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At least 973 records · Page 54
All sourcesNASA NTRSDOE OSTI
DOE OSTI2012

CCSI Risk Estimation: An Application of Expert Elicitation

The Carbon Capture Simulation Initiative (CCSI) is a multi-laboratory simulation-driven effort to develop carbon capture technologies with the goal of accelerating commercialization and adoption in the near future. One of the key CCSI technical challenges is representing and quantifying the inherent uncertainty and risks associated with developing, testing, and deploying the technology in simulated and real operational settings. To address this challenge, the CCSI Element 7 team developed a holistic risk analysis and decision-making framework. The purpose of this report is to document the CCSI Element 7 structured systematic expert elicitation to identify additional risk factors. We review the significance of and established approaches to expert elicitation, describe the CCSI risk elicitation plan and implementation strategies, and conclude by discussing the next steps and highlighting the contribution of risk elicitation toward the achievement of the overarching CCSI objectives.

CCSI↗
DOE OSTI2015

Prototypic Enhanced Risk Monitor Framework and Evaluation - Advanced Reactor Technology Milestone: M3AT-15PN2301054

This research report summaries the development and evaluation of a prototypic enhanced risk monitor (ERM) methodology (framework) that includes alternative risk metrics and uncertainty analysis. This updated ERM methodology accounts for uncertainty in the equipment condition assessment (ECA), the prognostic result, and the probabilistic risk assessment (PRA) model. It is anticipated that the ability to characterize uncertainty in the estimated risk and update the risk estimates in real time based on equipment condition assessment (ECA) will provide a mechanism for optimizing plant performance while staying within specified safety margins. These results (based on impacting active component O&M using real-time equipment condition information) are a step towards ERMs that, if integrated with AR supervisory plant control systems, can help control O&M costs and improve affordability of advanced reactors.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗
DOE OSTI2021

Systematic Enterprise Risk Management by Integrating the RISMC Toolkit and Cost-Benefit Analysis (Final Report)

The goal of this research is to theorize and quantify the relationships between safety and the financial performance of nuclear power plants (NPPs). The Socio-Technical Risk Analysis (SoTeRiA) theoretical framework, which connects the social aspects (e.g., safety culture) and structural features (e.g., safety practices) of an organization with organizational safety and financial risks, is used to theorize the direct and indirect relationships between safety and the financial performance of NPPs. An Integrated Enterprise Risk Management (I-ERM) methodological framework is developed to operationalize SoTeRiA to quantify NPP safety and financial performance in a unified platform where their underlying physical degradation mechanisms, coupled with maintenance performance (considering human and organizational factors), are explicitly incorporated to depict the interconnections and dependencies between safety and financial performance. In this study, NPP safety refers to both occupational safety and system safety (estimated from Probabilistic Risk Assessment, PRA), and financial performance refers to the monetary values associated with NPP operation and maintenance (O&M) strategies. This report covers a case study demonstrating the feasibility of the I-ERM methodological framework. More detailed development of one of the I-ERM modules, i.e., Probabilistic Physics-of-Failure (PPoF) analysis, and its connection with other I-ERM modules is demonstrated in a second case study. The outcome of this research will help NPP decision-makers create cost-saving maintenance strategies while maintaining safety by providing cost- and risk-informed recommendations regarding maintenance work processes and operational strategies.

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗
DOE OSTI2021

Cybersecurity Resiliency of Marine Renewable Energy Systems Part 2: Cybersecurity Best Practices and Risk Management

Marine renewable energy (MRE) is an emerging source of power for marine applications, marine devices, and coastal communities. This energy source relies on industrial control systems and IT to support operations and maintenance activities, which create a pathway for an adversary to gain unauthorized access to systems and data and disrupt operations. Incorporating cybersecurity risk prevention measures and mitigation capabilities from inception, development, operation, to decommissioning of the MRE system and components is paramount to the protection of energy generation and the security of network architecture and infrastructure. To improve the resilience of MRE systems as a predictable, affordable, and reliable source of energy, cybersecurity guidance was developed to enable operators to assess cybersecurity risks and implement security measures commensurate with the risk. This publication is the second of a two-part series, with Part 1 addressing a framework to determine cybersecurity risk by assessing the vulnerability of an MRE system to potential cyber threats and the consequences a cyberattack would have on the end user. This Part 2 publication describes an approach to select appropriate cybersecurity best practices commensurate with the MRE system's cybersecurity risk. The guidance includes 86 cybersecurity best practices, which are associated with 36 cybersecurity domains and grouped into nine categories. The best practices follow the core functions of the National Institute of Science and Technology Cybersecurity Framework (e.g., identify, detect, protect, respond, and and recover) and insights from both maritime and energy industry guidance documents to identify security measures effective in protecting information and operational technology assets prevalent in MRE systems.

