Understanding Osteoporosis: Pathophysiology, Risk Factors, Diagnosis, and Management

Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.

Risk Assessment,Management and Application in Nuclear Power Plant Operation

To introduce the basic concepts of technical specification of nuclear power plant,a risk assessment and management technique based on the probabilistic safety analysis( PSA) method was proposed. The risk-informed method was used,and an example was given to show how to use some specific risk metrics like CDF / LERF /ICDP / ILERP to analyze and manage the risk associated with activities in nuclear power plant operation. The advantage of this technique can be concluded from this paper,and this technique should be used more widely and deeply in nuclear industry.

Risk Assessment and Management of Hazardous Hydrological and Geological Processes in Ukraine

Due to long and irrational land-utilization, Ukraine deals with one of the most strained ecological situations in Europe. This work is devoted to the study of land resources transformation that was caused by human activity. The subject of study is to assess and forecast physical land and soil degradation, associated with the technical intensification of hazardous exogenous processes. The research is based on the use of methods of ecologic-geomorphological analysis, mathematical-statistical modeling and forecasting. This project gives characteristics to the main anthropogenic factors of threats and risks to land and soil, which take place in the territory of Ukraine. The estimation was conducted relatively dangerous hydrological and geological processes that are key factors of physical degradation of resources. These processes include erosion, flooding, secondary waterlogging, landslides and other collapsed phenomena. Graphic models reflect specific factors and environmental consequences of the most dangerous exogenous processes. Predicted is the development of dangerous hydrological and geological processes, influenced by technogenic factors. Different scenarios of physical land degradation are developed by the example of a specific technonatural geosystem. A measurement system of the sustainable usage and management of soil condition in Ukraine is improved.

On the Application of IPRA Tool in Risk Assessment and Management of International Construction Projects

Construction companies face threats from competition and must be able to adjust to modem technology and changes in customer expectations. These issues require efficient risk management techniques. The success of construction companies running projects in international markets depends on how the risks arise from the host country conditions as well as the project specific risk factors. Successful management of risks requires identification of risks, construction of a risk model which can be used to assess the magnitude of risks, and implementation of response strategies so that an acceptable risk-return balance can be achieved. The project success usually depends on the combination of all risks, response strategies used to mitigate risks, and a company＇s ability to manage them. There exists a need to develop risk models containing the risks of doing business in international markets and factors that affect manageability of these risks. One of the market＇s critical challenges is scheduled management and the understanding and application of program management. This paper uses systematic risk identification, classification and analysis, and measurement and response methodologies to help international contractors quantify the risks of project development and accomplishment.

A Socio-Technical Approach to Cyber Risk Management and Impact Assessment

Technology is increasingly being used by organisations to mediate social/business relationships and social/business transactions. While traditional models of impact assessment have focused on the loss of confidentiality, integrity and availability, we propose a new model based upon socio-technical systems thinking that places the people and the technology within an organisation’s business/functional context. Thus in performing risk management in a cyber security and safety context, a detailed picture of the impact that a security/safety incident can have on an organisation is developed. This in turn stimulates a more holistic view of the effectiveness, and appropriateness, of a counter measure.

Tangible Assets Threats and Hazards： Risk Assessment and Management in the Port Domain

Port systems are more prone to being risk oriented. Many specific methods have been found to assess risk in a port area or operation. A review is presented in different approaches on human and environmental risks in port area. On the other hand, there is no specific risk management method or fi＇amework to cope with threats and hazards regarding on port machines or material accidents and port assets damages or losses. This paper presents a risk management methodology, seeking to investigate a process of assessing the assets hazards and damages into the domain of port container terminal, by taking into account its different factors and their mutual influences. This methodology constitutes a decision support framework that will be used to conduct port to port risk evaluations or to assess a whole port＇s and terminal＇s risk level in the critical field of assets damages and losses, in order to facilitate improvement strategies. An empirical study is contacted for the years of 2003-2012, in order to provide evidence for risk assessment and management in an economic effective way, regarding port assets damages and losses, at the Port Container Terminal of Piraeus in Greece.

