Comprehensive epithelial tubo-ovarian cancer risk prediction model incorporating genetic and epidemiological risk factors

BackgroundEpithelial tubo-ovarian cancer (EOC) has high mortality partly due to late diagnosis. Prevention is available but may be associated with adverse effects. A multifactorial risk model based on known genetic and epidemiological risk factors (RFs) for EOC can help identify women at higher risk who could benefit from targeted screening and prevention.MethodsWe developed a multifactorial EOC risk model for women of European ancestry incorporating the effects of pathogenic variants (PVs) in BRCA1, BRCA2, RAD51C, RAD51D and BRIP1, a Polygenic Risk Score (PRS) of arbitrary size, the effects of RFs and explicit family history (FH) using a synthetic model approach. The PRS, PV and RFs were assumed to act multiplicatively.ResultsBased on a currently available PRS for EOC that explains 5% of the EOC polygenic variance, the estimated lifetime risks under the multifactorial model in the general population vary from 0.5% to 4.6% for the first to 99th percentiles of the EOC risk distribution. The corresponding range for women with an affected first-degree relative is 1.9%–10.3%. Based on the combined risk distribution, 33% of RAD51D PV carriers are expected to have a lifetime EOC risk of less than 10%. RFs provided the widest distribution, followed by the PRS. In an independent partial model validation, absolute and relative 5-year risks were well calibrated in quintiles of predicted risk.ConclusionThis multifactorial risk model can facilitate stratification, in particular among women with FH of cancer and/or moderate-risk and high-risk PVs. The model is available via the CanRisk Tool (www.canrisk.org).

Risk Sharing Method of PPP Model for Rural Sewage Treatment – Based on Interval Fuzzy Shapley Value

Rural sewage treatment is in need of more capital investment, in which the financing model of PPP (public-private partnership) is able to encourage the investment of social capital in this sector. Risk sharing is one of the core features in the PPP model. In view that the risk loss of projects cannot be accurately estimated, this article describes the uncertainty of risk loss with fuzzy numbers and allocates the distribution of risk loss among the participants of rural sewage treatment PPP projects with interval fuzzy Shapley value to ensure a more reasonable and effective risk distribution.

A Simulation-Based Comprehensive Analysis for Traffic Efficiency and Spatial Distribution of Risks in Short Weaving Area of Municipal Interchange

The weaving area is an important junction that affects the efficiency and traffic safety at the municipal interchanges. To explore the factors affecting traffic efficiency and the spatial distribution characteristics of traffic risks in the weaving areas of municipal interchanges, this study employed a microscopic traffic software of Vissim to construct a simulation model of weaving areas and evaluate the impact of road and traffic design parameters in the short weaving on traffic efficiency and risks, which includes ramp delay, mainline through lane (TL) traffic delay, average ramp speed, TL average speed, and collision rate. Through variance analysis via a large number of simulation scenarios, the weaving length is identified as the most important factor affecting traffic efficiency and risks in the short weaving area. Subsequently, three different types of weaving lengths with 350 m, 450 m, and 550 m were set to conduct the sensitivity analysis based on four performance indexes of mean acceleration and deceleration, acceleration range, deceleration range, and speed standard deviation as the representative variables of spatial risk distribution. The simulation results illustrate that a shorter weaving length has a significant influence on risk distribution, especially the highest risk probability at the positions after three-quarters of the inner and outer lanes in the short weaving area at the municipal interchange. Finally, this study verified the traffic risk reduction method of having traffic safety facilities and traffic organization at the complex interchange with double-entry and single-exit weaving areas in the city of Guangzhou, China. The research proposed a method to analyze the influence of the design parameters in the short weaving area on traffic efficiency and safety and provided a reference for the risk spatial distribution analysis and improvement in the short weaving area.

