Eligibility criteria for pediatric patients who may benefit from anti SARS-CoV-2 monoclonal antibody therapy administration: an Italian inter-society consensus statement

The fast diffusion of the SARS-CoV-2 pandemic have called for an equally rapid evolution of the therapeutic options.The Human recombinant monoclonal antibodies (mAbs) have recently been approved by the Food and Drug Administration (FDA) and by the Italian Medicines Agency (AIFA) in subjects aged ≥12 with SARS-CoV-2 infection and specific risk factors.Currently the indications are specific for the use of two different mAbs combination: Bamlanivimab+Etesevimab (produced by Eli Lilly) and Casirivimab+Imdevimab (produced by Regeneron).These drugs have shown favorable effects in adult patients in the initial phase of infection, whereas to date few data are available on their use in children.AIFA criteria derived from the existing literature which reports an increased risk of severe COVID-19 in children with comorbidities. However, the studies analyzing the determinants for progression to severe disease are mainly monocentric, with limited numbers and reporting mostly generic risk categories.Thus, the Italian Society of Pediatrics invited its affiliated Scientific Societies to produce a Consensus document based on the revision of the criteria proposed by AIFA in light of the most recent literature and experts’ agreement.This Consensus tries to detail which patients actually have the risk to develop severe disease, analyzing the most common comorbidities in children, in order to detail the indications for mAbs administration and to guide the clinicians in identifying eligible patients.

Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study

Background and Aims: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. Methods: Cross-sectional analysis of 8–16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. Results: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% ‘increased risk’, 9.7% ‘high risk’, 14.3% ‘very high risk’). Participants in the ‘very high risk’ group were less likely to be females (odds ratio 0.63; 95% CI: 0.52–0.76) and adolescents (0.60; 95% CI: 0.49–0.72), to practice ≥60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57–0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49–0.76). Mothers of participants in the ‘very high risk’ group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the ‘increased’ and ‘high risk’ categories had mothers with normal weight and ≥60 min/day of MVPA. Participants in the ’high risk’ group did not achieve ≥60 min/day of MVPA and showed lower adherence to the Mediterranean diet. Conclusions: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring’s childhood and adolescence, is associated with low BMI-WHtR disease risk.

Systematic Review of Risks in Domestic and Global IT Projects

The development of information technology projects is no longer limited to the domestic sphere. This study identifies the differentiation of risk categories between global and domestic projects through an exploratory research carried out by means of a systematic literature review. 1367 risks were identified in 37 articles and classified within 22 categories. The major concern regarded in domestic project management was the client (external risk) and scope (internal risk) and, in global project management, the psychic distance (external) and coordination and control (internal). The main difference between the risk categories for each project type refers to the psychic distance category, which was identified almost exclusively in global projects, thus making the external risks more relevant than those in domestic projects. On the other hand, it makes risks such as client, supplier and stakeholders be underestimated. The results indicate that project managers should focus on different risks depending on the type of IT project: global or domestic.

Managing the Current Risks of Companies

The taxation power of governments affects companies' business activities. For this reason, the legal limit of tax law must be known by taxpayers. Uncertainty, frequent changes, and interpretation differences in the tax field and reporting reveal tax risks. Today, companies, especially large ones, accept tax risk as a part of the risk management process. Focusing on tax risk management, this chapter presents the discussions on various definitions of tax risk and on the tax risk categories, factors that affect tax risk. The applicability of tax risk management is evaluated from the following perspectives in the chapter: empirical analyses conducted in different countries, tax control framework, and tax risk management practice in various countries. As a result, tax risks are manageable with the support of cooperative compliance models of revenue administrations in countries, the necessity of corporate governance principles, the situation of legal regulations, and the increasing risk management experience of especially large companies.

Research on food safety prediction method based on k-means clustering algorithm

Aiming at the problem of food risk prediction, this paper proposes a method based on clustering algorithm to predict product risk by raw material risk. Firstly, based on the provincial supply chain closed-loop hypothesis, this paper proposes the selection method of clustering indexes for products and their raw materials. Secondly, this paper uses the k-means clustering algorithm to cluster the products and the corresponding raw materials respectively, then based on the clustering Class results automatically determine the high-risk categories of the products and their raw materials. Finally, the analysis of the experimental data of the 8 categories of products and their raw materials shows that the ratio of the high-risk categories of products and the ratios of the corresponding high-risk categories of raw materials have a strong positive correlation. The experimental results prove the rationality of the raw material clustering index selection method proposed in this paper and the correctness of the method of predicting product risk based on the raw material risk based on the clustering algorithm.

Procedural Risk in Congenital Cardiac Catheterization (PREDIC 3 T)

Background Advancements in the field, including novel procedures and multiple interventions, require an updated approach to accurately assess patient risk. This study aims to modernize patient hemodynamic and procedural risk classification through the creation of risk assessment tools to be used in congenital cardiac catheterization. Methods and Results Data were collected for all cases performed at sites participating in the C3PO (Congenital Cardiac Catheterization Project on Outcomes) multicenter registry. Between January 2014 and December 2017, 23 119 cases were recorded in 13 participating institutions, of which 88% of patients were <18 years of age and 25% <1 year of age; a high‐severity adverse event occurred in 1193 (5.2%). Case types were defined by procedure(s) performed and grouped on the basis of association with the outcome, high‐severity adverse event. Thirty‐four unique case types were determined and stratified into 6 risk categories. Six hemodynamic indicator variables were empirically assessed, and a novel hemodynamic vulnerability score was determined by the frequency of high‐severity adverse events. In a multivariable model, case‐type risk category (odds ratios for category: 0=0.46, 1=1.00, 2=1.40, 3=2.68, 4=3.64, and 5=5.25; all P ≤0.005) and hemodynamic vulnerability score (odds ratio for score: 0=1.00, 1=1.27, 2=1.89, and ≥3=2.03; all P ≤0.006) remained independent predictors of patient risk. Conclusions These case‐type risk categories and the weighted hemodynamic vulnerability score both serve as independent predictors of patient risk for high‐severity adverse events. This contemporary procedure‐type risk metric and weighted hemodynamic vulnerability score will improve our understanding of patient and procedural outcomes.