Research about Online Security Warning and Risk Assessment of Power Grid Based on Energy Management System

In this paper, online security warning and risk assessment of power grid are proposed, based on data from EMS （Energy Management System）, combined with information of real-time operation state, component status and external operating environment. It combines the two factors, contingency likelihood and severity, that determine system reliability, into risk indices on different loads and operation modes, which provide precise evaluation of the power grid＇s security performance. According to these indices, it can know the vulnerable area of the system and whether the normal operating mode or repair mode is over-limited or not, and provide decision-making support for dispatchers. Common cause outages and equipment-aging are considered in terms of the establishment of outage model. Multiple risk indices are defined in order to reflect the risk level of the power grid more comprehensively.

Application of Hazard Vulnerability Analysis Based on Kaiser Model in Neonatal Breast Milk Management

Objective:To analyze the existing risks in breast milk management at the neonatal department and provide corresponding countermeasures.Methods:22 risk events were identified in 7 risk links in the process of bottle-feeding of breast milk.Hazard Vulnerability Analysis based on the Kaiser model was applied to investigate and evaluate the risk events.Results:High-risk events include breast milk quality inspection,hand hygiene during collection,disinfection of collectors,cold chain management,hand hygiene during the reception,breast milk closed-loop management,and post-collection disposal.Root cause analysis of high-risk events was conducted and breast milk management strategies outside the hospital and within the neonatal department were proposed.Conclusion:Hazard Vulnerability Analysis based on the Kaiser model can identify and assess neonatal breast milk management risks effectively,which helps improve the management of neonatal breast milk.It is conducive to the safe development and promotion of bottle feeding of breast milk for neonates,ensuring the quality of medical services and the safety of children.

Comparing rockfall hazard and risk assessment procedures along roads for different planning purposes

Hazard and risk assessment procedures of different types of rockfall were analyzed to compare their outcomes when they are applied to the same case study.Although numerous methodologies are available in literature,rockfall hazard and risk analyses are often limited to standard estimations,affected by a margin of uncertainty,especially when relevant engineering projects are about to be realized.Based on the design purpose,different types of approaches can be chosen among the qualitative and quantitative ones available in literature,which allow different levels of analysis.One of the main criticisms related to rockfall events is the risk affecting linear structures,such as road or railways,due both to their strategic relevance for trade and communications and to the great entity of the exposed value(traffic units)traveling along them.In this perspective,a comparison between the qualitative method known as Evolving Rockfall Hazard Assessment(EHRA),the semi-quantitative modified Rockfall Hazard Rating System(RHRS)and the quantitative Rockfall Risk Management(RoMa)approach is herein commented according to a practical application to a case study.It is the case of the rockfall threat along slopes crossed by a strategic road connecting two of the most known spots of eastern Sicily(Italy),at the Taormina tourist complex.Data were retrieved from both recent literature and technical surveys on field.Achieved results highlight how the approaches are affected by a different level of detail and uncertainty,arising also by some necessary assumption that must be taken into account,especially when mitigation measures or territory planning have to be designed.Achieved results can be also taken into account for similar studies worldwide,in order to choose the most suitable procedure based on the design purpose.This is indeed crucial in the perspective of the optimization of time and economic resources in the territorial planning practice.

Critical role of risk management in ground engineering and opportunities for improvement

Green mining is concerned with mining in a sustainable manner, such that the needs of the present are met without compromising future generations. The achievement of this objective depends on balancing social, environmental and economic objectives and has to have regard to both active mining operations and legacy issues associated with mine closure. Ground engineering has a critical role in achieving green mining objectives but its contribution is characterised by pervasive uncertainty. Uncertainty equates to risk. This means that ground engineering should be practiced within a risk management framework that aims to both prevent unwanted outcomes and to mitigate their consequences to an acceptable level. This keynote address presents the fundamentals of risk management and demonstrates its effectiveness by reference to improvements in the safety performance of the NSW coal sector over the past three decades.Nevertheless, ground control remains a mix of art and science, relying heavily on judgements which should be premised on knowledge, skill and experience(that is, competence). Risk management has now been enshrined in mining legislation and operating practice in Australia for over two decades.Notwithstanding this, near-hit and accident and incident investigations, commissions of inquiry and legal proceedings almost invariably identify deficiencies and opportunities for improvements necessary to achieve the objectives of sustainable mining. Three of the more important opportunities which have global application in relation to ground engineering are discussed. These relate to the vexing issue of defining competency in ground engineering; the criteria for undertaking rigorous risk assessment; and the need for ground engineers to become involved in mine rehabilitation and closure planning over the full life cycle of a mine, commencing at the prefeasibility stage.

