data are used and governance seeks to intervene upon futures yet to occur.

Background Strongyloides stercoralis and hookworm are two soil-transmitted helminths (STH) that are highly prevalent in Cambodia. Strongyloides stercoralis causes long-lasting infections and significant morbidity but is largely neglected, while hookworm causes the highest public health burden among STH. The two parasites have the same infection route, i.e. skin penetration. The extent of co-distribution, which could result in potential high co-morbidities, is unknown in highly endemic settings like Cambodia. The aim of this study was to predict the spatial distribution of S. stercoralis-hookworm co-infection risk and to investigate determinants of co-infection in Preah Vihear Province, North Cambodia. Methods A cross-sectional survey was conducted in 2010 in 60 villages of Preah Vihear Province. Diagnosis was performed on two stool samples, using combined Baermann technique and Koga agar culture plate for S. stercoralis and Kato-Katz technique for hookworm. Bayesian multinomial geostatistical models were used to assess demographic, socioeconomic, and behavioural determinants of S. stercoralis-hookworm co-infection and to predict co-infection risk at non-surveyed locations. Results Of the 2576 participants included in the study, 48.6% and 49.0% were infected with S. stercoralis and hookworm, respectively; 43.8% of the cases were co-infections. Females, preschool aged children, adults aged 19–49 years, and participants who reported regularly defecating in toilets, systematically boiling drinking water and having been treated with anthelmintic drugs had lower odds of co-infection. While S. stercoralis infection risk did not appear to be spatially structured, hookworm mono-infection and co-infection exhibited spatial correlation at about 20 km. Co-infection risk was positively associated with longer walking distances to a health centre and exhibited a small clustering tendency. The association was only partly explained by climatic variables, suggesting a role for underlying factors, such as living conditions and remoteness. Conclusions Both parasites were ubiquitous in the province, with co-infections accounting for almost half of all cases. The high prevalence of S. stercoralis calls for control measures. Despite several years of school-based de-worming programmes, hookworm infection levels remain high. Mebendazole efficacy, as well as coverage of and compliance to STH control programmes should be investigated. Electronic supplementary material The online version of this article (10.1186/s13071-017-2604-8) contains supplementary material, which is available to authorized users.

Risk maps facilitate discussion among different stakeholders and provide a tool for spatial targeting of health interventions. We present maps documenting shrinking risk profiles after deworming with respect to soil-transmitted helminthiasis among schoolchildren from disadvantaged neighbourhoods in Port Elizabeth, South Africa. Children were examined for soil-transmitted helminth infections using duplicate Kato-Katz thick smears in March 2015, October 2015 and May 2016, and subsequently treated with albendazole after each survey. The mean infection intensities for Ascaris lumbricoides were 9,554 eggs per gram of stool (EPG) in March 2015, 4,317 EPG in October 2015 and 1,684 EPG in March 2016. The corresponding figures for Trichuris trichiura were 664 EPG, 331 EPG and 87 EPG. Repeated deworming shrank the risk of soil-transmitted helminthiasis, but should be complemented by other public health measures.

The article considers the issues of preliminary planning of audit, including documentation of new client risk profiling procedures.

While tendering for jobs, a contractor is expected to analyse the various risks in each prospective project and price them appropriately. Contingencies are included in the tender price to cater for the various risks based on their impacts on the project targets and profit margin. Currently in New Zealand (NZ), there is little or no information on the various contractual risks and their mitigation measures. This has led to contractors over compensating or under compensating for risks with costly consequences. This study aimed to establish priority contractual risks in the NZ construction industry, and their mitigation measures. The research was based on a questionnaire survey of consultants and contractors. Descriptive statistics and multi-attribute techniques were used in the data analysis. Results showed 21 risk factors which were segregated into 6 broad categories in diminishing levels of significance as follows: Site conditions, main contractor, pricing, subcontractor, external and client- related risks. Putting tags and conditions to risky price items in the tender bids, and transferring the risks onto other parties were analysed as the 2 most effective out of the 5 key risk mitigation measures identified. Being cautious of the priority risks and application of the identified effective risk mitigation measures could guide contractors and the project team to more appropriately budget for and respond to risks, thereby ensuring more satisfactory project outcomes.