97 MATHEMATICS AND COMPUTING↗
NASA NTRS2004

Managing Risk to Ensure a Successful Cassini/Huygens Saturn Orbit Insertion (SOI)

I. Design: a) S/C designed to be largely single fault tolerant; b) Operate in flight demonstrated envelope, with margin; and c) Strict compliance with requirements & flight rules. II. Test: a) Baseline, fault & stress testing using flight system testbeds (H/W & S/W); b) In-flight checkout & demos to remove first time events. III. Failure Analysis: a) Critical event driven fault tree analysis; b) Risk mitigation & development of contingencies. IV) Residual Risks: a) Accepted pre-launch waivers to Single Point Failures; b) Unavoidable risks (e.g. natural disaster). V) Mission Assurance: a) Strict process for characterization of variances (ISAs, PFRs & Waivers; b) Full time Mission Assurance Manager reports to Program Manager: 1) Independent assessment of compliance with institutional standards; 2) Oversight & risk assessment of ISAs, PFRs & Waivers etc.; and 3) Risk Management Process facilitator.

risk managment↗
NASA NTRS2022

Modernizing NASA's Risk Classification System

NASA's risk classification system dates back to an era when every new NASA space mission was a one-of-a-kind build, and the only way to obtain reliability was as a by-product through a combination of reliability analyses, extensive and stringent quality requirements, and extensive testing. Originally, there were very limited commercial capabilities to develop systems to work reliably in space, so NASA considered its own homegrown approach the only recipe for success. This approach involved very detailed and prescriptive piece-part controls and no reliance on (and to some extent a rejection of) any type of commercial practices. Often risk was considered to be the lowest when NASA had the maximum amount of control and prescription, and the highest when commercial practices were largely employed, and these principles drove risk classification in the agency. Over time, however, commercial capabilities grew, and many products became standardized and commercialized, while the agency maintained its tried-and-true approach, paying little attention to the evolution of the commercial sector. In fact, the commercial sector was developing systems that have direct, proven reliability, established over time, while NASA still maintained the approach to ignore the reality of the commercialized aspects of standard products, label them as high risk, and attempt to change them to align with the agency's piece-part control practices. A table of mission classification vs lifetime for missions launched after 2000 indicates no correlation between lifetime and classification, with the few exceptions involving missions that have very limited objectives and no valid purpose to continue after they were met. This paper steps through some of the key historical elements in risk classification and NASA's overall approach to assurance, and presents some elements being brought forward to modernize the approach and take advantage of the growing capability in the commercial sector.

risk↗
DOE OSTI2022

The Distributed Energy Resource Risk Manager

Organizations need a comprehensive approach to managing security and privacy risks, especially for energy resources that are becoming increasingly distributed. A tool by the National Renewable Energy Laboratory (NREL) makes it possible to manage these risks and maintain the highest standards of cybersecurity. To simplify risk management for facilities and distributed energy resources, NREL has created the Distributed Energy Resource Risk Manager, an automated, user-friendly tool that helps navigate and implement one of the most widely trusted frameworks for information security, the National Institute of Standards and Technology Risk Management Framework.

compliance↗
DOE OSTI2012

Screening Assessment of Potential Human-Health Risk from Future Natural-Gas Drilling Near Project Rulison in Western Colorado

The Project Rulison underground nuclear test was conducted in 1969 at a depth of 8,400 ft in the Williams Fork Formation of the Piceance Basin, west-central Colorado (Figure 1). The U.S. Department of Energy Office of Legacy Management (LM) is the steward of the site. Their management is guided by data collected from past site investigations and current monitoring, and by the results of calculations of expected behavior of contaminants remaining in the deep subsurface. The purpose of this screening risk assessment is to evaluate possible health risks from current and future exposure to Rulison contaminants so the information can be factored into LM's stewardship decisions. For example, these risk assessment results can inform decisions regarding institutional controls at the site and appropriate monitoring of nearby natural-gas extraction activities. Specifically, the screening risk analysis can provide guidance for setting appropriate action levels for contaminant monitoring to ensure protection of human health.

