Search Results (160)

Background/Objectives: Pelvic exenteration (PE) might be a curative option for patients with advanced pelvic malignancies. Due to its significant morbidity and mortality rates, PE necessitates meticulous patient selection, and a comprehensive understanding of disease spread. This study outlines the experience at a single tertiary referral center and investigates prognostic factors influencing survival post-PE, thereby guiding clinical decision-making processes. Methods: Patients undergoing PE for advanced pelvic gynecological malignancies between 01/2016 and 12/2023 were retrospectively analyzed using a prospectively managed database. Eligibility for PE was determined through individualized tumor board evaluations based on CT/MRI imaging, excluding patients with distant metastases. Baseline demographic and clinical characteristics, operative details, complication rates, and histopathological findings were assessed using univariate and multivariate regression analyses. Disease-free (DFS) and overall survival (OS) were assessed by Kaplan-Meier analysis. Poor outcome prognostic factors were identified, outlining an optimal candidate profile for PE. Results: A total of 70 patients were included. The median age was 54.5 years. Forty-three patients (61.4%) presented with recurrent disease and the majority were diagnosed with cervical cancer (n = 48, 68.6%). Total PE was performed in 40 patients (57.1%), with complete tumor resection achieved in 68.6% of patients (n = 48). Sixteen patients (22.8%) experienced grade IV/V complications. Median DFS and OS were 8.2 and 16.4 months, respectively. Multivariate analysis identified R1 resection status and para-aortic lymph node involvement as independent negative prognostic factors. Conclusions: PE is a viable option for selected patients with advanced primary and recurrent pelvic gynecological malignancies. When complete tumor resection is feasible, patients may derive benefit from PE, although the risk of severe perioperative complications must be carefully evaluated. Full article

The paper presents the financial potential of recycling waste electronic equipment (WEE) in the form of printed circuit boards, hard drives, and lithium-ion batteries. Metal contents in selected types of WEE were presented, as well as their price and importance from an environmental, economic, and geopolitical perspective using indicators of relative supply risk and abiotic depletion potential (ADP). The potential benefits that recycling can bring to the company and the environment were presented. Furthermore, the mass balance and value of recovered metals were estimated for southern Poland, and potential possibilities for the management of the remaining separation products were presented. Finally, verified physical recycling methods for the presented WEE were described. Full article

Aviation safety recommendations are the National Transportation Safety Board’s key mechanism for effecting improvements and curtailing subsequent accidents. Aviation safety recommendations and their associated correspondence have been minimally explored in the extant literature, potentially overlooking constrained versus successful risk mitigation themes. This research aimed to qualitatively explore 187 aviation safety recommendations using a framework adapted from the SHELL model. The research also examined the recommendations’ correspondence content to illuminate the characteristics typical of positive versus negative sentiments. The results included risk mitigation themes distributed across the categories of addressees, report statuses, and reiterations. Addressing company, management, manning, or regulatory issues was the most prevalent risk mitigation strategy, followed by physical environment and other human-system support mitigations. The sentiment analyses’ results included distributions across addressees, statuses, time, reiterations, and correspondences. NTSB and addressee correspondence sentiments remained mostly consistent over time and interactions, whereas differences were observed based on addressees and unacceptable report statuses. This article offers the first systematic analysis of NTSB aviation safety recommendations’ risk mitigation themes and addressee correspondences. Full article

The Middle East and North Africa (MENA) region has faced challenges like political instability and economic fluctuations, which have impacted non-performing loans (NPL) levels. At the same time, over the years, reforms and regulations have encouraged stronger board structures to enhance corporate governance and improve risk management. The purpose of this paper is to investigate how board characteristics affect non-performing in the MENA region. Board characteristics shape governance quality, which influences risk management and reduces banks’ risk-taking behaviours. Hence, effective governance can reduce non-performing loans by improving oversight and credit decisions. To this end, we used a sample of 70 banks operating in 12 countries in the MENA region from 2010 to 2022. The System Generalized Method of Moments (SGMM) was employed as an empirical technique. To benefit from a comparative analysis, we divided the entire sample into two subsamples. The first subsample covers six Gulf Cooperation Council (GCC) countries with 42 banks. The second subsample is also relative to six non-Gulf Cooperation Council (non-GCC) countries with 28 banks. The empirical findings indicate that the presence of independent board members, a higher number of female board members, board remuneration, and the board index decrease NPLs across all regions, including MENA, GCC, and non-GCC. However, we found that board size, tenure, and duality increase NPLs. The results of this paper are beneficial for both policymakers and bankers, as they provide insights into how governance through board characteristics influences credit risk. These results support better decision-making in board appointments and governance practices to improve risk management and reduce non-performing loans. Full article

