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نتیجه جستجو - Risk

تعداد مقالات یافته شده: 1770
ردیف عنوان نوع
61 Gestational diabetes and fetal growth in twin compared with singleton pregnancies
دیابت بارداری و رشد جنین در دوقلوها در مقایسه با بارداری های تک قلویی-2021
BACKGROUND: Gestational diabetes mellitus is associated with accelerated fetal growth in singleton pregnancies but may affect twin pregnancies differently because of the slower growth of twin fetuses during the third trimester of pregnancy and their greater predisposition to fetal growth restriction.
OBJECTIVE: This study aimed to evaluate the association of gestational diabetes mellitus with longitudinal fetal growth in twin pregnancies and to compare this association with that observed in singleton pregnancies.
STUDY DESIGN: This was a retrospective cohort study of all women with a singleton or twin pregnancy who were followed up at a single tertiary referral center between January 2011 and April 2020. Data on estimated fetal weight and individual fetal biometric indices were extracted from ultrasound examinations of eligible women. Generalized linear models were used to model and compare the change in fetal weight and individual biometric indices as a function of gestational age between women with and without gestational diabetes mellitus in twin pregnancies and between women with and without gestational diabetes mellitus in singleton pregnancies. The primary outcome was estimated fetal weight as a function of gestational age. The secondary outcomes were longitudinal growth of individual fetal biometric indices and the rate of small for gestational age and large for gestational age at birth.
RESULTS: A total of 26,651 women (94,437 ultrasound examinations) were included in the analysis: 1881 with a twin pregnancy and 24,770 with a singleton pregnancy. The rate of gestational diabetes mellitus in the twin and singleton groups was 9.6% (n¼180) and 7.6% (n¼1893), respectively. The estimated fetal weight in singleton pregnancies with gestational diabetes mellitus was significantly higher than that in pregnancies without gestational diabetes mellitus (P<.001) starting at approximately 30 weeks of gestation. The differences remained similar after adjusting for maternal age, chronic hypertension, nulliparity, and neonatal sex (P<.001). In twin pregnancies, fetal growth was similar between pregnancies with and without gestational diabetes mellitus (P¼.105 and P¼.483 for unadjusted and adjusted models, respectively). The findings were similar to the association of gestational diabetes mellitus with the risk of large for gestational fetuses and the growth of each biometric index. When stratified by type of gestational diabetes mellitus treatment, twin pregnancies with gestational diabetes mellitus was associated with accelerated fetal growth only in the subgroup of women with medically treated gestational diabetes mellitus (P<.001), which represented 12% (n¼21) of the twin pregnancy group with gestational diabetes mellitus.
CONCLUSION: In contrast to singleton pregnancies, twin pregnancies with gestational diabetes mellitus is less likely to be associated with accelerated fetal growth. This finding has raised the question of whether the diagnostic criteria for gestational diabetes mellitus and the blood glucose targets in women diagnosed with gestational diabetes mellitus should be individualized for twin pregnancies.
Key words: gestational diabetes mellitus | growth | macrosomia | large for gestational age | multifetal pregnancy | twin pregnancy
مقاله انگلیسی
62 Preliminary lessons from COVID-19 disruptions of small-scale fishery supply chains
دروس مقدماتی مربوط به اختلالات COVID-19 در زنجیره های تامین شیلات در مقیاس کوچک-2021
The ongoing COVID-19 pandemic and associated mitigation measures have disrupted global systems that support the health, food and nutrition security, and livelihoods of billions of people. These disruptions have likewise affected the small-scale fishery (SSF) sector, disrupting SSF supply chains and exposing weaknesses in the global seafood distribution system. To inform future development of adaptive capacity and resilience in the sector, it is important to understand how supply chain actors are responding in the face of a macroeconomic shock. Comparing across seven SSF case studies in four countries, we explore how actors are responding to COVID-19 disruptions, identify constraints to adaptive responses, and describe patterns of disruption and response across cases. In all cases examined, actors shifted focus to local and regional distribution channels and particularly drew on flexibility, organization, and learning to re-purpose pre-existing networks and use technology to their advantage. Key constraints to reaching domestic consumers included domestic restrictions on movement and labor, reduced spending power amongst domestic consumers, and lack of existing distribution channels. In addition, the lack of recogni- tion of SSFs as essential food-producers and inequities in access to technology hampered efforts to continue local seafood supply. We suggest that the initial impacts from COVID-19 highlight the risks in of over-reliance on global trade networks. The SSFs that were able to change strategies most success- fully had local organizations and connections in place that they leveraged in innovative ways. As such, supporting local and domestic networks and flexible organizations within the supply chain may help build resilience in the face of future macroeconomic shocks. Importantly, bolstering financial wellbeing and security within the domestic market both before and during such large-scale disruptions is crucial for supporting ongoing supply chain operations and continued food provision during macroeconomic crises.