AN AHP APPLICATION FOR FAILURE RISK-BASED RANKING OF ELECTRIC VEHICLE PROJECTS

In order to address challenges in the sustainable development of transportation, economy, and environment, governments along with conventional automobile manufacturers and consumers are extremely interested in the development of the electric vehicle (EV) manufacturing industry and market. However, many manufacturers are worried about entering the EV market because of some of the limitations of EVs and government economic policies. A framework for failure risk-based ranking of EV projects is proposed that applies the Analytic Hierarchy Process (AHP) as a method of ranking. The hierarchy structure of the AHP is created with the risk categories, risk factors, and EV project candidates at different levels of the decision. By specifying the failure risk categories and failure risk factors, the ranking of EV project failure risks and the EV projects are accomplished via the pairwise comparison in the AHP. The results from the ranking provide useful information for planning and decision making. In fact, the results of the proposed method make it possible to specify the EV projects that are feasible to carry out and to compare the various projects at the technical and economic level.

SCORE2 Assessment in the Calculation of Cardiovascular Risk in Patients with Rheumatoid Arthritis

Patients with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD). Risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the risk of CVD in patients with RA. In this sense, the use of noninvasive tools, such as the carotid ultrasound, has made it possible to identify RA patients at high risk of CVD who had subclinical atherosclerosis disease and who had been included in the low or moderate CVD risk categories when the SCORE risk tables were applied. The 2003 SCORE calculator was recently updated to a new prediction model: SCORE2. This new algorithm improves the identification of individuals from the general population at high risk of developing CVD in Europe. Our objective was to compare the predictive capacity between the original SCORE and the new SCORE2 to identify RA patients with subclinical atherosclerosis and, consequently, high risk of CVD. 1168 non-diabetic patients with RA and age > 40 years were recruited. Subclinical atherosclerosis was searched for by carotid ultrasound. The presence of carotid plaque and the carotid intima media wall thickness (cIMT) were evaluated. SCORE and SCORE2 were also calculated. The relationships of SCORE and SCORE2 to each other and to the presence of subclinical carotid atherosclerosis were studied. The correlation between SCORE and SCORE2 was found to be high in patients with RA (Spearman’s Rho = 0.961, p < 0.001). Both SCORE (Spearman’s Rho = 0.524) and SCORE2 (Spearman’s Rho = 0.521) were similarly correlated with cIMT (p = 0.92). Likewise, both calculators showed significant and comparable discriminations for the presence of carotid plaque: SCORE AUC 0.781 (95%CI 0.755–0.807) and SCORE2 AUC 0.774 (95%CI 0.748–0.801). Using SCORE, 80% and 20% of the patients were in the low or moderate and high or very high CVD risk categories, respectively. However, when the same categories were evaluated using SCORE2, the percentages were different (58% and 42%, respectively). Consequently, the number of RA patients included in the high or very high CVD risk categories was significantly higher with SCORE2 compared to the original SCORE. (p < 0.001). In conclusion, although predictive capacity for the presence of carotid plaque is equivalent between SCORE and SCORE2, SCORE2 identifies a significantly higher proportion of patients with RA who are at high or very high risk of CVD.

Consistency and Construct Validity of the Five-Level System for Risk Communication Using Static and Dynamic Tools: An Investigation Using the Static-99R and VRS-SO

This study examined the Council of State Governments’ five-level system for risk communication, as applied to the Static-99R and Violence Risk Scale–Sexual Offense Version (VRS-SO). Aims of the system include increasing consistency in risk communication and linking risk categories to psychologically meaningful constructs. We investigated concordance between risk levels assigned by the instruments, and distributions of VRS-SO dynamic needs associated with Static-99R risk levels, among a multisite sample ( n = 1,404) of persons who have sexually offended. Concordant categorical risk ratings were assigned in just over a third of cases, suggesting that consistency remains a concern with the system, particularly when conceptually disparate tools are applied. Densities of criminogenic needs varied widely among persons assigned the same risk level by the Static-99R and diverged from the descriptions ascribed by the system. These findings can inform clinical assessments and further refinement of the system.

Climate protection as an opportunity for banks to increase earnings and consumer trust

Banks are currently facing numerous challenges. In addition to the ongoing cheap money policy of the European Central Bank, a regulated market environment and a rapidly progressive digitization, financial institutions are increasingly confronted with topics such as sustainability and climate protection. From the latter derive not only risks but also chances for banks. Sustainability risks can impact different risk categories such as market risks, credit risks, operational risks, and liquidity risks. Moreover, reputational risks can occur in this context. This is especially important as bank customers constantly develop a greater awareness of ecological issues, and thus, develop increasing expectations on how companies – like banks – deal with issues like climate protection and sustainability. For this reason, we will start with a theoretical explanation of the key words and then present the results of our customer survey to highlight the current expectations of bank customers in the context of climate protection. Based on this, we formulate recommendations for banks on how to generate a competitive advantage by engaging in climate protection and by taking sustainable actions.