Search Results (531)

Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review uses a narrative synthesis followed by PRISMA 2020. A PubMed search (1992–2025) identified 83 studies; after screening, 52 studies (2010–2025) were included. Eligible designs were registry-based, multicenter, single-center, or prospective audits. Given substantial heterogeneity in study designs, FTR definitions, and outcome measures, a narrative synthesis was performed; no formal risk-of-bias assessment or meta-analysis was conducted. Results: Definitions of FTR varied (in-hospital, 30-day, 90-day, severity-based, and complication-specific cases). Reported rates differed by definition: average reported rates were 13.2% for 90-day CD ≥ III (G1); 10.3% for in-hospital/30-day CD ≥ III (G3); and 7.4% for 30-day “serious/major” morbidity (G8). Absolute differences were +3.0 and +2.9 percentage points (exploratory, descriptive comparisons). Five domains were consistently associated with lower FTR: (i) centralization to high-volume centers; (ii) safe adoption/refinement of surgical techniques; (iii) optimized perioperative management including early imaging and structured escalation pathways; (iv) patient-level risk stratification and prehabilitation; and (v) non-technical skills (NTSs) such as decision-making, situational awareness, communication, teamwork, and leadership. Among NTS domains, stress and fatigue management were not addressed in any included study. Limitations: Evidence is predominantly observational with substantial heterogeneity in study designs and FTR definitions; the search was limited to PubMed; and no formal risk-of-bias, publication-bias assessment, or meta-analysis was performed. Consequently, estimates and associations are descriptive/associative with limited certainty and generalizability. Conclusions: NTSs were rarely used or measured across the included studies, with validated instruments; quantitative assessment was uncommon, and no study evaluated stress or fatigue management. Reducing the FTR after pancreatic surgery will require standardized, pancreas-specific definitions of FTR, process-level rescue metrics, and deliberate strengthening of NTS. We recommend a pancreas-specific operational definition with an explicit numerator/denominator: numerator = all-cause mortality within 90 days of surgery; denominator = patients who experience major complications (Clavien–Dindo grade III–V, often labeled “CD ≥ 3”). Addressing the gaps in stress and fatigue management and embedding behavioral metrics into quality improvement programs are critical next steps to reduce preventable mortality after complex pancreatic cancer procedures. Full article

Widespread casualties and property damage due to structural failures following devastating earthquakes have once again highlighted the critical significance of evaluating the seismic performance of existing buildings. In this context, a fundamental part of modern pre-disaster management is to evaluate the potential seismic risks of existing structures and implementing the necessary precautions. This study focuses on determining regional risk priorities using a rapid assessment methodology applied to a sample of reinforced-concrete (RC) structures in the Centre of Bitlis city, situated in the high-seismic-risk Lake Van Basin. Risk prioritization was made among the buildings based on the Turkish Rapid Assessment technique revised in 2019 for 100 different RC buildings with one to seven stories. The negative parameters utilized in this method were analyzed both in relation to the 6 February 2023, Kahramanmaraş earthquakes and the assessed building stock. Additionally, the study provides a comprehensive review of the existing building inventory across the region and offers recommendations for potential precautions to mitigate earthquake risks. Full article

Cold-air pooling (CAP) and frost risk represent significant climate-related hazards in karstic and agricultural environments, where local topography and surface cover strongly modulate microclimatic conditions. This study focuses on the Mohos sinkhole, Hungary’s cold pole, situated on the Bükk Plateau, to investigate the formation, structure, and persistence of CAPs in a Central European karst depression. High-resolution terrain-based modeling was conducted using UAV-derived digital surface models combined with multiple GIS tools (Sky-View Factor, Wind Exposition Index, Cold Air Flow, and Diurnal Anisotropic Heat). These models were validated and enriched by multi-level temperature measurements and thermal imaging under various synoptic conditions. Results reveal that temperature inversions frequently form during clear, calm nights, leading to extreme near-surface cold accumulation within the sinkhole. Inversions may persist into the day due to topographic shading and density stratification. Vegetation and basin geometry influence radiative and turbulent fluxes, shaping the spatial extent and intensity of cold-air layers. The CAP is interpreted as part of a broader interconnected multi-sinkhole system. This integrated approach offers a transferable, cost-effective framework for terrain-driven frost hazard assessment, with direct relevance to precision agriculture, mesoscale model refinement, and site-specific climate adaptation in mountainous or frost-sensitive regions. Full article