Risk Distribution Characteristics and Optimization of Short Weaving Area for Complex Municipal Interchanges

This paper is focused on analyzing the risk distribution characteristics in short weaving areas of urban interchanges. The study was carried out on merge-diverge weaving areas with different lengths of 350 m, 450 m, and 550 m. To evaluate and identify the risk, the average speed, speed standard deviation, acceleration range, and average absolute value of acceleration were selected as indicators. Vissim simulation was applied to collect the identification indicator value of 21 typical lane sections. The results show that the risk is concentrated at the 3/4 section and exit section of the outer lane. The vehicle-operating status of the inner and middle lanes is almost unaffected. The operating speed of the outer lane is approximately 4/5 of the same position in the inner lane at 3/4 of the length of the weaving segment, while the speed standard deviation is approximately 2 times greater, and the acceleration range is approximately 2–3 times greater. Moreover, the acceleration of the average absolute value is also approximately 2–3 times greater. To balance the risk distribution, an optimization method is proposed based on the result analysis. Compared with the original design, the results show that a reasonable method of traffic organization for the complex weaving area can effectively improve the risk distribution in the weaving area and reduce the high peak of risk concentration. These results provide a basis for the optimization method and traffic organization of short weaving areas of municipal interchanges.

Risk Distribution between UN Peacekeepers and Local Civilians: An Ethical Analysis

Since the beginning of UN peace operations, there has been discussion as to exactly how they should be carried out. Thus far, a just theory of UN peacekeeping operations has not yet been formed, in the way a Theory of Just War for waging war or a theory of police ethics for law enforcement in a peace context had been formed. The article discusses what a justified risk distribution between UN peacekeepers and local civilians should be. One of the points of criticism of UN peacekeeping missions is the lack of protection of the local population in the course of an escalating situation. Familiar examples are the traumas of Rwanda (1994) and Srebrenica (1995). Discussing differences between UN peacekeeping missions, warfare, and law enforcement, it appears that peacekeepers have more in common with law enforcers than with combatants during wartime. Through the method of analogy and by applying some typically military ethics principles, the moral status of the UN peacekeepers is analyzed. Finally, a risk distribution analysis between UN peacekeepers and the local population is carried out, by offering a concise overview by philosophers of arguments for and against taking fewer risks by peacekeepers. The analysis reveals important deontological and consequentialist arguments. Taking also into consideration that transferring more risk to the peacekeeping troops alone does not mandatory lead to less exposure to risk of the vulnerable and innocent local civilians, it can be concluded that a more practical, virtuous, responsible risk calculation will be necessary at that point to find the best risk distribution.

Creating Justice

Beyond community and aesthetics lie deeper, and sometimes murkier, responsibilities. Can the built environment facilitate or even create more just conditions? Can it, by the same token, create injustice, whether wittingly or otherwise? This chapter addresses those questions using traditional notions of social justice theory and of public goods. Elements of risk distribution likewise are addressed, with respect to the uneven spread of both happiness and suffering enabled by buildings and urban planning.

Comprehensive Risk Assessment of Schistosomiasis Epidemic Based on Precise Identification of Oncomelania hupensis Breeding Grounds—A Case Study of Dongting Lake Area

Spatio-temporal epidemic simulation, assessment, and risk monitoring serve as the core to establishing and improving the national public health emergency management system. In this study, we investigated Oncomelania hupensis breeding grounds and analyzed the locational and environmental preferences of snail breeding in Dongting Lake (DTL), Hunan, China. Using geographic information systems and remote sensing technology, we identified schistosomiasis risk areas and explored the factors affecting the occurrence and transmission of the disease. Several key conclusions were drawn. (1) From 2006 to 2016, the spatial change of potential O. hupensis breeding risk showed a diminishing trend from the eastern and northern regions to southwest DTL. Environmental changes in the eastern DTL region resulted in the lakeside and hydrophilic agglomerations of the O. hupensis populations. The shift in snail breeding grounds from a fragmented to centralized distribution indicates the weakening mobility of the O. hupensis population, the increasing independence of solitary groups, and the growing dependence of the snail population to the local environment. (2) The spatial risk distribution showed a descending gradient from west Dongting area to the east and an overall pattern of high in the periphery of large lakes and low in other areas. The cold-spot areas had their cores in Huarong County and Anxiang County and were scattered throughout the peripheral areas. The hot-spot areas had their center at Jinshi City, Nanxian County, and the southern part of Huarong County. The areas with increased comprehensive risks changed from centralized and large-scale development to fragmented shrinkage with increased partialization in the core area. The risk distribution’s center shifted to the northwest. The spatial risk distribution exhibited enhanced concentricity along the major axis and increased dispersion along the minor axis.