Keywords: Small-scale fisheries | COVID-19 | Adaptive capacity | Supply chain | Resilience | Global seafood distribution system
مقاله انگلیسی
63 Comparison of machine learning classifiers: A case study of temperature alarms in a pharmaceutical supply chain
مقایسه طبقه بندی کننده های یادگیری ماشین: مطالعه موردی هشدارهای دما در یک زنجیره تأمین دارویی-2021
Temperature deviations are critical in a pharmaceutical supply chain (SC) due to quality deterioration concerns and resulting health risks. The current solutions ensuring temperature maintenance are either labor-intensive or prone to triggering alarms that require no corrective measures, which, in turn, increase the alarm investigation costs. Machine learning (ML) methods have fared well both in the areas characterized by the execution of repetitive tasks and in the identification of false alarms; however, they have not been applied in the context of temperature monitoring in a pharmaceutical SC. In this paper, we used the real-world data of a large international logistics service provider for the period of 2013–2018 and compared the optimized performance of 10 ML classification methods in the task of false temperature alarm identification. Such additional features as temperature in the location of possible physical handling and average temperature deviation were either externally collected or estimated to enrich the models. In general, gradient boosting achieved the best performance in our evaluations, with an accuracy of 95.9% in comparison with the value of 16.6% demonstrated by the current legacy rule-based system. The feature ranking and sensitivity tests pointed to the strength of the features indicating an absolute temperature deviation and the location of cargo along the SC. The tests simulating model applications on new dissimilar observations showed various performance losses across classifiers, with the best stability retained for a new customer scenario and largest performance decreases for a new temperature range scenario.© 2021 Elsevier Ltd. All rights reserved.
Keywords: Cold supply chain | Pharmaceutical | Temperature alarm | Rule-based monitoring | Machine learning | Prediction
مقاله انگلیسی
64 ارتباط بین نوع زایمان و افسردگی پس از آن (PPD)
سال انتشار: 2021 - تعداد صفحات فایل pdf انگلیسی: 8 - تعداد صفحات فایل doc فارسی: 21
پیش زمینه : افسردگی پس از زایمان (PPD) با پیامدهای نامطلوب سلامتی از جمله خودکشی مادران همراه است. نوع زایمان از جمله ریسک فاکتورهای مربوط به افسردگی پس از زایمان (PPD) می باشد اما مطالعات گسترده ای در زمینه ارتباط بین نوع زایمان با افسردگی پس از زایمان صورت نگرفته است. هدف از این مطالعه بررسی ارتباط بین نوع زایمان با افسردگی پس از آن بین یک و شش ماه پس از زایمان می باشد.
روش ها : در یک مطالعه سراسری بر روی 89954 مادر با تولد تک قلو زنده، ما ارتباط بین نوع زایمان و خطرات افسردگی پس از زایمان ( PPD ) را بررسی کردیم. PPD با استفاده از مقیاس افسردگی پس از زایمان ادینبورگ (≥13) در 1 و 6 ماه پس از زایمان ارزیابی شد. نسبت احتمال ( Odds ratios (ORs) ) با فاصله اطمینان ( confidence intervals (CIs) ) 95% از افسردگی پس از زایمان ( PPD ) با استفاده از رگرسیون لجستیک (logistic regression ) چند متغیره پس از تعدیل عوامل فیزیکی، اجتماعی-اقتصادی و روانی قبل از تولد محاسبه شد.