The risk of debris flow comprehensively reflects both the natural and social attributes of debris flow disasters, composed of the hazard of debris flow and the vulnerability of the bearing body. The geological environment of the Kashgar-to-Khunjerab section of the China–Pakistan Economic Corridor is complex, with widespread debris flow disasters, strong activity, and severe hazards, posing a significant threat to corridor construction and public safety. Therefore, conducting debris flow risk assessments in the Kashgar-to-Khunjerab section of the China–Pakistan Economic Corridor has great significance for disaster prevention and control. Based on field investigation data of debris flows, this study evaluates the hazard of debris flows in the study area through the frequency ratio and frequency ratio–logistic regression coupled models. The vulnerability of debris flows was evaluated through a contribution weight model. Based on the assessment results of hazard and vulnerability, a risk assessment model was utilized to explore the risk situation of debris flow disasters in the Kashgar-to-Khunjerab section of the China–Pakistan Economic Corridor. The results show that the frequency ratio–logistic regression coupled model (AUC = 0.867) is more suitable for debris flow disasters hazard assessment. The area of medium hazard zones and above accounts for 68.6% of the total area. The vulnerability in the study area is generally concentrated in the township regions along the Kashgar-to-Khunjerab section of the China–Pakistan Highway. The proportion of medium and above vulnerability zones areas reaches 55.6%. The risk levels of the study area generally radiate outward from the Kashgar-to-Khunjerab section of the China–Pakistan Highway, exhibiting a decreasing trend of from high to low. The distribution areas of different risk zones initially increase and then decrease with the rise in risk levels, and the area of medium risk zones and above accounts for 50.8% of the total area. Approximately 91.7% of debris flow disaster points are located in high and very high risk zones. This indicates that the study area has a high level of risk. The study results can provide a scientific basis for planning debris flow disasters prevention and mitigation measures, and the proposed assessment methods can also serve as a reference and guidance for debris flow risk assessment in the study area and other regions. Full article

Urbanization poses growing threats to archaeological heritage sites embedded within cities, necessitating innovative monitoring and documentation strategies. This study investigates the use of Unmanned Aerial Vehicle (UAV) photogrammetry for mapping and 3D modelling of urban archaeological landscapes, focusing on the Byzantine-era Didymoteicho Fortress in northern Greece. High-resolution aerial imagery was captured and processed into an orthophoto mosaic and a detailed 3D model of the site’s monuments and their urban surroundings. The UAV-based survey provided comprehensive, up-to-date spatial data that traditional ground methods could not easily achieve in dense urban settings. The results illustrate how UAV mapping can document complex heritage structures, detect risks (such as structural deterioration or encroachment by development), and inform preservation efforts. The discussion situates these findings within global heritage management practices, highlighting UAV technology as a cost-effective, accurate, and non-invasive tool for safeguarding cultural heritage in urban areas. The suggested methodology enhances heritage documentation and risk assessment, demonstrating strong potential for policy integration and proactive conservation planning in historic cities. Full article

Background/Objective: The gait pattern of children born very preterm shows gait decrements compared to their full-term peers in dual-task walking. It is essential to identify children at a higher risk for these gait deficits. The aim of this study was to compare spatiotemporal gait variables in preschool-age children born very preterm at risk for developmental coordination disorder (DCD) with those not at risk. Methods: Preschool-age children born < 30 weeks’ gestation. Risk for DCD was defined as (i) ≤16th percentile on the Movement Assessment Battery for Children—Second Edition, (ii) ≥80 on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, and (iii) without cerebral palsy. Spatiotemporal gait variables and variability were assessed using GAITRite^® during preferred speed, cognitive and motor dual-task, and tandem conditions. Variables included speed (cm/s), step time (s), cadence (steps/min), step length (cm), base of support (BOS; cm), and single and double support time (%gait cycle). Results: Of 111 children who were assessed, 26 children were classified as at risk for DCD. Most gait variables were similar between groups at preferred speed walking. Children at risk for DCD had wider BOS and shorter single support time in motor dual-tasking (mean difference [MD] = 0.86 cm, 95% confidence interval [CI] 0.10, 1.61; MD = −1.77%, 95% CI −3.36, −0.19) compared to those not at risk. Similarly, wider BOS and higher cadence were found when tandem walking (MD = 0.63 cm, 95% CI 0.07, 1.20; MD = 0.63 steps/min, 95% CI 0.07, 1.20). Conclusions: Children born very preterm at risk for DCD had poorer walking performance than those not at risk for DCD at preschool age, especially during dual-task situations. Clinicians may incorporate complex gait assessments into early evaluations to detect subtle impairments in children. Future research is needed to investigate the impact of gait variability on children’s daily lives and participation in sports activities. Full article