Recently, there has been tremendous interest on the use of large language models (LLMs) in radiology. LLMs have been employed for various applications in cancer imaging, including improving reporting speed and accuracy via generation of standardized reports, automating the classification and staging of abnormal findings in reports, incorporating appropriate guidelines, and calculating individualized risk scores. Another use of LLMs is their ability to improve patient comprehension of imaging reports with simplification of the medical terms and possible translations to multiple languages. Additional future applications of LLMs include multidisciplinary tumor board standardizations, aiding patient management, and preventing and predicting adverse events (contrast allergies, MRI contraindications) and cancer imaging research. However, limitations such as hallucinations and variable performances could present obstacles to widespread clinical implementation. Herein, we present a review of the current and future applications of LLMs in cancer imaging, as well as pitfalls and limitations. Full article

This study examines how board diversity affects the capital structure decisions of United Kingdom (UK)-listed firms on the London Stock Exchange (LSE) under varying market conditions for the period from 2002 to 2021. Data were gathered from BoardEx, ORBIS, and DataStream databases. Linear regression and fixed-effect models were used, along with transition two- and three-regime regression models. The findings reveal that educational diversity consistently negatively affects capital structure across all market conditions. Gender diversity and board independence improve capital structure, except in extreme market states. However, age diversity negatively influences capital structure only in extremely bad market conditions, while board size positively impacts capital structure in good, moderate, and extremely good markets. Nationality diversity has no significant effect across all market conditions. These results align with pecking order, trade-off, and agency theories, emphasizing the need to balance debt and equity. This study highlights the importance of tailoring board composition to market conditions. Enhancing gender diversity and board independence can improve debt financing, especially in stable markets. Companies are encouraged to continually assess board diversity to align with shifting market dynamics for better capital structure decisions. Full article

Liver malignancies, both primary and metastatic tumors, are a major cause of cancer-related mortality. Colorectal cancer alone results in liver metastases in nearly 50% of patients, with approximately 85% presenting with unresectable disease. Similarly, hepatocellular carcinoma and intrahepatic cholangiocarcinoma frequently present at advanced stages, limiting curative options. Systemic therapies provide modest survival benefits, underscoring the need for alternative treatments. Locoregional approaches, such as thermal ablation and chemoembolization, while effective, have notable limitations, including invasiveness, peri-procedural risks, and the requirement to interrupt systemic treatments. Histotripsy is a novel, non-invasive method that uses focused ultrasound-induced cavitation to enable precise tumor ablation without heat or radiation. Our institution utilizes a multidisciplinary tumor board approach to evaluate patients for histotripsy, particularly in cases involving unresectable disease, complex surgical candidacy, palliative intent related to disease control and symptom management, or as bridging therapy for transplantation. Early results, including preclinical data and the THERESA and #HOPE4LIVER trials, highlight its efficacy in treating liver tumors with minimal complications. This review outlines institutional protocols for histotripsy, covering pre- and post-procedural management, along with ethical considerations of current treatment paradigms. As a patient-centered approach, histotripsy offers a novel treatment option with a favorable safety profile and compatibility with systemic therapies. Full article

This study investigates the relationship between cyber risks and dividend policy, as well as how boards, as a governance mechanism, affect the dividend policy under cyber risk. This study collected firm-level financing, corporate governance, and control variables from the Bloomberg database during the period 2013–2022. This paper measures of cyber risk through publicly available corporate disclosures on Form 10-K. The findings confirmed that cyber risks significantly impact dividend policy by posing challenges to corporate technical communication and financial transparency. Effective boards play a critical role in guiding companies toward governance strategies that enhance dividend policy and improve cybersecurity. This study involves policy and practical implications, where research findings suggest the need to strengthen regulatory frameworks that encourage the adoption of strong governance practices and advanced cybersecurity practices within companies. On the practical level, companies should adopt a proactive approach to managing cyber risks by enhancing investments in this area and developing flexible dividend policies. Full article