Predictive value of the unplanned extubation risk assessment scale in hospitalized patients with tubes

BACKGROUND Critical patients often had various types of tubes,unplanned extubation of any kind of tube may cause serious injury to the patient,but previous reports mainly focused on endotracheal intubation.The limitations or incorrect use of the unplanned extubation risk assessment tool may lead to improper identification of patients at a high risk of unplanned extubation and cause delay or nonimplementation of unplanned extubation prevention interventions.To effectively identify and manage the risk of unplanned extubation,a comprehensive and universal unplanned extubation risk assessment tool is needed.AIM To assess the predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale in inpatients.METHODS This was a retrospective validation study.In this study,medical records were extracted between October 2020 and September 2021 from a tertiary comprehensive hospital in southwest China.For patients with tubes during hospitalization,the following information was extracted from the hospital information system:age,sex,admission mode,education,marital status,number of tubes,discharge mode,unplanned extubation occurrence,and the Huaxi Unplanned Extubation Risk Assessment Scale(HUERAS)score.Only inpatients were included,and those with indwelling needles were excluded.The best cut-off value and the area under the curve(AUC)of the Huaxi Unplanned Extubation Risk Assessment Scale were been identified.RESULTS A total of 76033 inpatients with indwelling tubes were included in this study,and 26 unplanned extubations occurred.The patients’HUERAS scores were between 11 and 30,with an average score of 17.25±3.73.The scores of patients with or without unplanned extubation were 22.85±3.28 and 17.25±3.73,respectively(P<0.001).The results of the correlation analysis showed that the correlation coefficients between each characteristic and the total score ranged from 0.183 to 0.843.The best cut-off value was 21,and there were 14135 patients with a high risk of unplanned extubation,accounting for 18.59%.The Cronbach’sα,sensitivity,specificity,positive predictive value,and negative predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale were 0.815,84.62%,81.43%,0.16%,and 99.99%,respectively.The AUC of HUERAS was 0.851(95%CI:0.783-0.919,P<0.001).CONCLUSION The HUERAS has good reliability and predictive validity.It can effectively identify inpatients at a high risk of unplanned extubation and help clinical nurses carry out risk screening and management.

Risk Thinking in ISO Quality Management System

The importance of risk thinking is emphasized in the ISO quality management system.In order to do a good job in quality management,we should use risk thinking to do a good job in risk management,improve the level of quality management,and enhance customer satisfaction,so that enterprises can meet the international quality certification standards in the process of development,and have greater development space in the market.Therefore,this paper studies the risk thinking in the ISO quality management system,summarizes the concept of risk thinking in the ISO quality management system,analyzes the problems existing in the application of risk thinking in the ISO quality management system of Chinese enterprises,and puts forward some suggestions for improvement one by one.It is hoped that the analysis can promote Chinese enterprises to fully integrate risk-based thinking into quality management,calmly cope with risks and opportunities,and make customers more satisfied with their services and products.