نتایج : از میان 89954 زن , 3.7% در ماه اول پس از زایمان و 2.8% در ماه ششم پس از زایمان دارای افسردگی بودند. در مقایسه با زایمان طبیعی واژینال بدون کمک, زایمان به شکل سزارین به شکل بارزی با افسردگی در ماه اول همراه بود اما در ماه ششم به این شکل نبود و ORهای تعدیل شده به ترتیب 1.10 (95% CI، 1.00-1.21) و 1.01 (95% CI، 0.90-1.13) بودند.
افسردگی در ماه اول در زنانی که پریشانی روانی در دوران بارداری داشتند مشهود بود (OR تعدیل شده 1.15؛ 95% فاصله اطمینان (CI)، 1.03-1.28) اما ارتباط مشاهده شده پس از سازگار شدن مادر با موضوع با روش تغذیه نوزاد کاهش یافت.
نتیجه گیری : مادرانی که در دوران بارداری مشکلات روانی داشته اند و مادرانی که با روش سزارین زایمان کرده اند در معرض ابتلا به به افسردگی پس از زایمان می باشند.
کلمات کلیدی: سزارین | افسردگی پس از زایمان | پریشانی روانی | شیردهی | مطالعه آینده نگر
مقاله ترجمه شده
65 Nonlinear analysis and active management of production-distribution in nonlinear supply chain model using sliding mode control theory
تحلیل غیرخطی و مدیریت فعال تولید-توزیع در مدل غیر خطی زنجیره تامین با استفاده از تئوری کنترل حالت کشویی-2021
This paper deals with system dynamics approach for dynamical behaviors and control synthesis of supply chain system by utilizing three-stage production-distribution model. The presented approach offers systematic tools for determining fundamental relationships between multi-echelons in the supply chain dynamics by using eigenvalues, bifurcation, and time history investigation. By exploring system dynamics on time series analysis, it is found that system performance has suffered severely from the bullwhip effect under impacts of model uncertainties and perturbed demand. The novel fractional-order sliding mode control algorithm has been presented based on adaptation mechanism, ensuring that the shipment flows are robustly stable in supply chain networks against disruptions. This is a smarter way of getting sufficient strength to sustain existing competitive market for mitigating the risks and improving the supply chain performance. The system stability has been thoroughly analyzed by using Routh-Hurwitz criterion and Lyapunov theory. Extensive numerical simulations have been conducted to obtain insights into the system behaviors and to validate effectiveness of active control policies by matching the shipment sent to customer demand, ensuring supply chains resilience. Finally, it is found that the presented approach can help decision-makers develop more efficient supply chain management system against severe market disruptions.
Keywords: System dynamics | Supply chain management | Production-distribution model | Fractional order | Sliding mode control | Adaptive law
مقاله انگلیسی
66 Global status of knowledge for the prevention and emergency management of traumatic dental injuries among non-dental healthcare professionals: A systematic review and meta-analysis
وضعیت جهانی دانش برای پیشگیری و مدیریت اورژانس آسیب های دندانی آسیب دیده در میان متخصصان مراقبت های بهداشتی غیر دندانپزشکی: بررسی سیستماتیک و متاآنالیز-2021
Objectives: This Systematic Review was conducted to evaluate the global status of the knowledge of prevention and emergency management of traumatic dental injuries among non-dental healthcare pro- fessionals (NDHCP).
Methods: The protocol was designed as per PRISMA guidelines and registered in PROSPERO (CRD42020192381). A broad-based search using text-words and MeSH terms was performed in estab- lished databases as per a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity and reliability were excluded. Data extraction was performed and risk of bias assessment was done using the Joanna Briggs Institute’s critical appraisal tool and a meta-analysis was performed.
Results: The qualitative synthesis included 14 studies between 2009-2020 with nine of them from Asia. Majority of the studies had low risk of bias and reported poor overall level of knowledge. Less than 40% of the NDHCP had received a dental trauma first aid training in six of the 10 studies and majority of the > participants ( 50%) believed that dental trauma training was required in five studies. Less than 36% of the participants were adequately aware of the correct approach towards management of avulsed permanent tooth in five studies.
