Why Business Digitalization Is Still So Risky

Due to rapid IT advances and escalated globalization, business digitalization has been accelerating. However, the average success rate of such endevors remains low. As an attempt to reveal why the digital transformation of a business is still so risky, this research analyzes how commonly encountered risks in IS projects are responded to and how the responses affect project outcomes. Resulting from the authors' previous work, they hypothesize that information systems are much more complex as they play an increasingly pivotal role in executing most business functions, and subsequently, the risk pattern of IS projects may have evolved, and that as businesses keep adding more information systems to the enterprise infrastructure, rather than via a piecemeal approach, a framework for enterprise-wide digital integration must be established to guide and evaluate business digitalization. The finding from this research should largely validate their hypotheses and allow them to call for a refocus of the efforts on digitalizing an enterprise.

Early childhood adversity and non-affective psychosis: a study of refugees and international adoptees in Sweden

Background Previous Scandinavian studies have shown increased levels of psychiatric morbidity in young refugees and international adoptees with an origin outside Europe. This study investigated their risk of non-affective psychotic disorders (NAPD) and whether this risk is influenced by early childhood adversity, operationalised as age at adoption/residency, and/or gender. Methods Register study in Swedish national cohorts born 1972–1990 including 21 615 non-European international adoptees, 42 732 non-European refugees that settled in Sweden at age 0–14 years and 1 610 233 Swedish born. The study population was followed from age 18 to year 2016 for hospitalisations with a discharge diagnosis of NAPD. Hazard ratios (HRs) were calculated in gender stratified Cox regression models, adjusted for household income at age 17. Results The adjusted risks of NAPD were 2.33 [95% confidence interval (CI) 2.07–2.63] for the international adoptees and 1.92 (1.76–2.09) for the former child refugees, relative to the Swedish-born population. For the international adoptees there was a stepwise gradient for NAPD by age of adoption from adjusted HR 1.66 (1.29–2.03) when adopted during the first year of life to adjusted HR 4.56 (3.22–6.46) when adopted at ages 5–14 years, with a similar risk pattern in women and men. Age at residency did not influence the risk of NAPD in the refugees, but their male to female risk ratio was higher than in Swedish-born and the adoptees. Conclusion The risk pattern in the international adoptees gives support to a link between early childhood adversity and NAPD. Male gender increased the risk of NAPD more among the refugees.

Energy Balance-Related Behavior Risk Pattern and Its Correlates During COVID-19 Related Home Confinement

Self-reported weight gain during the COVID-19 shelter-at-home has raised concerns for weight increases as the pandemic continues. We aimed to investigate the relationship of psychological and health markers with energy balance-related behaviors during the pandemic-related extended home confinement. Ratings for stress, boredom, cravings, sleep, self-control, and beliefs about weight control were collected from 1,609 adults using a questionnaire between April 24th–May 4th, 2020, while COVID-19 associated shelter-in-place guidelines were instituted across the US. We calculated four energy balance behavior scores (physical activity risk index, unhealthy eating risk index, healthy eating risk index, sedentary behavior index), and conducted a latent profile analysis of the risk factors. We examined psychological and health correlates of these risk patterns. Boredom, cravings for sweet/savory foods, and high sleepiness ratings related to high risk of increasing unhealthy eating and sedentary behavior and decreasing physical activity and healthy eating. Having greater self-control, control over cravings, or positive mood was related to lowering all aspects of energy intake and energy expenditure risks. Although individuals in risk pattern classes showed similarity in physical activity and healthy/unhealthy eating habits, they exhibited different patterns of positive mood, craving control, food cravings, boredom, and self-control. Psychological and health variables may have a significant role to play in risk behaviors associated with weight gain during the COVID-19 related home confinement. Emerging behavioral patterns may be meaningful in developing targeted weight management interventions during the current pandemic.

Flooding Risk Assessment and Analysis Based on GIS and the TFN-AHP Method: A Case Study of Chongqing, China

Flood risk assessment and mapping is required for management and mitigation of flood in mountain cities. However, the specific characteristics of population, society, economy, environment, transportation and other disaster-bearing bodies in various regions of mountain cities are significantly different, which increases the uncertainty of risk assessment index weight and risk assessment accuracy. To overcome these problems, the triangular fuzzy number-based analytical hierarchy process (TFN-AHP) was employed to determine the weights of eleven indexes influencing flooding. Further, the geographic information system (GIS) spatial statistics technique was introduced to investigate global regional risk pattern, as well as to identify local risk hot spots. Experiments were conducted using open data of Chongqing, China. From the results, it was observed that the TFN-AHP has a higher efficiency in flood risk assessment on mountain cities than the AHP method. The dynamically changing risk pattern and risk hot spots were explored, and the results are generally consistent with seasonal characteristics of precipitation. Lastly, sensitivity analysis of assessment factors’ weights was conducted. The comparative consequences indicate that TFN-AHP can better assess the flooding risk and can be successfully applied to urban development policy.

