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Contractors face most of the construction risks among stakeholders, and insurance is a common method to mitigate these risks. However, not all risks are insurable. While prior studies have typically assessed risk insurability through a binary approach (insurable versus non-insurable) and lacked clear criteria, this study offers a novel perspective by evaluating the insurability of construction risks based on four criteria: 'accidental events,' 'quantifiable,' 'numerous and homogenous,' and 'evaluable.' This study develops a fuzzy-based model to assess the degree of the construction risk insurability, accounting for the uncertainty, imprecision, and vagueness inherent in evaluating insurability against a specific criterion and criteria combinations. The model is applied to assess the insurability of several construction risks, illustrating its practical application. This paper concludes by discussing the model's limitations and suggesting directions for future research. [ABSTRACT FROM AUTHOR]

Patients often present with symptoms that are disproportionate to the observed disease state, and grade disease severity differently from healthcare providers (HPs). This discordant symptom burden and severity grading (DSG) results in poorer patient care. Current research on DSG is limited, relying on structured models that are theoretically incomplete. To fully understand the factors driving DSG. Qualitative study of dermatology patients and HPs. Interview data were analyzed using grounded theory to derive a model of the causes of DSG. Eighteen patients and 12 HPs were interviewed. Results reflect a tendency for patients to grade their conditions more severely than HPs. Factors driving DSG are related to emotional and cognitive disparities in the constructs used to grade severity, varying consequences of disease due to differing resilience and coping methods, socio-psychological factors influencing how patients report their symptoms, and the context of the consult. A better understanding of DSG is required for achieving mutual understanding and patient-centered collaborative care. It is easy to label a patient with high symptom burden as having a low threshold for discomfort, or for a patient to presume that the doctor is unempathetic. This study suggests the causes of DSG are nuanced and multifactorial. [ABSTRACT FROM AUTHOR]

Introduction: Biofilm contributes significantly to bacterial persistence in endoscope channels. Enhanced cleaning methods capable of removing biofilm from all endoscope channels are required to decrease infection risk to patients. This head-to-head study compared cyclic build-up biofilm removal of an automated endoscope channel cleaner (AECC) with standard manual cleaning according to instructions for use (IFU) in polytetrafluorethylene channels., Methods: Cyclic build-up biofilm was grown in 1.4-mm (representing air/water and auxiliary channels) and 3.7-mm (representing suction/ biopsy channels) inner diameter polytetrafluorethylene channels. All channels were tested for residual total organic carbon, protein, and viable bacteria. Internationally recognized ISO 15883-5:2021 alert levels were used as cleaning benchmarks for protein (3 μg/cm 2 ) and total organic carbon (6 μg/cm 2 )., Results: The automated cleaner significantly outperformed manual cleaning for all markers assessed (protein, total organic carbon, viable bacteria) in 1.4-mm and 3.7-mm channels representing air/water/auxiliary and suction/biopsy channels, respectively. Manual cleaning failed to remove biofilm from the air/water and auxiliary channels. According to the IFU, these channels are not brushed, suggesting a potential root cause for a portion of the numerous endoscopy-associated infections reported in the literature., Conclusion: AECC shows potential to deliver enhanced cleaning over current practice to all endoscope channels and may thereby address infection risk., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Our aim is to highlight a case report of pneumothorax post-shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors. We report the case of a 75-year-old male non-smoker, who underwent right shoulder arthroscopy without regional anaesthesia in the left lateral position and subsequently suffered a pneumothorax post-operatively. A PubMed Medline and Cochrane database search was carried out, and 32 articles were identified and thoroughly reviewed. Overall, among the articles that propose a mechanism, 75% (9/12) consider the pathogenesis to be multifactorial. The exact mechanism is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should maintain a low threshold for obtaining diagnostic plain radiographs in the event of clinical suspicion., Competing Interests: The authors declare no potential conflict of interest., (© 2024 Malaysian Orthopaedic Association (MOA). All Rights Reserved.)

Meningiomas are neoplasm arising from meningoepithelial cells, most commonly in the fifth to sixth decade of life. Meningiomas are rare in paediatric population, accounting for 0.4-4.1% of all paediatric tumours and less than 3% of paediatric brain tumours. However, meningiomas represent the most common dural based tumours in children. We describe a rare case of paediatric fibroblastic meningioma within the left middle cranial fossa masquerading as an intra-axial mass lesion. Our discussion will be centred on atypical features of paediatric meningiomas and differential diagnosis of extra-axial mass lesion in the paediatric population.

Ureaplasma spp. are associated with preterm birth. In recent times, it has become apparent that Ureaplasma parvum, but not Ureaplasma urealyticum, is of most relevance. We recently demonstrated this in Australian pregnant women and using high-resolution melt (HRM) PCR, further showed that U. parvum genotype SV6 was of particular significance. However, our assay was unable to identify multiple genotypes in the same sample, required a separate species-level qPCR for low titre samples and was not ideal for diagnostic laboratories due to the nature of HRM PCR result interpretation. Consequently, our current study developed a novel, one-step PlexPCR assay capable of detecting U. parvum and genotypes SV1, SV3 and SV6 in a single reaction directly from clinical samples. We then validated this using vaginal swab DNA from our Australian cohort of pregnant women. The PlexPCR was highly sensitive, detecting all targets to between 0.4 × 10 -5  ng DNA (SV3) and 0.4 × 10 -6  ng DNA (U. parvum, SV1 and SV6). Compared to our HRM PCR, the PlexPCR defined genotype distribution in all seven cases previously reported as 'mixed', and detected another eight cases where multiple genotypes (two) were present in samples previously reported as single genotypes using HRM PCR., Significance and Impact of the Study: Ureaplasma spp. have been associated with prematurity for decades, however, only a minority of studies have examined this beyond the genus level. In those that have, Ureaplasma parvum has been strongly associated with preterm birth. We recently demonstrated this in Australian women and further showed that U. parvum genotype SV6 was of particular significance. Our PlexPCR assay allows rapid detection and concurrent genotyping of U. parvum in clinical samples and may be of particular interest to obstetricians, particularly those caring for women at a high risk of preterm birth, and any other disease phenotypes where U. parvum is of interest., (© 2017 The Authors. Letters in Applied Microbiology published by John Wiley & Sons Ltd on behalf of The Society for Applied Microbiology.)