(Figure↗
DOE OSTI2017

Projected drought risk in 1.5°C and 2°C warmer climates

The large socioeconomic costs of droughts make them a crucial target for impact assessments of climate change scenarios. Using multiple drought metrics and a set of simulations with the Community Earth System Model targeting 1.5°C and 2°C above preindustrial global mean temperatures, we investigate changes in aridity and the risk of consecutive drought years. If warming is limited to 2°C, these simulations suggest little change in drought risk for the U.S. Southwest and Central Plains compared to present day. In the Mediterranean and central Europe, however, drought risk increases significantly for both 1.5°C and 2°C warming targets, and the additional 0.5°C of the 2°C climate leads to significantly higher drought risk. Our study suggests that limiting anthropogenic warming to 1.5°C rather than 2°C, as aspired to by the Paris Climate Agreement, may have benefits for future drought risk but that such benefits may be regional and in some cases highly uncertain.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2019

Bioaccumulation of Cr, Ni, Cd and Pb in the Economically Important Freshwater Fish Schizothorax plagiostomus from Three Rivers of Malakand Division, Pakistan: Risk Assessment for Human Health

Contamination of freshwater ecosystems such as rivers with hazardous heavy metals is an environmental problem of public health concern. Accumulation of potentially toxic heavy metals in freshwater fish causes a potential health threat to their consumers including humans. The present research aimed to (1) investigate the accumulation of four potentially toxic heavy metals viz. Cr, Ni, Cd and Pb in muscle tissue of the commercially important freshwater fish Schizothorax plagiostomus at different sites of River Swat, River Panjkora and River Barandu in northern Pakistan (2) to compare gross metal accumulation in the fish samples by calculating metal pollution index (MPI) and (3) to assess potential risk to the health of the fish consumers. Samples were analyzed for the heavy metals by flame atomic absorption spectrophotometry (FAAS). Risk analysis showed that Ni risk was higher at River Panjkora and River Barandu, Pb risk was higher at River Swat and River Panjkora while Cd risk was quite low at all the three rivers.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2023

Further understanding “severe” climate risk

What makes one climate risk more “severe” or “dangerous” than others? Acknowledging that the notion of dangerousness can substantially vary from one sociocultural context to another, this Perspective paper builds on recent literature to explore three notions that are estimated to be foundational to climate risk severity: the physical, ecological and social thresholds leading to transformational and possibly abrupt changes; the irreversibility of these changes; and the cascading effects within and across the systems affected. While not necessarily the most determining dimensions of risk, they deserve more attention and integration into frameworks to assess “severe” climate risk, such frameworks remaining under-developed. The paper also takes stock of issues related to the spatial scale(s) of and the evidence base for severe climate risks. It lands on four intertwined research directions across geographies, sectors and populations, that are hypothesized to play a critical role in the coming decade, from feeding the next IPCC cycle to more broadly supporting the development of anticipatory adaptation policies.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2014

Combined impact of lead, cadmium, polychlorinated biphenyls and non-chemical risk factors on blood pressure in NHANES

