How Damage Diversification Can Reduce Systemic Risk

We consider the problem of risk diversification in complex networks. Nodes represent e.g. financial actors, whereas weighted links represent e.g. financial obligations (credits/debts). Each node has a risk to fail because of losses resulting from defaulting neighbors, which may lead to large failure cascades. Classical risk diversification strategies usually neglect network effects and therefore suggest that risk can be reduced if possible losses (i.e., exposures) are split among many neighbors (exposure diversification, ED). But from a complex networks perspective diversification implies higher connectivity of the system as a whole which can also lead to increasing failure risk of a node. To cope with this, we propose a different strategy (damage diversification, DD), i.e. the diversification of losses that are imposed on neighboring nodes as opposed to losses incurred by the node itself. Here, we quantify the potential of DD to reduce systemic risk in comparison to ED. For this, we develop a branching process approximation that we generalize to weighted networks with (almost) arbitrary degree and weight distributions. This allows us to identify systemically relevant nodes in a network even if their directed weights differ strongly. On the macro level, we provide an analytical expression for the average cascade size, to quantify systemic risk. Furthermore, on the meso level we calculate failure probabilities of nodes conditional on their system relevance

A k-shell decomposition method for weighted networks

We present a generalized method for calculating the k-shell structure of weighted networks. The method takes into account both the weight and the degree of a network, in such a way that in the absence of weights we resume the shell structure obtained by the classic k-shell decomposition. In the presence of weights, we show that the method is able to partition the network in a more refined way, without the need of any arbitrary threshold on the weight values. Furthermore, by simulating spreading processes using the susceptible-infectious-recovered model in four different weighted real-world networks, we show that the weighted k-shell decomposition method ranks the nodes more accurately, by placing nodes with higher spreading potential into shells closer to the core. In addition, we demonstrate our new method on a real economic network and show that the core calculated using the weighted k-shell method is more meaningful from an economic perspective when compared with the unweighted one.Comment: 17 pages, 6 figure

Which electronic health record system should we use? A systematic review

The UK government had intended to introduce a comprehensive EHRs system in England by 2020. These EHRs would run across primary, secondary, and social care linking data in a single digital platform. This systematic review's objectives were to identify studies that compare EHRs in terms of direct comparison between systems and evaluate them using System and Software Quality Requirements and Evaluation (SQuaRE) ISO/IEC 25010. A systematic review was performed by searching EMBASE and Ovid MEDLINE databases between 1974 and April 2021. All original studies that appraised EHR systems and their providers were included. The main outcome measures were EHR system comparison and SQuaRE's eight characteristics: functional suitability, performance efficiency, compatibility, usability, reliability, security, maintainability, and portability. A total of 724 studies were identified using the search criteria. After review of titles and abstracts, this was filtered down to 40 studies as per exclusion and inclusion criteria set out in our study selection. Seven studies compared more than one EHR. The following number of studies looked at the various aspects of the SQuaRE respectively. Nineteen studies addressed functional suitability, n=18 performance efficiency, n=12 compatibility, n=25 usability, n=6 reliability, n=2 security, n=16 maintainability, and n=13 portability. Epic was the most studied EHR system and one of the most implemented vendors in the USA market, and one of the top ten in UK. It is difficult to assess which is the most advantageous EHR system currently available when looking at them in accordance with SQuaRE's eight characteristics for software evaluation

Effect of airplane transport of donor livers on post-liver transplantation survival

Aim: To evaluate the effect of long haul airplane transport of donor livers on post-transplant outcomes. Methods: A retrospective cohort study of patients who received a liver transplantation was performed in Perth, Australia from 1992 to 2012. Donor and recipient characteristics information were extracted from Western Australian liver transplantation service database. Patients were followed up for a mean of six years. Patient and graft survival were evaluated and compared between patients who received a local donor liver and those who received an airplane transported donor liver. Predictors of survival were determined by univariate and multivariate analysis using cox regression. Results: One hundred and ninety-three patients received a local donor liver and 93 patients received an airplane transported donor liver. Airplane transported livers had a significantly lower alanine transaminase (mean: 45 U/L vs 84 U/L, P = 0.035), higher donor risk index (mean: 1.88 vs 1.42, P \u3c 0.001) and longer cold ischemic time (CIT) (mean: 10.1 h vs 6.4 h, P \u3c 0.001). There was a weak correlation between CIT and transport distance (r 2 = 0.29, P \u3c 0.001). Mean follow up was six years and 93 patients had graft failure. Multivariate analysis found only airplane transport retained significance for graft loss (HR = 1.92, 95%CI: 1.16-3.17). One year graft survival was 0.88 for those with a local liver and was 0.71 for those with an airplane transported liver. One year graft loss was due to primary graft non-function or associated with preservation injury in 20.8% of recipients of an airplane transported liver compared with 4.6% in those with a local liver (P = 0.027). Conclusion: Airplane transport of donor livers was independently associated with reduced graft survival following liver transplantation

The Swiss Board Directors Network in 2009

We study the networks formed by the directors of the most important Swiss boards and the boards themselves for the year 2009. The networks are obtained by projection from the original bipartite graph. We highlight a number of important statistical features of those networks such as degree distribution, weight distribution, and several centrality measures as well as their interrelationships. While similar statistics were already known for other board systems, and are comparable here, we have extended the study with a careful investigation of director and board centrality, a k-core analysis, and a simulation of the speed of information propagation and its relationships with the topological aspects of the network such as clustering and link weight and betweenness. The overall picture that emerges is one in which the topological structure of the Swiss board and director networks has evolved in such a way that special actors and links between actors play a fundamental role in the flow of information among distant parts of the network. This is shown in particular by the centrality measures and by the simulation of a simple epidemic process on the directors network.Comment: Submitted to The European Physical Journal

The association of fat and other macronutrients with breast cancer: a case-control study from Greece.