This article examines the impact of an undetected Instrument Landing System (ILS) failure on crew situational awareness. A literature review of similar aviation accidents is presented, highlighting the recurring challenge of misleading instrument indications and their influence on approach safety. The research environment consisted of flight simulator replicating both ideal and accident-weather conditions at two airports, with the final scenario involving a simulated ILS receiver malfunction providing erroneous yet seemingly valid indications. Six pilots with varying flight hours participated, conducting four simulated approaches under different conditions. Flight path stability, deviation from glide slope and course, approach speed, and decision-making were recorded and analyzed. The results indicate that experienced pilots detected inconsistencies more quickly, maintained more stable control inputs, and initiated go-arounds earlier, while less experienced pilots required more time but were still able to correctly assess the risks. The primary goal of this research was to identify cognitive mechanisms and operational decision-making processes under simulated conditions, not to establish universally generalizable outcomes. The findings underline the importance of simulator-based training incorporating unexpected navigation system failures to reinforce cross-checking habits, enhance situational awareness, and improve decision-making during critical phases of flight. Full article

Background: Pancreatic cancer (PC) remains one of the deadliest malignancies, with long-term survival often reliant on early detection through surgery and chemotherapy. Unfortunately, the late-stage presentation of the disease contributes to its poor prognosis, leading to an increased focus on surveillance for high-risk individuals (HRIs) to facilitate earlier diagnosis. Despite the growing implementation of such programmes globally, there is a lack of longitudinal studies examining the benefits of PC surveillance, particularly regarding the well-being of participants. The study aimed to evaluate the distress experienced by HRIs 3-years after engaging in PC screening at Verona Pancreas Institute and to describe which participant characteristics contributed to the increase in stress. Methods: This is a longitudinal follow-up (FU) of a previously published cohort. HRIs with heredo-familial predisposition undergoing PC surveillance with MRCP and a clinical visit were re-evaluated from 2019 to 2023 in the same psychological assessment using Perceived Stress Scale (PSS), General Self-Efficacy Scale (GSES), Coping Orientation to Problems Experienced (COPE) and The Scale of Perceived Social Support (MSPSS) 3 years after the baseline assessment. The FU assessments were conducted by a clinical psychologist via telephone after the radiological and clinical evaluations were made. Results: Of the 54 HRIs initially evaluated, ten did not respond to phone contacts. The remaining 44 HRIs, of whom 29 (65.9%) were female, with a mean age of 56.1 years (SD = 10.2), agreed to participate in a FU psychological assessment. After 3 years, the participant exhibited an increase in stress levels (PSS—T0 mean 14.8; T1 mean 16.9), a decrease in problem-solving abilities (GSES—from 32.02 to 28.09, p < 0.01), a deterioration in adaptive capacity to the situation (COPE total score from 64.0 to 61.39, p = 0.05), and a reduction in perceived social support (MSPSS—T0: 4.59; T1: 4.27, p = 0.02). A significant decrease was also observed in the use of denial (from 2.84 to 2.32; p = 0.02). Based on the psychological characteristics of the 44 HRIs, stratified according to PSS reassessed at FU, 3 distinct clusters were identified: (a) Normal Stress (32% of the sample): HRIs with a PSS score < 14; (b) Stable Clinical Stress (46% of the sample): HRIs with PSS at FU > 14 and PSS at baseline > 14; (c) New Clinical Stress (22% of the sample): HRIs with PSS at FU > 14 and PSS at baseline < 14. After 3 years of surveillance for PC, 67% of the total study sample (Stable Clinical Stress group and New Clinical Stress group) exhibited high perceived stress. Over the course of the 3 years, 7 HRIs (15.9%) lost a family member due to PC. Conclusions: The data suggest the need to include psychological care pathways within the surveillance programmes. These insights can enhance existing literature and aid in creating comprehensive surveillance programmes for PC, addressing all care aspects, including mental health. Full article

