Search

Flood magnitude, frequency and intensity are bound to increase in many parts of the world due to global warming and its consequent effect as climate change impacts. The main purpose of this paper is to apply the classical probable maximum precipitation and probable maximum flood methodologies leading to a new concept of risk level charts, which provide hydrograph time to peak probable maximum discharge after the beginning of precipitation, base time and peak discharge values. Dimensionless hydrograph methodology is employed for flood hydrograph analysis. The applications of probable maximum precipitation and probable maximum flood methodologies are presented for Algerian meteorology stations' annual maximum daily precipitation amounts from 23 different locations at Hodna drainage basin in the north-eastern of Algeria. Classical probable maximum precipitation frequency factor is obtained for each meteorology station record, which are then converted to pointwise probable maximum flood amounts that are helpful to construct practically applicable flood charts. A new relationship is provided between probable maximum precipitation and the frequency factor for the study area. The efficiency factor is calculated for each station to understand whether there is a further possibility for extreme precipitation, and consequent flood occurrences.

Background: An unhealthy diet is a major risk factor for cardiovascular disease attributing to the burden of non-communicable diseases. Current dietary guidelines are not sufficiently implemented and effective strategies to encourage people to change and maintain healthy diets are lacking. We aimed to evaluate the impact of incorporating dietary assessment into ten-year absolute risk charts for atherosclerotic cardiovascular disease (ASCVD). Methods: In the prospective Copenhagen General Population Study including 94 321 individuals, we generated sex-specific ten-year absolute risk scores for ASCVD according to adherence to dietary guidelines, using a short and valid food frequency questionnaire. To account for competing risk, we used the method of Fine-Gray. Findings: Non-adherence to dietary guidelines was associated with an atherogenic lipid and inflammatory profile. Ten-year absolute risk of ASCVD increased with increasing age, increasing systolic blood pressure, and decreasing adherence to dietary guidelines for both sexes. The highest ten-year absolute risk of ASCVD of 38% was observed in men aged 65–69 years who smoked, had very low adherence to dietary guidelines, and a systolic blood pressure between 160 and 179 mmHg. The corresponding value for women was 26%. Risk charts replacing dietary assessment with non-HDL cholesterol yielded similar estimates. Interpretation: Incorporation of a short dietary assessment into ten-year absolute risk charts has the potential to motivate patients to adhere to dietary guideline recommendations. Improved implementation of national dietary guidelines must be a cornerstone for future prevention of cardiovascular disease in both younger and older individuals. Funding: The Lundbeck Foundation (R278-2018-804) and the Danish Heart Foundation.

Construction risk assessment is the final and decisive stage of risk analysis. When highly changeable conditions of works execution are predicted, risk should be evaluated in the favorable, moderate, and difficult random conditions of construction. Given the random conditions, the schedule and cost estimate of the construction are developed. Based on these values, the risk of final deadline delay and the risk of total cost increase of construction completion are calculated. Next, the charts of the risks are elaborated. Risk changes are shown in the charts and are analyzed in the range [1, 0].

Risk assessment charts are visualized and easy to use in patient education by public health nurses. The aim of our study was to assess the risk factors and for death and lifestyles to construct risk assessment charts for death using the data from a small community. From June 1992, we conducted the JMS cohort study in Wara town, Gifu, Japan. Participants were tested for systolic blood pressure, total cholesterol, high-density lipoprotein-cholesterol and blood glucose. Information about medical history, food frequency, and lifestyle was obtained by a questionnaire. Physical activity was assessed according to the criteria used in The Framingham Study. All participants were followed up annually during an annual health care check, visits, phone call, and mailings. Risk charts were created based on calculations of the 10-year absolute risk that were associated with all cause death. A total of 1,371 participants (615 males and 756 females) were analyzed in this study. Total all-cause death was 356. In males, the physical activity index was associated with all-cause death (Hazard ratio 0.92 95％ CI 0.87-0.97) and showed a tendency towards low mortality in females (HR 0.92 95％ CI 0.82-1.01). In both sexes, the risk of death was lower in participants who frequently consumed citrus fruit（HR for the infrequent intake group versus the normal intake group, and infrequent intake group vs the high intake group: 0.63 95％ CI 0.35-1.14 and 0.23 0.09-0.55 for males, 1.02, 0.51-2.06 and 0.39, 0.19-0.90 for females). We constructed risk-assessment charts for death in Wara town on the basis of hazard ratios. We used data from the Wara area, a Japanese rural population, to develop risk charts that estimated the 10-year risk for all-cause mortality.