The Greek diet is characterized by a high total fat but low saturated fat intake. In a hospital-based case-control study of female breast cancer conducted in Athens (1989-91), 820 patients with confirmed cancer of the breast were compared with 795 orthopaedic patient controls and 753 hospital visitor controls, matched to the cases by age and interviewer. Diet was ascertained through a semiquantitative food frequency questionnaire; macronutrient intakes were estimated from the nutrient content of a selected typical portion size for each specified food item, summed for all items. Logistic regression was used to analyse the data, controlling for demographic and reproductive risk factors for breast cancer as well as for total energy intake and mutual confounding influences among nutrients. There was no significant or suggestive association of total protein, total fat, categories of fat or total carbohydrates with breast cancer risk. Thus, the mutually adjusted relative risk per quintile and (in parenthesis) 95% confidence interval were: for protein, 1.06 (0.94-1.20); saturated fat, 0.99 (0.89-1.11); monounsaturated fat, 0.97 (0.88-1.07), polyunsaturated fat, 1.05 (0.97-1.13); and total carbohydrates, 1.03 (0.94-1.12). In alternative analytical approaches only total protein appeared to be positively associated to the occurrence of breast cancer with some consistency, but the results were far from statistically significant. These findings do not support a role for fat or other energy-generating nutrients in the aetiology of breast cancer

Tracheotomy in COVID-19 patients : Optimizing patient selection and identifying prognostic indicators

Background: Tracheotomy, through its ability to wean patients off ventilation, can shorten ICU length of stay and in doing so increase ICU bed capacity, crucial for saving lives during the COVID-19 pandemic. To date, there is a paucity of patient selection criteria and prognosticators to facilitate decision making and enhance precious ICU capacity. Methods: Prospective study of COVID-19 patients undergoing tracheotomy (n = 12) over a 4-week period (March-April 2020). Association between preoperative and postoperative ventilation requirements and outcomes (ICU stay, time to decannulation, and death) were examined. Results: Patients who sustained FiO2 ≤ 50% and PEEP ≤ 8 cm H2O in the 24 hours pretracheotomy exhibited a favorable outcome. Those whose requirements remained below these thresholds post-tracheotomy could be safely stepped down after 48 hours. Conclusion: Sustained FiO2 ≤ 50% and PEEP ≤ 8 cm H2O in the 48 hours post-tracheotomy are strong predictive factors for a good outcome, raising the potential for these patients to be stepped down early, thus increasing ICU capacity

Intrasession and Between-Visit Variability of Sector Peripapillary Angioflow Vessel Density Values Measured with the Angiovue Optical Coherence Tomograph in Different Retinal Layers in Ocular Hypertension and Glaucoma

PURPOSE: To evaluate intrasession and between-visit reproducibility of sector peripapillary angioflow vessel-density (PAFD, %) values in the optic nerve head (ONH) and radial peripapillary capillaries (RPC) layers, respectively, and to analyze the influence of the corresponding sector retinal nerve fiber layer thickness (RNFLT) on the results. METHODS: High quality images acquired with the Angiovue/RTVue-XR Avanti optical coherence tomograph (Optovue Inc., Fremont, USA) on 1 eye of 18 stable glaucoma and ocular hypertension patients were analyzed using the Optovue 2015.100.0.33 software version. Three images were acquired in one visit and 1 image 3 months later. RESULTS: PAFD image quality for all images necessary to calculate reproducibility was sufficient to analysis only in 18 of the 83 participants (21.7%) who were successfully imaged for RNFLT. Intrasession coefficient of variation (CV) ranged between 2.30 and 3.89%, and 3.51 and 5.12% for the peripapillary sectors in the ONH and RPC layers, respectively. The corresponding between-visit CV values ranged between 3.05 and 4.26%, and 4.99 and 6.90%, respectively. Intrasession SD did not correlate with the corresponding RNFLT in any sector in either layer (P>/=0.170). In the ONH layer sector PAFD values did not correlate with the corresponding RNFLT values (P>/=0.100). In contrast, in the RPC layer a significant positive correlation between the corresponding sector PAFD and RNFLT values was found for all but one peripapillary sectors (Pearson-r range: 0.652 to 0.771, P</=0.0046). CONCLUSION: Though in several patients routine use of PAFD measurement may be limited by suboptimal image quality, in the successfully imaged cases (21.7% of the study eyes in the current investigation) reproducibility of sector PAFD values seems to be sufficient for clinical research. In stable patients intrasession variability explains most of the between-visit variability. Sector PAFD variability is independent from sector RNFLT, a marker of glaucoma severity. In the RPC layer sector PAFD and RNFLT show strong to very strong positive correlation

Credit Default Swaps Drawup Networks: Too Tied To Be Stable?

We analyse time series of CDS spreads for a set of major US and European institutions on a pe- riod overlapping the recent financial crisis. We extend the existing methodology of {\epsilon}-drawdowns to the one of joint {\epsilon}-drawups, in order to estimate the conditional probabilities of abrupt co-movements among spreads. We correct for randomness and for finite size effects and we find significant prob- ability of joint drawups for certain pairs of CDS. We also find significant probability of trend rein- forcement, i.e. drawups in a given CDS followed by drawups in the same CDS. Finally, we take the matrix of probability of joint drawups as an estimate of the network of financial dependencies among institutions. We then carry out a network analysis that provides insights into the role of systemically important financial institutions.Comment: 15 pages, 5 figures, Supplementary informatio