Risk Assessment at the Design Phase of Construction Projects in Ghana

The study was carried out exclusively in Ghana to explore the approaches employed by consultants in risk assessment at the design phase of projects in Ghana. One hundred and fourteen (114) consultants were selected out of a population of one hundred and eighty six (186) from three main professional associations in Ghana made up of the Ghana Institute of Architects, Ghana Institution of Engineers and the Ghana Institution of Surveyors (Quantity Surveying Division) practicing in Ghana for the study. Both primary and secondary data were collected. A descriptive survey was also used to observe and describe the presence, frequency or absence of characteristics of a phenomenon as it naturally occurred, in order to gain additional information. A questionnaire was also designed to collect data from the architects, engineers and quantity surveyors. The data was analyzed using Statistical Package for the Social Scientists (SPSS) 17.0. Descriptive and inferential statistics, such as frequency tables, percentages and cross tabulations were used in the data analysis and summaries. Simple tests of associations were undertaken by using Chi square and Cramer’s V statistics to compare relationships between variables. Again, relative importance index was also used to analyze some of the data by computing to deduce their rankings. The relative importance index was used to analyze some of the data by computing to deduce their rankings. The research revealed that majority of consultants had an average knowledge of risk management. Based on the findings it was recommended that consultants undergo advanced training in risk assessment. It was therefore suggested that consultancy firms should develop a set of laid down procedures for consultants to use in risk assessment in order that the use of intuition employed by majority is lessened. The challenges observed in risk assessment and the remedial steps suggested curtailing the detrimental effects of risks would be of wide importance to many developing economies.

Heart Rate Variability Applied to Short-Term Cardiovascular Event Risk Assessment

Cardiovascular disease (CVD) risk assessment is an important instrument to enhance the clinical decision in the daily practice as well as to improve the preventive health care promoting the transfer from the hospital to patient’s home. Due to its importance, clinical guidelines recommend the use of risk scores to predict the risk of a cardiovascular disease event. Therefore, there are several well known risk assessment tools, unfortunately they present some limitations.This work addresses this problem with two different methodologies:1) combination of risk assessment tools based on fusion of Bayesian classifiers complemented with genetic algorithm optimization;2) personalization of risk assessment through the creation of groups of patients that maximize the performance of each risk assessment tool. This last approach is implemented based on subtractive clustering applied to a reduced-dimension space.Both methodologies were developed to short-term CVD risk prediction for patients with Acute Coronary Syndromes without ST segment eleva-tion (ACS-NSTEMI). Two different real patients’ datasets were considered to validate the developed strategies:1) Santa Cruz Hospital, Portugal, N=460 patients;2)LeiriaPombal Hospital Centre, Portugal, N=99 patients.This work improved the performance in relation to current risk assessment tools reaching maximum values of sensitivity, specificity and geometric mean of, respectively, 80.0%, 82.9%, 81.5%. Besides this enhancement, the proposed methodologies allow the incorporation of new risk factors, deal with missing risk factors and avoid the selection of a single tool to be applied in the daily clinical practice. In spite of these achievements, the CVD risk assessment (patient stratification) should be improved. The incorporation of new risk factors recognized as clinically significant, namely parameters derived from heart rate variability (HRV), is introduced in this work. HRV is a strong and independent predictor of mortality in patients following acute myocardial infarction. The impact of HRV parameters in the characterization of coronary artery disease (CAD) patients will be conducted during hospitalization of these patients in the Leiria-Pombal Hospital Centre (LPHC).

The 2008 Irish Dioxin Crisis:Prevention is better than Crisis Management

In Ireland, in 2008, pig feed manufactured from recycled human food became contaminated with dioxin and this led to a global recall of all Irish pork products produced from 1st September to 6th December 2008. This case study illustrates several points a) the food chain is only as secure as its weakest link, b) due to the complexity of the modern food chain, once pork is processed, precise traceability to a particular farm of origin is impossible, c) even with a single food agency, overseeing the policing of the food chain, things can go wrong, d) it demonstrated the benefits of having credible consumer protection agencies to undertake scientific risk assessment and communicate with the public, e) if risk management decisions are taken quickly, and communicated in an open and transparent manner to the public, adverse human health effects can be avoided and consumer confidence can maintained, f) in the EU the legal limit for dioxins in pork fat is 1 picogram per gram (10-12 ) and attempting to communicate the risks associated with this level of contamination plus the concepts of bioaccumulation and body burden and the need for continued exposure to result in adverse health effects is extremely challenging, g) there was a major economic impact and damage to the country's reputation as a food exporter and finally h) it illustrates that prevention is better that crisis management. Other countries can learn lessons from this incident that may prevent similar occurrences in their jurisdictions.