Conclusion: The knowledge of non-dental health care professionals regarding the emergency manage- ment of traumatic dental injuries was insufficient or low in the majority of studies and the knowledge about prevention was not evaluated. There was a paucity of studies from the countries of Europe and Australia, with wide variability in the study methods, categories of the participants and questionnaire characteristics.
© 2021 Elsevier Ltd. All rights reserved.
keywords: آسیب های دندانی آسیب دیده | اطلاع | دانش | متخصصان مراقبت های بهداشتی غیر دندان | پرستاران | پزشکان | بررسی سیستماتیک | Traumatic dental injury | Awareness | Knowledge | Non-dental healthcare professionals | Nurses | Doctors | Systematic review
مقاله انگلیسی
67 Mental accounts with horizon and asymmetry preferences
حسابهای ذهنی با ترجیحات افق و نامتقارن-2021
This paper extends mental accounting theory with an investment horizon and asymmetric trade-off between extreme gains and losses. This horizon-asymmetry mental accounting (HAMA) framework widens the spectrum of investors’ optimal portfolio choices considerably. Risk aversion, implied from the mean-variance portfolio theory, and the bond-to-stock ratio decline with the investment horizon. HAMA investors with a large gain–loss asymmetry trade-off are more concerned about skewness and kurtosis rather than variance. To apply the model to United States stock data, we develop a parsimonious semi-parametric version of HAMA that relies on the moments of return distributions. The analysis of optimal portfolios shows that investors who care significantly about upside potential hold asymmetric, leptokurtic, and less diversified allocations.
keywords: حساب های ذهنی | انتخاب نمونه کارها | افق | پتانسیل صعودی | خطر گریزی | Mental accounts | Portfolio choice | Horizon | Upside potential | Risk aversion
مقاله انگلیسی
68 Managing Cardiac Patients: Dentists’ Knowledge, Perceptions, and Practices
مدیریت بیماران قلبی: دانش دندانپزشکان، ادراکات و شیوه های دندانپزشکان-2021
Objectives: Dental patients may require invasive treatment, and awareness of their medical conditions is essential for optimal care. We assessed the knowledge, perceptions, and attitudes of dentists practicing in Saudi Arabia (SA) and their associations with managing patients with common cardiac conditions. Methods: A national survey of knowledge and attitudes of practicing dentists towards patients with common cardiac conditions was conducted from May 2019 to July 2020 in SA. The survey comprised a newly developed, validated, electronic, self-administered English questionnaire.
Results: Overall, 282 dentists completed the survey, of whom 45.5% perceived cardiac patients as difficult to manage, while 64.5% stated that they refer these patients to cardiologists before dental intervention. Regarding knowledge about cardiac conditions, 72% achieved an overall knowledge score <55%; however, their infective endocarditis scores were better. Consultants and specialists (P < .001), those with a PhD/board certification (P = .013), dentists with prior education on cardiac patient management (P = .002), and those working with a cardiologist (P = .016) scored higher on knowledge. Conversely, private dentists (P = .003) and those referring patients to cardiologists before treatment (P = .003) scored lower. Dentists’ knowledge of cardiovascular diseases in women was low; only those who believed women experience a greater risk of cardiac complications achieved a higher score. Approximately 90.1% wished to receive education regarding cardiac patient management.
Conclusions: Knowledge of cardiac patient management was suboptimal in this study. Dentists perceived cardiac patients as difficult to manage, but wished to learn more regarding optimal management. Thus, postgraduate education programmes that promote optimal dental management strategies for cardiac patients are necessary.
keywords: Knowledge | Attitude | Dentist | Cardiac patient | Cardiac disease | Cardiovascular disease in women
مقاله انگلیسی
69 Effects of self-management interventions on heart failure: Systematic review and meta-analysis of randomized controlled trials - Reprint
اثرات مداخلات خودمراقبتی بر نارسایی قلبی: بررسی سیستماتیک و متاآنالیز آزمایش های کنترل شده تصادفی - چاپ مجدد-2021
Background: Self-management intervention is an important component of disease management in patients with heart failure. It can improve heart failure knowledge, quality of life, and heart failure-related hospitalizations of heart failure patients. However, studies on the effect of two self-management interventions tasks have reported conflicting results.