High blood pressure is associated with exposure to multiple chemical and non-chemical risk factors, but epidemiological analyses to date have not assessed the combined effects of both chemical and non-chemical stressors on human populations in the context of cumulative risk assessment. We developed a novel modeling approach to evaluate the combined impact of lead, cadmium, polychlorinated biphenyls (PCBs), and multiple non-chemical risk factors on four blood pressure measures using data for adults aged ≥20 years from the National Health and Nutrition Examination Survey (1999–2008). We developed predictive models for chemical and other stressors. Structural equation models were applied to account for complex associations among predictors of stressors as well as blood pressure. Models showed that blood lead, serum PCBs, and established non-chemical stressors were significantly associated with blood pressure. Lead was the chemical stressor most predictive of diastolic blood pressure and mean arterial pressure, while PCBs had a greater influence on systolic blood pressure and pulse pressure, and blood cadmium was not a significant predictor of blood pressure. The simultaneously fit exposure models explained 34%, 43% and 52% of the variance for lead, cadmium and PCBs, respectively. The structural equation models were developed using predictors available from public data streams (e.g., U.S. Census), which would allow the models to be applied to any U.S. population exposed to these multiple stressors in order to identify high risk subpopulations, direct intervention strategies, and inform public policy. - Highlights: • We evaluated joint impact of chemical and non-chemical stressors on blood pressure. • We built predictive models for lead, cadmium and polychlorinated biphenyls (PCBs). • Our approach allows joint evaluation of predictors from population-specific data. • Lead, PCBs and established non-chemical stressors were related to blood pressure. • Framework allows cumulative risk assessment in specific geographic settings.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2014

Nonylphenol in pregnant women and their matching fetuses: Placental transfer and potential risks of infants

As the predominant environmental biodegradation product of nonylphenol (NP) ethoxylates and with proven estrogenic effects, NP is formed during the alkylation process of phenols. The purposes of this study were (1) to examine maternal and prenatal exposure to NP in Taiwan, (2) to determine the level of placental protection against NP exposure as well as the level of NP in breast milk, and (3) to assess the potential risk for breastfed newborns exposed to NP through the milk. Thirty pairs of maternal and fetal blood samples, placenta, and breast milk during the 1st and the 3rd months of lactation were collected. External NP exposures of these specimens were then analyzed by using high-performance liquid chromatography coupling with fluorescence detection. Next, the socio-demographics, lifestyle, delivery method, dietary and work history were collected using a questionnaire. In addition, the daily intake of NP from consuming breast milk in the 1st and 3rd months for newborns was studied through deterministic and probabilistic risk assessment methods. The geometric means and geometric standard deviation of NP levels in maternal blood, fetal cord blood, placenta, and breast milk in the 1st and 3rd months were 14.6 (1.7) ng/ml, 18.8 (1.8) ng/ml, 19.8 (1.9) ng/g, 23.5 (3.2) ng/ml, and 57.3 (1.4) ng/ml, respectively. The probabilistic percentiles (50th, 75th, and 95th) of daily intake NP in breast milk were 4.33, 7.79, and 18.39 μg/kg-bw/day in the 1st month, respectively, and were 8.11, 10.78, 16.08 μg/kg-bw/day in the 3rd month, respectively. The probabilistic distributions (5th, 25th, and 50th) of risk for infants aged 1 month old were 0.27, 0.64, and 1.15, respectively, and that for infants aged 3 month old were 0.31, 0.46, and 0.62, respectively. Through repeated exposure from the dietary intake of expectant mothers, fetuses could encounter a high NP exposure level due to transplacental absorption, partitioning between the maternal and fetal compartments. Daily NP intake via breast milk in three month-old babies exceeded the tolerable daily intake (TDI) of 5 µg/kg bw/day indicated a potential risk for Taiwan infants. - Highlights: • A cohort of pregnant women was established and followed until delivery. • The pregnant and lactating mothers and their infants were exposed to NP. • Fetuses in Taiwan showed high NP milk level. • Daily NP intake via breast milk indicated a potential risk for Taiwan infants.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Approach on environmental risk assessment of nanosilver released from textiles