Risk stratification for primary prevention of cardiovascular disease is today performed using traditional risk factors such as age, gender, blood pressure, serum cholesterol, smoking habits, and plasma glucose. However, these factors perform poorly in the daily clinic where individual risk prediction is needed. It has been suggested to supplement traditional factors with markers of subclinical organ damage to identify subjects with increased susceptibility for the negative influence from the traditional risk factors. Although many new markers are independently associated with cardiovascular risk, their clinical impact on risk prediction is uncertain. In this chapter the evidence for incremental risk prediction for the most promising markers is reviewed, and it is demonstrated that many new markers provide only modest impact on risk prediction with greatest improvement in intermediate risk groups. However, several aspects are still uncertain and need to be examined in the setting of a randomized study. These include actual net benefit of the use of these new markers in risk stratification after taking into account cost, risk associated with the measurements, and the increased downstream medication and examinations, as well as actual changes in patient and physician behavior and clinical outcome.

Risk stratification for primary prevention of cardiovascular disease is today performed using traditional risk factors such as age, gender, blood pressure, serum cholesterol, smoking habits, and plasma glucose. However, these factors perform poorly in the daily clinic where individual risk prediction is needed. It has been suggested to supplement traditional factors with markers of subclinical organ damage to identify subjects with increased susceptibility for the negative influence from the traditional risk factors. Although many new markers are independently associated with cardiovascular risk, their clinical impact on risk prediction is uncertain. In this chapter the evidence for incremental risk prediction for the most promising markers is reviewed, and it is demonstrated that many new markers provide only modest impact on risk prediction with greatest improvement in intermediate risk groups. However, several aspects are still uncertain and need to be examined in the setting of a randomized study. These include actual net benefit of the use of these new markers in risk stratification after taking into account cost, risk associated with the measurements, and the increased downstream medication and examinations, as well as actual changes in patient and physician behavior and clinical outcome.

OBJECTIVES: In the past years, several risk charts have been created to increase the accuracy of cardiovascular risk stratification. The most widely used and validated algorithms do not included target organ damage as risk prediction. The aim of the present study was to evaluate whether preclinical renal damage is associated with cardiovascular diseases independently of individual risk profile assessed by risk charts. METHODS: The study population was that of Italy-Developing Education and awareness on MicroAlbuminuria in patients with hypertensive Disease, a large observational study conducted on hypertensive patients in Italy. The Framingham Risk Score (FRS), Systematic COronary Risk Estimation (SCORE) and Progetto Cuore Risk Score (Progetto Cuore RS) were computed in each eligible patient. Chronic kidney disease was defined by the presence of albuminuria or by a reduction of glomerular filtration rate. RESULTS: Study participants were categorized to have low, medium and high risk according to the tertiles of the three charts. Prevalence of total cardiovascular diseases progressively and significantly increased according to the degrees of risk assessed by the three charts, the highest prevalence being in participants with a high-risk profile (both high and medium vs. low risk

Despite the wide improvement of diagnostic techniques and the introduction of effective pharmacological and instrumental therapeutic strategies aimed to the treatment of cardiovascular diseases, their incidence and lethality are still elevated, with economic implications increasingly less sustainable by the public medical systems. The modern practice of cardiovascular prevention requires, thus, that diagnostic and therapeutic interventions, both at population level and on the single patient, should be more and more precise, effective, and appropriate. From this point of view, a correct global cardiovascular risk stratification assumes a preponderant relevance, in order to allow an adequate therapeutical response. For this purpose several work instruments, as risk charts and guidelines, namely dedicated to arterial hypertension and dyslipidemias, were developed and offered to clinicians interested in cardiovascular prevention. The aim of this review is to illustrate, in synthesis, those instruments, aiming to facilitate their implementation, thus reducing the actual gap between theoretical indications and the real world.