Association of Alcohol Intake and Fracture Risk in Elderly Varied by Affected Bones: A Nationwide Longitudinal Study

Objective Previous studies investigating association of alcohol intake and fracture risk in elderly yielded conflicting results. We first examined the association between alcohol intake and total fracture risk in elderly subjects and further analyzed whether the association varied by fracture locations.Methods This is a nationwide population-based cohort study which included all people aged 66 (n=1,431,539) receiving the National Screening Program during 2009–2014. Time-to-event were defined as duration from study recruitment, the day they received health screening, to the occurrence of fracture.Results Total fracture was significantly lower in mild drinkers [adjusted hazard ratio (aHR)=0.952; 95% confidence interval (95% CI) =0.931–0.973] and higher in heavy drinkers (aHR=1.246; 95% CI=1.201–1.294) than non-drinkers. Risk pattern of alcohol consumption and fracture differed according to affected bones. Similar J-shaped trends were observed for vertebra fractures, but risk of limb fracture showed a linear relationship with alcohol intake. For hip fracture, risk decrement was more pronounced in mild and moderate drinkers, and significant increment was noted only in very severe drinkers [≥60 g/day; (aHR)=1.446; 1.162–1.801].Conclusion Light to moderate drinking generally lowered risk of fractures, but association between alcohol and fracture risk varied depending on the affected bone lesions.

Non-linear Multipliers for Risk Interactions

The purpose of this chapter is to mathematically describe three types of risk interactions (internal risk amplifications, knock-on, and compounding) associated with the static and dynamic PSS–PDS mismatches. This is required to factor all relevant instances of risk interactions into Monte Carlo models. It is shown that corresponding three types of non-linearity parameters should be introduced to form non-linear (quadratic) multipliers for interacting risks. In the linear case (non-interacting risks) all non-linearity parameters are equal to zero and all non-linear multipliers are equal to one. As a risk may take part in several interactions it has several non-linear multipliers. Required non-linearity parameters and non-linear multipliers for opportunities are also developed. When all relevant instances of risk interactions are factored to a project risk register, they describe an aggregated impact of the affinity of interacting risks (dynamic risk pattern) on project schedule and cost objectives.

Arrhythmic gut microbiome signatures for risk profiling of Type-2 Diabetes

SummaryTo combat the epidemic increase in Type-2-Diabetes (T2D), risk factors need to be identified. Diet, lifestyle and the gut microbiome are among the most important factors affecting metabolic health. We demonstrate in 1,976 subjects of a prospective population cohort that specific gut microbiota members show diurnal oscillations in their relative abundance and we identified 13 taxa with disrupted rhythmicity in T2D. Prediction models based on this signature classified T2D with an area under the curve of 73%. BMI as microbiota-independent risk marker further improved diagnostic classification of T2D. The validity of this arrhythmic risk signature to predict T2D was confirmed in 699 KORA subjects five years after initial sampling. Shotgun metagenomic analysis linked 26 pathways associated with xenobiotic, amino acid, fatty acid, and taurine metabolism to the diurnal oscillation of gut bacteria. In summary, we determined a cohort-specific risk pattern of arrhythmic taxa which significantly contributes to the classification and prediction of T2D, highlighting the importance of circadian rhythmicity of the microbiome in targeting metabolic human diseases.

Analysis of Factors Influencing the Prognostic Significance of Hyponatremia in Peritoneal Dialysis Patients

Background: The evidence linking low serum sodium levels with the risk of mortality in peritoneal dialysis (PD) patients is controversial. Considering the different mechanisms contributing to hyponatremia in these patients, it is conceivable that the prognostic significance of this factor may vary, according to the clinical setting. Methods: Following a retrospective, observational design, we analyzed the association between hyponatremia and mortality in 748 patients incident on PD. We applied multivariate strategies of analysis, with the main objective of identifying subgroups of patients in whom hyponatremia could sustain different degrees of association with mortality (main outcome variable). For this purpose, we performed preliminary analyses to: (1) disclose predictors of serum sodium levels before and after (mean of first 3 months) initiation of PD (main study variable) and (2) investigate the overall prognostic significance of hyponatremia, in our patients. Results: Comorbidity, hypoalbuminemia, and lower glomerular filtration rate (GFR) were main predictors of hyponatremia. Use of icodextrin was another inverse correlate of serum sodium, and the only consistent predictor of a decline of natremia, once PD was started. Multivariate analysis confirmed early hyponatremia as an independent marker of survival. However, stratified analyses showed that this association was most apparent in specific subsets, namely, hypoalbuminemic, more anemic patients with higher baseline levels of GFR and C-reactive protein and faster peritoneal solute transport rates. Other factors potentially reinforcing the prognostic significance of hyponatremia included lower lean body mass levels, nonprescription of renin-angiotensin-aldosterone system antagonists, and use of icodextrin-based PD solution. On the contrary, baseline overhydration or categorization by classic predictors of mortality (age, comorbidity, diabetes) did not appear to influence the risk pattern associated with lower serum sodium levels. Conclusions: Our results suggest that hyponatremia performs as a consistent correlate of the risk of mortality mainly in PD patients manifesting direct or indirect signs of inflammation and wasting, while this association is not apparently linked to the presence of overhydration or nominal, preexisting comorbid conditions.