A framework utilizing Information and Communication Technology (ICT) in tsunami evacuation training is proposed to counteract the adverse effects of evacuation by car despite the evacuation on foot principle during tsunamis. This approach involves tsunami evacuation simulation technology and Kiken Yochi (hazard prediction) training (KYT). The simulator was validated based on the insights acquired from Ishinomaki City residents who lived through the Great East Japan earthquake. Data were collected on safe evacuations in chaotic traffic situations, to create a quiz-like training application for traffic safety education. Training effectiveness was assessed using the simulator and KYT-based application, focusing on Nishio City, which is a projected tsunami target following a potential Nankai Trough earthquake. Most participants experiencing the simulator understood the drawbacks of using cars and were willing to evacuate on foot if a nearby safe place was accessible. However, some participants still opted for car evacuation despite acknowledging the risks. A comprehensive approach is required to achieve a significant reduction in car usage during evacuations. Application-oriented experiments indicated heightened situational awareness and hazard prediction among participants although no statistically significant differences in gaze duration were found. Further research is required to objectively and quantitatively evaluate the application’s impact on traffic safety. Full article

To address the difficulty frontline commanders face in accurately perceiving fireground risks during the early stages of oil storage tank fires, in this study, we propose a method that integrates complex network theory with a multi-source information fusion approach based on cloud models and Dempster-Shafer (D-S) evidence theory for situational analysis and dynamic perception. Initially, the internal evolution of accident scenarios within individual tanks is modeled as a single-layer network, while scenario propagation between tanks is represented through inter-layer connections, forming a multi-layer complex network for the storage area. The importance of each node is evaluated to assess the risk level of scenario nodes, enabling preliminary situational awareness, with limited reconnaissance information. Subsequently, the cloud model’s capability to handle fuzziness is combined with D-S theory’s strength in fusing multi-source data. Multi-source heterogeneous information is integrated to obtain the confidence levels of key nodes across low, medium, and high-risk categories. Based on these results, high-risk scenarios in oil storage tank emergency response are dynamically adjusted, enabling the updating and prediction of accident evolution. Finally, the proposed method is validated using the 2015 Gulei PX plant explosion case study. The results demonstrate that the approach effectively identifies high-risk scenarios, enhances dynamic situational perception, and is generally consistent with actual accident progression, thereby improving emergency response capability. Full article

This paper propose a practical field-based screening protocol for evaluating the risk of hamstring injury. This is done by discerning the most important factors that better explain the underlying structure among various measurements. Following a cross-sectional study design, ninety-nine professional and semi-professional football players were assessed at the team’s facilities during the preseason period. The collected data included aspects of demographic characteristics; previous injuries; athlete sense of burnout (Athlete Burnout Questionnaire (ABQ)); hamstring (HS) flexibility (passive single leg raise test); isometric hamstring strength (make and brake test); isometric quadriceps strength; single-leg triple hop for distance; endurance of the core muscles (prone bridge, side bridge and Biering–Sørensen tests); and hamstring strength endurance (single leg hamstring bridge test). Subsequently, Exploratory Factor Analysis was performed. Following a summarized dimension reduction process, the twenty-three assessment variables were grouped into a parsimonious model of six main risk factors. Specifically, the resulting model explains 55.7% of the total variance, comprising HS and core endurance (20.2% of the variance), HS strength (12.8%), previous injuries (8.9%), ABQ (5.8%), lower limb strength (4.1%), and strength limb symmetry (3.8%). The proposed model provides a practical protocol, facilitating sports scientists in evaluating the risk for HI in the highly complex reality of field-based situations. Full article