Based on the increased utilization of nanosilver (silver nanomaterials=AgNM) as antibacterial agent, there is the strong need to assess the potential environmental implication associated with its new application areas. In this study an exemplary environmental risk assessment (ERA) of AgNM applied in textiles was performed. Environmental exposure scenarios (via municipal sewage treatment plant (STP)) with wastewater supply from domestic homes) were developed for three different types of textiles equipped with AgNM. Based on these scenarios predicted environmental concentrations (PECs) were deduced for STPs and for the environmental compartments surface water, sediment as well as soil. These PECs were related to PNECs (predicted no effect concentrations). PNECs were deduced from results of ecotoxicity tests of a selected AgNM (NM-300K). Data on ecotoxicology were derived from various tests with activated sludge, cyanobacteria, algae, daphnids, fish, duckweed, macrophytes, chironomids, earthworms, terrestrial plants as well as soil microorganisms. Emission data for the AgNM NM-300K from textiles were derived from washing experiments. The performed ERA was based on the specifications defined in the ECHA Guidances on information requirements and chemical safety assessment. Based on the chosen scenarios and preconditions, no environmental risk of the AgNM NM-300K released from textiles was detected. Under conservative assumptions a risk quotient for surface water close to 1 indicated that the aquatic compartment may be affected by an increased emission of AgNM to the environment due to the high sensitivity of aquatic organisms to silver. Based on the successful retention of AgNM in the sewage sludge and the still ongoing continual application of sewage sludge on farmland it is recommended to introduce a threshold for total silver content in sewage sludge into the respective regulations. Regarding potential risk mitigation measures, it is emphasized to preferably directly introduce AgNM into the textile fiber since this will strongly minimize the release of AgNM during washing. If this is not possible due to technical limitations or other reasons, the introduction of a threshold level controlling the release of AgNM from textiles is suggested. It has to be noted that this study is a case study which is only valid for the investigated NM-300K and its potential application in textiles. - Highlights: • Washing: release rates of AgNM depend on furnishing in textiles. • Calculated PNECs for the aquatic compartment were low. • For the chosen scenarios no environmental risk of AgNM from textiles was observed. • AgNM is retained in sewage sludge. • In WWTP most of the silver adsorbs to sewage sludge and thus, may reach farmland.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2018

Occurrence of cyclic imines in European commercial seafood and consumers risk assessment

Highlights: • First study of cyclic imines in commercial shellfish samples from Europe. • First study including samples from eight European countries during two years. • First report dealing risk assessment on pinnatoxins. • Completes information regarding spirolides from the EFSA report on 2010. • Increases database on levels of CIs in shellfish to perform a risk assessment. Cyclic imines constitute a quite recently discovered group of marine biotoxins that act on neural receptors and that bioaccumulate in seafood. They are grouped together due to the imino group functioning as their common pharmacore, responsible for acute neurotoxicity in mice. Cyclic imines (CIs) have not been linked yet to human poisoning and are not regulated in the European Union (EU), although the European Food Safety Authority (EFSA) requires more data to perform conclusive risk assessment for consumers. Several commercial samples of bivalves including raw and processed samples from eight countries (Italy, Portugal, Slovenia, Spain, Ireland, Norway, The Netherlands and Denmark) were obtained over 2 years. Emerging cyclic imine concentrations in all the samples were analysed on a LC-3200QTRAP and LC-HRMS QExactive mass spectrometer. In shellfish, two CIs, pinnatoxin G (PnTX-G) and 13-desmethylspirolide C (SPX-1) were found at low concentrations (0.1–12 µg/kg PnTX-G and 26–66 µg/kg SPX-1), while gymnodimines and pteriatoxins were not detected in commercial (raw and processed) samples. In summary, SPX-1 (n: 47) and PnTX-G (n: 96) were detected in 9.4% and 4.2% of the samples, respectively, at concentrations higher than the limit of quantification (LOQ), and in 7.3% and 31.2% of the samples at concentrations lower than the LOQ (25 µg/kg for SPX-1 and 3 µg/kg for PnTX-G), respectively. For the detected cyclic imines, the average exposure and the 95th percentile were calculated. The results obtained indicate that it is unlikely that a potential health risk exists through the seafood diet for CIs in the EU. However, further information about CIs is necessary in order to perform a conclusive risk assessment.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2020

Probabilistic risk-based Area of Review (AoR) determination for a deep-saline carbon storage site

