High Frequency of Microvascular Dysfunction in US Outpatient Clinics: A Sign of High Residual Risk? Data from 7,105 Patients

Previous studies have linked peripheral microvascular dysfunction measured by arterial tonometry to high residual risk in on-statin patients. Digital thermal monitoring (DTM) of microvascular function is a new and simplified technique based on fingertip temperature measurements that has been correlated with the burden of atherosclerosis and its risk factors. Here, we report analyses of DTM data from two large US registries: Registry-I (6,084 cases) and Registry-II (1,021 cases) across 49 US outpatient clinics. DTM tests were performed using a VENDYS device during a 5-minute arm-cuff reactive hyperemia. Fingertip temperature falls during cuff inflation and rebounds after deflation. Adjusted maximum temperature rebound was reported as vascular reactivity index (VRI). VRI distributions were similar in both registries, with mean ± SD of 1.58 ± 0.53 in Registry-I and 1.52 ± 0.43 in Registry-II. In the combined dataset, only 18% had optimal VRI (≥2.0) and 82% were either poor (<1.0) or intermediate (1.0-2.0). Women had slightly higher VRI than men ( 1.62 ± 0.56 vs. 1.54 ± 0.47 , p < 0.001 ). VRI was inversely but mildly correlated with age ( r = − 0.19 , p < 0.001 ). Suboptimal VRI was found in 72% of patients <50 years, 82% of 50-70 years, and 86% of ≥70 years. Blood pressure was not correlated with VRI. In this largest registry of peripheral microvascular function measurements, suboptimal scores were highly frequent among on-treatment patients, possibly suggesting a significant residual risk. Prospective studies are warranted to validate microvascular dysfunction as an indicator of residual risk.

Risk Assessment at the Plate Production Unit (PPL) of PT. INKA (Persero)

Introduction: The plate manufacturing production unit is one of the work units in PT. INKA (Persero), which involves the interaction between humans and machines in its activities, heavy equipment, and materials, all of which can cause possible hazard impacts that can impact the safety and health of workers. The purpose of this study is to conduct risk assessment on occupational safety and health aspects by identifying risks, assessing risks, identifying control efforts and assessing residual risk as a form of efforts to prevent occupational accidents and occupational diseases, using existing resources effectively and efficiently. Method: This research is a type of qualitative research, through interviews and observations, with cross-sectional studies and descriptive analysis. The interviewees for this study were K3LH management managers, steel managers, and machine operators in the plate production unit (PPL). The tools in this study werean interview guide, Job Safety Analysis (JSA) and Hazard Identification Risk Assessment Determining Control (HIRADC) using the AS / NZS 4360: 2004 Risk Management Worksheet Standard Risk Matrix. Results: From the research, it was found that there are 94 hazards for 11 different machines. Regarding the risk levels, there are 9 extreme risk levels, 46 high risk levels, 33 medium risk levels and 6 low risk levels. Conclusion: There are still 61 risks with medium risk level and 6 remaining risks with high risk level that still need control. Control efforts have been implemented by PT. INKA (Persero) in accordance with the hierarchy of control, such as the use of PPE and the provision of work SOPs. Keywords: hazard identification, risk management, risk assessment, risk control, residual risk

Technique for Evaluating the Security of Relational Databases Based on the Enhanced Clements–Hoffman Model

Obtaining convincing evidence of database security, as the basic corporate resource, is extremely important. However, in order to verify the conclusions about the degree of security, it must be measured. To solve this challenge, the authors of the paper enhanced the Clements–Hoffman model, determined the integral security metric and, on this basis, developed a technique for evaluating the security of relational databases. The essence of improving the Clements–Hoffmann model is to expand it by including a set of object vulnerabilities. Vulnerability is considered as a separate objectively existing category. This makes it possible to evaluate both the likelihood of an unwanted incident and the database security as a whole more adequately. The technique for evaluating the main components of the security barriers and the database security as a whole, proposed by the authors, is based on the theory of fuzzy sets and risk. As an integral metric of database security, the reciprocal of the total residual risk is used, the constituent components of which are presented in the form of certain linguistic variables. In accordance with the developed technique, the authors presented the results of a quantitative evaluation of the effectiveness of the protection of databases built on the basis of the schema with the universal basis of relations and designed in accordance with the traditional technology of relational databases.

The Prevalence of Human Immunodeficiency Virus Infection among Voluntary Blood Donors in Mainland China: A Systematic Review and Meta-Analysis

BACKGROUND: The epidemic of Human Immunodeficiency Virus (HIV) in China has been increasing. Despite the implementation of screening strategies, there was still the residual risk of transfusion-transmitted HIV. This study investigated the HIV prevalence among voluntary blood donors during the past 24 years in order to characterize the epidemiology of HIV.METHODS: The literature concerning the HIV screening reactive rate and prevalence in Chinese voluntary blood donors were collected through the systematic searching of four electronic databases. After integrating data, following the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses guidelines, data manipulation and statistical analyses were conducted by Stata 12.0. We investigated the trend of HIV prevalence (and 95% CIs) and related epidemiological characteristics among blood donors in mainland China.RESULTS: The results indicated that HIV prevalence was 0.0165% (95% CI, 0.0155%-0.0176%) with a remarkable rise, which varied from 2000 (0.0034%) to 2017 (0.0247%). Importantly, the heterogeneity was found in occupations and Donation frequency. Additionally, the HIV prevalence were significantly higher among male donors than among female donors.CONCLUSIONS: Our results indicated obvious difference between HIV screening reactive rate and HIV prevalence in Chinese blood donors and HIV screening reactive rate cannot reflect reality of HIV infection. In this study, continuous increased trend of HIV prevalence demonstrates extended residual risk of blood transfusion, and the whole society is supposed to pay close attention to HIV infection.