In probabilistic risk assessment (PRA), the fracture limit of fuel cladding tubes under loss-of-coolant accident conditions plays a critical role in determining the core damage, highlighting the need for accurate modeling of cladding tube fracture behavior. However, for high-burnup cladding tubes, it is often infeasible to conduct extensive experiments due to limited material availability, high costs, and technical constraints. These limitations make it difficult to acquire sufficient data, leading to substantial epistemic uncertainty in fracture modeling. To enhance the realism of PRA results under such constraints, it is essential to develop methods that can effectively reduce epistemic uncertainty using limited experimental data. In this study, we propose a Bayesian approach for designing experimental conditions based on a widely applicable information criterion (WAIC) in order to effectively reduce the uncertainty in the prediction of fuel cladding tube fracture with limited data. We conduct numerical experiments to evaluate the effectiveness of the proposed method in comparison with conventional approaches based on empirical loss and functional variance. Two cases are considered: one where the true and predictive models share the same mathematical structure (Case 1) and one where they differ (Case 2). In Case 1, the empirical loss-based design performs best when the number of added data points is fewer than approximately 10. In Case 2, the WAIC-based design consistently achieves the lowest Bayes generalization loss, demonstrating superior robustness in situations where the true model is unknown. These results indicate that the proposed method enables more informative experimental designs on average and contributes to the effective reduction in epistemic uncertainty in practical applications. Full article

Ports with Mediterranean-like traffic profiles combine dense passenger, cargo, touristic, and local operations in confined waters where many small craft sail without AIS, increasing collision risk. Nature of such traffic in often unpredictable, due to often and sudden course corrections or changes. In such situations, it is possible that larger ships cannot manoeuvre to avoid collisions with small vessels. Hence, it is important to the port authority to develop a fast and adoptable mean to reduce collision risks. We present an end-to-end shore-based framework that detects and tracks vessels from fixed cameras (YOLOv9 + DeepSORT), estimates speed from monocular lateral video with an artificial neural network (ANN), and visualises collision risk in augmented reality (AR) for VTS/port operators. Validation in the Port of Split using laser rangefinder/GPS ground truth yields MAE 1.98 km/h and RMSE 2.18 km/h (0.605 m/s), with relative errors 2.83–21.97% across vessel classes. We discuss limitations (sample size, weather), failure modes, and deployment pathways. The application uses stationary port camera as an input. The core calculations are performed at user’s computer in the building. Mobile application uses wireless communication to show risk assessment at augmented reality smart phone. For training of ANN, we used The Split Port Ship Classification Dataset. Full article

Mine roof water inrush represents a prevalent hazard in mining operations, characterized by its concealed onset, abrupt occurrence, and high destructiveness. Since mine water inrush is controlled by multiple factors, rigorous risk assessment in hydrogeologically complex coal mines is critically important for operational safety. This study focuses on the roof water inrush hazard in coal seams of the Banji coal mine, China. The conventional water-conducting fracture zone height estimation formula was calibrated through comparative analysis of empirical models and analogous field measurements. Eight principal controlling factors were systematically selected, with subjective and objective weights assigned using AHP and EWM, respectively. Game theory was subsequently implemented to compute optimal combined weights. Based on this, the vulnerability index model and fuzzy comprehensive evaluation model were constructed to assess the roof water inrush risk in the coal seams. The risk in the study area was classified into five levels: safe zone, relatively safe zone, transition zone, relatively hazardous zone, and hazardous zone. A zoning map of water inrush risk was generated using Geographic Information System (GIS) technology. The results show that the safe zone is located in the western part of the study area, while the hazardous and relatively hazardous zones are situated in the eastern part. Among the two models, the fuzzy comprehensive evaluation model aligns more closely with actual engineering practices and demonstrates better predictive performance. It provides a reliable evaluation and prediction model for addressing roof water hazards in the Banji coal seam. Full article

Modern technologies are transforming occupational health and safety training by enhancing education, innovation, fire prevention, and promoting sustainability conditions in various sectors of industries. Digital tools such as virtual reality, artificial intelligence, and interactive simulations improve learning efficiency, engagement, and risk awareness. By integrating the technologies, companies can better prepare employees for hazardous situations, reduce workplace accidents, and ensure compliance with safety regulations. Fire courses on fire prevention and control are an essential element in health and safety trainings, and a crucial aspect of safety management. In any business, employees should be prepared for emergency situations, including fires by using modern tools like artificial intelligence. This article aimed to assess the implementation of modern technologies in Polish occupational health and safety training across various industrial sectors. Additionally, this research considered variations in training program development based on company size and financial capacity, highlighting the importance of integrating training, education, and innovative technologies into the company’s overall development strategy. The relationships between safety training programs, education, and innovation in 597 industrial companies were evaluated. The research findings suggest that integrating innovative technologies into training can improve working conditions in a more sustainable way and enhance the market competitiveness of enterprises. Full article