Regulatory oversight of a geologic carbon sequestration (GCS) project relies on iterative estimations, throughout the project lifetime, of the area where increased risks to underground sources of drinking water (USDWs) may occur due to injection of CO2. This area, referred to as Area of Review (AoR), is typically delineated by predicting the migration of fluid between the reservoir and the lowermost USDW via an open wellbore using predictions from physics-based reservoir simulators. The inherent uncertainty in input parameters used in reservoir modeling therefore affects the accuracy of determining the AoR for a project. Furthermore, the standard analytical approaches for calculating a critical pressure to delineate the risk area yield an infinite AoR for cases where the injection reservoir is overpressured relative to the USDW. A methodology is presented in this paper to better characterize the risk to USDWs while accounting for the uncertainty in reservoir modeling, with an application to a permitted GCS project with an overpressured injection formation, FutureGen 2.0. The methodology is demonstrated using the National Risk Assessment Partnership’s open-source integrated assessment model (NRAP-Open-IAM) to develop a probabilistic estimate of impact risk to USDW quality. CO2 and pressure predictions from the reservoir modeling conducted using the STOMP-CO2 simulator for the FutureGen 2.0 site are used in a NRAP-Open-IAM model with reservoir, wellbore, and aquifer components to: (1) assess the extent of potential leakage into the USDW for the predicted reservoir pressure conditions; (2) evaluate the extent of potential impact using “no-net-degradation” thresholds; and (3) account for uncertainty in reservoir permeabilities.

03 NATURAL GAS↗
DOE OSTI2021

Data requirements for improving the Quantitative Risk Assessment of liquid hydrogen storage systems

Quantitative Risk Assessment (QRA) supports the development of risk-informed safety codes and standards which are employed to enable the safe deployment of hydrogen technologies essential to decarbonize the transportation sector. System reliability data is a necessary input for rigorous QRA. Here, the lack of reliability data for bulk liquid hydrogen (LH 2 ) storage systems located on site at fueling stations limits the use of QRAs. In turn, this hinders the ability to develop the necessary safety codes and standards that enable worldwide deployment of these stations. Through a QRA-based analysis of a LH 2 storage system, this work focuses on identifying relevant scenario and probability data currently available and ascertaining future data collection requirements regarding risks specific to liquid hydrogen releases. The work developed consists of the analysis of a general bulk LH 2 storage system design located at a hydrogen fueling station. Failure Mode and Effect Analysis (FMEA) and traditional QRA modeling tools such as Event Sequence Diagrams (ESD) and Fault Tree Analysis (FTA) are employed to identify, rank, and model risk scenarios related to the release of LH 2 . Based on this analysis, scenario and reliability data needs to add LH 2 -related components to QRA are identified with the purpose of improving the future safety and risk assessment of these systems.

08 HYDROGEN↗
DOE OSTI2012

Competing-Risks Mortality After Radiotherapy vs. Observation for Localized Prostate Cancer: A Population-based Study

Purpose: Contemporary patients with localized prostate cancer (PCa) are more frequently treated with radiotherapy. However, there are limited data on the effect of this treatment on cancer-specific mortality (CSM). Our objective was to test the relationship between radiotherapy and survival in men with localized PCa and compare it with those treated with observation. Methods: A population-based cohort identified 68,797 men with cT1-T2 PCa treated with radiotherapy or observation between the years 1992 and 2005. Propensity-score matching was used to minimize potential bias related to treatment assignment. Competing-risks analyses tested the effect of treatment type (radiotherapy vs. observation) on CSM, after accounting to other-cause mortality. All analyses were carried out within PCa risk, baseline comorbidity status, and age groups. Results: Radiotherapy was associated with more favorable 10-year CSM rates than observation in patients with high-risk PCa (8.8 vs. 14.4%, hazard ratio [HR]: 0.59, 95% confidence interval [CI]: 0.50-0.68). Conversely, the beneficial effect of radiotherapy on CSM was not evident in patients with low-intermediate risk PCa (3.7 vs. 4.1%, HR: 0.91, 95% CI: 0.80-1.04). Radiotherapy was beneficial in elderly patients (5.6 vs. 7.3%, HR: 0.70, 95% CI: 0.59-0.80). Moreover, it was associated with improved CSM rates among patients with no comorbidities (5.7 vs. 6.5%, HR: 0.81, 95% CI: 0.67-0.98), one comorbidity (4.6 vs. 6.0%, HR: 0.87, 95% CI: 0.75-0.99), and more than two comorbidities (4.2 vs. 5.0%, HR: 0.79, 95% CI: 0.65-0.96). Conclusions: Radiotherapy substantially improves CSM in patients with high-risk PCa, with little or no benefit in patients with low-/intermediate-risk PCa relative to observation. These findings must be interpreted within the context of the limitations of observational data.

62 RADIOLOGY AND NUCLEAR MEDICINE↗