Objective: This study conducted an up-to-date systematic review of the literature to evaluate the effects of self-management interventions on heart failure knowledge, quality of life, and heart failure-related hospitalizations in patients with heart failure. Design: Systematic review and meta-analysis. Data sources: We searched PubMed, Embase, Web of Science, Cochrane Library, and the references of articles in 14th December 2019.
Methods: The study characteristics included: authors, year, country, sample size, mean age of patients with heart failure, duration of intervention, recruitment and intervention delivery, interventions based on self-efficacy theory, cognitive behavioral therapy, disease management, self-care education. The risk of bias for each study was assessed independently by two investigators based on the Cochrane Handbook. This study used Revman to analyze different research outcomes. The fixed-effect model was used in the absence of significant heterogeneity or low heterogeneity, and if the heterogeneity was high, the random effect model was used.
Results: A total of 4977 publications were retrieved in this study. After eliminating duplicates and screening for titles and abstracts, 209 articles were retrieved for full-text evaluation. Finally, a total sample size analyzed across 15 randomized controlled trials was 2630 participants. This study showed that selfmanagement interventions significantly improved heart failure knowledge (0.61, 95% confidence interval (CI) 0.27–0.95, p = 0.0004), quality of life (0.20, 95% CI 0.02–0.38, p = 0.03), and heart failure-related hospitalization (OR 0.40, 95% CI 0.29 to 0.55, p<0.00001) in patients with heart failure.
Conclusions: This study reveals the beneficial effects of self-management interventions on heart failure knowledge, quality of life, and heart failure-related hospitalization in patients with heart failure. Therefore, high quality randomized controlled designs are needed to explore the optimal self-management interventions for patients with heart failure.
keywords: نارسایی قلبی | خود مدیریت | دانش نارسایی قلب | کیفیت زندگی | بستری شدن از نارسایی های قلب | Heart failure | Self-management | Heart failure knowledge | Quality of life | Heart failure-related hospitalization
مقاله انگلیسی
70 Mapping global fuel cell vehicle industry chain and assessing potential supply risks
نقشه برداری از زنجیره صنعت خودروی سوختی سوخت جهانی و ارزیابی خطرات احتمالی تأمین-2021
Fuel cell vehicles (FCVs) have the potential to contribute significantly to improving air quality and addressing climate concerns in the future. However, due to the highly dynamic technology and manufacturing developments, there is a lack of understanding of the state- of-the-art global FCV industry chain and associated supply risks. This study fills such a research gap by mapping global FCV industry chain during the period 2017e2019, and assessing the supply risks of relevant key commodities. The results show that significant supply risks existed in global FCV industry chain, especially in upstream commodities like platinum and gas diffusion layer (GDL). The combined indicator of Herfindahl-Hirschman Index and Worldwide Governance-Indicator (HHI-WGI) is used to quantify the supply risks, showing that HHI-WGI of platinum is on the highest level. On the national level, supply risks are identified primarily in platinum for Japan, in vehicles for the United States, and along the entire industry chain for China. Network analysis is conducted to visualize and analyze how countries, companies and commodities are connected, showing that the highest supply risks were identified in GDLs. It is recommended that country-specific measures should be taken to mitigate supply risks, including building up national stocks of critical materials, investing overseas, enhancing the guidance over industry policies, and stepping up infrastructure construction.© 2021 Hydrogen Energy Publications LLC. Published by Elsevier Ltd. All rights reserved.* Corresponding author. State Key Laboratory of Automotive Safety and Energy, Tsinghua University, Beijing 100084, China. E-mail address: hao@tsinghua.edu.cn (H. Hao).https://doi.org/10.1016/j.ijhydene.2021.02.0410360-3199/© 2021 Hydrogen Energy Publications LLC. Published by Elsevier Ltd. All rights reserved.
Keywords: Fuel cell vehicle | Industry chain | Supply risk | Network analysis
مقاله انگلیسی
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