Migration and risks of potentially toxic elements from sewage sludge applied to acid forest soil

`The application of sewage sludge(SS)to forested lands may lead to the downward migration of potentially toxic elements(PTEs)through rainfall and thus pose risk to the subsoil and groundwater.Batch column experiments were conducted using leaching water equivalent to the rainfall amount in the study area over 3 years to investigate changes in concentrations of PTEs,including copper(Cu),zinc(Zn),lead(Pb),cadmium(Cd),and nickel(Ni)in the leachate from the acidic forest soil.Water quality index of leachate,potential ecological risk and human health risk in soil at different leaching stages were compared.Sewage sludge was applied at SS/soil mass ratios of 0:100(controls),15:85(T1),30:70(T2),45:55(T3),60:40(T4),and 75:25(T5).All treatments resulted in increased PTEs concentration in the upper 20 cm soil,T3-T5 increased potential ecological risk from"low"(control)to"moderate"or"considerable".During first year leaching,PTEs concentration increased with increasing SS/soil ratios,but the water quality index of T1-T3 was"excellent"or"good".Pb,Cu,Cd,and Ni in the 20-40 cm soil depth,and Zn in the 60-80 cm soil depth were also enriched,but potential ecological risk was"low".In subsequent leaching,PTEs concentration of leachate gradually returned to the background value and water quality index was"excellent".There were no significant changes in PTEs and ecological risk observed.During the monitoring process,the health risk caused by the migration of PTEs to the human body was always within the acceptable range.Overall,this study provides a reference for the management of risks from the application of SS on forestlands,i.e.,SS/soil ratios<45:55 is recommended on forestlands,and special attention should be given to early leaching risk.In addition,it also provides an important assessment method for the risk of PTEs leaching and migration in forested land application.

低空空域无人机运行安全保障技术研究综述

低空空域飞行活动日趋频繁,无人机类型多样且性能差异较大,飞行过程中易与建筑物或其他航空器发生飞行冲突。为实现低空空域的规范化、安全化、精细化和智慧化管控,需不断提升保障无人机运行安全的技术手段,例如冲突风险探测、安全风险评估等。文章从无人机的轨迹预测与意图识别、低空空域飞行冲突探测、低空空域风险评估及预警告警等3方面进行了研究。首先,总结了在无人机轨迹预测和意图识别方面的研究成果和面临的问题挑战;其次,基于低空空域冲突探测形式,分析不同探测方法的优缺点;随后,围绕低空空域风险评估及预警告警技术,分析当前研究需要解决的核心问题;最后,对无人机冲突探测和风险评估技术等方面进行了展望。

依赖模糊层次分析算法的建设工程项目风险分析

近年来对建筑项目风险管理的研究逐步全面。由于建筑工程项目风险受技术、人力、环境、质量等诸多因素的影响,加之现如今存在监理监管和项目管理等多种项目风险评估方式,项目风险评估的准确性存在不准确等问题。首先基于建筑工程施工的基本流程,建立了建筑工程施工阶段风险管理模型,在模型的基础上,研究了基于AHP和模糊算法的风险评估方法的建设工程项目风险分析法,并分别以监理监管、项目管理、两者并行管理三种方式,对项目风险进行了计算。结果显示,采用两者并行的管理方式,其项目风险更低。

护士在健康风险评估及管理中的作用

护士作为健康风险评估与管理的前沿窗口和重要纽带,在个体和人群的健康管理中发挥着重要作用。文章基于大健康视角及数智化趋势,综述了护士在健康信息收集、健康体检与信息监测、健康风险因素预判、健康风险管理的实施与效果评价共5个方面中的角色作用,梳理了护士应对人群健康风险管理需求时面临的机遇和挑战,以期对护士从事健康风险管理提供借鉴与指导。