This study details the design and implementation of a real-time river monitoring station established on the Sakarya River, capable of instantaneously tracking water levels and flow rates. The system comprises an ultrasonic distance sensor, a GSM module (Global System for Mobile Communications), which enables real-time wireless data transmission to a server via cellular networks, a solar panel, a battery, and a microcontroller board. The river monitoring station operates by transmitting water level data collected by the ultrasonic distance sensor to a server via a communication module developed on a microcontroller board using an Arduino program, and then sharing these data through a web interface. The developed system performs regular and continuous water level readings without the need for human intervention. During the installation and calibration of the monitoring station, laboratory and field tests were conducted, and the obtained data were validated by comparison with data from the hydropower plant located upstream. This system, mounted on a bridge, measures water levels twice per minute and sends these data to the relevant server via the GSM module. During this process, precipitation data were utilized as a critical reference point for validating measurement data for the 2023 hydrological year, with changes in precipitation directly correlated with river water levels and calculated flow values, which were analyzed accordingly. The real-time river monitoring station allows for instantaneous monitoring of the river, achieving a measurement accuracy of within 0.1%. The discharge values recorded by the system showed a high correlation (r² = 0.92) with data from the hydropower plant located upstream of the system, providing an accurate and comprehensive database for water resource management, natural disaster preparedness, and environmental sustainability. Additionally, the system incorporates early warning mechanisms that activate when critical water levels are reached, enabling rapid response to potential flood risks. By combining energy-independent operation with IoT (Internet Of Things)-based communication infrastructure, the developed system offers a sustainable solution for real-time environmental monitoring. The system demonstrates strong applicability in field conditions and contributes to advancing technologies in flood risk management and water resource monitoring. Full article

We investigated the relationship between corporate governance mechanisms and bank performance in the Nigerian banking sector. We focused on data from 2012 to 2022 extracted from the balance sheets of deposit money banks in Nigeria. We employed the Generalized Method of Moments (GMM) with Stata 13 and Python library to analyze the data. The research underscores the positive influence of non-executive directors and effective credit risk management on risk-adjusted return on assets in the Nigerian banking sector. Conversely, larger board sizes and higher levels of independence negatively impact performance. Notably, corporate governance variables do not significantly determine risk-adjusted return on equity, except for a negative association with lending rates. Practical implications include advocating for non-executive directors, optimizing board size and prioritizing robust credit risk management for enhanced financial outcomes. This research contributes to understanding the crucial role of corporate governance in the Nigerian banking sector, emphasizing its significance for prudent risk management and stakeholder confidence. Full article

This paper deals with the occurrence of construction defects, particularly those due to water penetration in buildings. The considered defects mainly originated from improper management of validation checks during the design or execution phases. From a technical point of view, validation checks are valuable tools for public administrations to mitigate litigation and construction defects during or after building and infrastructure work. A large proportion of defects are due to rigid design procedures, which require technical specialists to address specific issues (architectural, structural, material, etc.), and the main problems are often caused by a lack of coordination. Another frequent cause of defects is the sequence of planning stages (preliminary, final, and executive in Italian regulation), and different technicians may manage the same design, sometimes with different tender procedures. In other cases, the contradictory requirements imposed by various regulatory authorities (fire corps, agency for the management of artistic heritage, etc.) create conflicts and lead to wrong technical decisions through attempts to fulfill contradictory requests. An independent technical board, such as a team of validators, is therefore able to help the regulatory authority, reducing the risks of errors during the design process and avoiding litigation during construction phases. Several approaches to validation are presented, from “best practice” to “prescriptive validation”. An analysis of four examples of litigation due to relevant defects is shown and discussed, where a lack of coordination and the absence of real validation checks are the main causes of litigation. A discussion of these examples provides indications and suggestions for strategies to mitigate the occurrence of construction defects. Full article

This research examines the link between environmental, social, and governance (ESG) risk ratings and board characteristics on corporate performance. Using 2023 data from 117 companies on the Saudi Stock Exchange, the study employs Ordinary Least Squares (OLS) regression and Python for data analysis. Our findings reveal a negative effect of ESG risk scores on financial performance measures, indicating that higher ESG risks hinder firm performance measured by ROE and ROIC. Furthermore, both the size and independence of the board decrease corporate performance in Saudi firms. Family-controlled ownership structures often limit the effectiveness of independent directors in enhancing performance. In Saudi firms, women’s board participation shows an insignificant impact on corporate performance, suggesting that the Tokenism Theory may apply. It is recommended that firms empower women in leadership roles and develop robust ESG risk management frameworks to mitigate risks and enhance financial performance. Full article

The data about pregnancy while having a low ejection fraction are scarce, since pregnancy is not recommended for women with an ejection fraction of less than 30%. There is an increased risk of obstetrical complications and adverse maternal-fetal outcomes. Pregnancy is a rough journey for this group of patients. However, a successful pregnancy can be achieved when cardiac complications are managed during pregnancy. The early recognition of women at risk of cardiovascular events and early referral can optimize the maternal and neonatal outcomes with close collaboration between the maternal-fetal medicine specialist and the cardiologist. The study’s aim was to assess the experience of our tertiary center with regard to the adverse maternal outcome for women with an ejection fraction ≤ 30% compared to those with an EF > 30% in our tertiary center. The fetal and obstetric outcome for pregnancies with an EF ≤ 30% was compared to that for pregnancies with an EF > 30%. Methodology: After receiving the approval of the local Ethical Board Review, a retrospective study was conducted at King Faisal Specialist Hospital and Research Center (KFSHRC) in the city of Riyadh, Kingdom of Saudi Arabia. Our study population included women with cardiomyopathy (acquired or congenital) who were followed up or delivered in KFSHRC from the period of January 2004 till March 2020. Cases were identified by reviewing the database from the Cardiac Center Echocardiograph and maternal fetal medicine unit. The data on the maternal and fetal outcome were gathered from the hospital medical records. An adverse maternal outcome included: death, hospitalization due to decompensated heart failure, and worsening cardiovascular status during pregnancy. Adverse fetal outcomes included: miscarriages, termination of pregnancy, FGR, and placental insufficiency. Obstetrics complications included: complications related to the mode of delivery, antepartum hemorrhage, postpartum hemorrhage, or preeclampsia. Results: Our study included 44 subjects, examining the differences between those with an ejection fraction greater than 30 (n = 21 subjects) and those with an ejection fraction less than or equal to 30 (n = 23) with respect to demographics, co-morbidities, and outcomes (maternal, pregnancy, fetal, ultrasound, and baby). There was no evidence of any differences in the demographics. From among the co-morbidities, there was a statistically higher rate of dilated cardiomyopathy and lower rate of rheumatic heart disease in those with a lower ejection fraction. Also, women with a lower ejection fraction tended to deliver through a means other than simple vaginal delivery. There was a significant association (p = 0.0296) indicating that individuals with a lower ejection fraction tended to have a lower gestational age at delivery. The information on whether the pregnancy resulted in a live birth was available for all but one of the mothers. Across all the mothers, 32 (74%) resulted in a live birth and 11 did not. The percentage of pregnancies resulting in a live birth in the group for which the ejection fraction was greater than 30 was 90% and that in the group for which the ejection fraction was less than or equal to 30 was 59% (p = 0.0339). From among the ultrasound and baby outcomes, only the rate of the babies being discharged alive differed statistically between the two ejection fraction groups, with those mothers having a lower ejection fraction experiencing fewer babies being discharged alive (p = 0.0310). Conclusions: In conclusion, women with a low ejection fraction are at an increased risk of maternal-fetal complications. In our study, the lower the EF (≤30) the worse were the fetal and neonatal outcomes; however, in terms of the maternal outcomes, it was the same whether the EF was low or ultra-low. Yet, these groups of patients need to be counseled about the facts of poor obstetrical outcomes with an emphasis on preconceptual counseling. Full article

Wavelet coherence analysis (WCA) examines the dynamic interactions between economic policy uncertainty (EPU) in Brazil, Chile, Colombia, and Mexico and key external variables, using monthly data from 2010 to 2022. The findings reveal the following: (i) medium-term co-movements (4–16 months) between EPU and global financial indicators, including the Chicago Board Options Exchange (CBOE) Market Volatility Index (RVIX), Merrill Lynch Option Volatility Estimate Index (RMOVE), and Global EPU Index (RGEPU), emphasizing the sustained influence of financial volatility on domestic policy environments, particularly during global turbulence; (ii) significant interactions between EPU and the Climate Policy Uncertainty Index (RCPU) in resource-dependent economies like Brazil and Colombia, with pronounced effects in medium- and long-term horizons; (iii) bidirectional relationships between Brent crude oil prices (RBRENT) and EPU in Brazil, Colombia, and Mexico, where oil price fluctuations shape policy uncertainty, especially during global market disruptions; and (iv) notable co-movements between EPU and the Dow Jones Sustainability World Index (RW1SGI) in Brazil, Chile, and Mexico, highlighting sensitivity to shifts in sustainability-driven markets. These results underscore the need for economic diversification, strengthened financial safeguards, and integrated climate risk management to mitigate external shocks. By exploring the time–frequency dynamics of global uncertainties and domestic policy environments, this study provides actionable insights for fostering resilience and stability in Latin America’s interconnected economies while addressing vulnerabilities to global market volatility and sustainability transitions. Full article