Search results for: project risk factors

Authors: Khaled Hesham Hyari, Amjad Almani

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Construction projects in the public sector are commonly awarded through competitive bidding. In the last decade, the Construction projects environment in the Middle East went through many changes. These changes have been caused by different factors including the economic crisis, delays in monthly payments, international competition and reduced number of projects. These factors had a great impact on the bidding behaviors of contractors and their pricing strategies. This paper examines the competition characteristics in public construction projects through an analysis of bidding results of contractors in public construction projects over a period of 6 years (2006-2011) in Jordan. The analyzed projects include all categories of projects such as infrastructure, buildings, transportation and engineering services (design and supervision contracts). Data for the projects were obtained from the General Tender’s Directorate in Jordan and includes 462 projects. The analysis performed in this projects includes, studying the bid spread in all projects as it is an indication of the level of competition in the analyzed bids. The analysis studied the factors that affect bid spread such as number of bidders, Value of the project, Project category and years. It also studying the “Signal to Noise Ratio” in all projects as it is an indication of the accuracy of cost estimating performed by competing bidders and bidder´s evaluation of project risks. The analysis performed includes the relationship between signal to noise ratio and different parameters such as project category, number of bidders and changes over years. Moreover, the analysis includes determining the bidder´s aggressiveness in bidding as it is an indication of competition level in such projects. This was performed by determining the pack price which can be considered as the true value of the project and comparing it with the lowest bid submitted for each project to determine the level of aggressiveness in submitted bids. The analysis performed in this project should prove to be useful to owners in understanding bidding behaviors of contractors and pointing out areas that needs improvement in preparing bidding documents. Also the project should be useful to contractors in understanding the competitive bidding environment and should help them to improve their bidding strategies to maximize the success rate in obtaining contracts.

Keywords: construction projects, competitive bidding, public construction, competition

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Authors: Nyla Anjum, Humaira Bano

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Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

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Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

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Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

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Authors: Narissara Nuthammachot, Dimitris Stratoulias

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Fire is one of the main causes of environmental and ecosystem change. Therefore, it is a challenging task for fire risk assessment fire potential mapping. The study area is Hua Sai district, Nakorn Sri Thammarat province, which covers in a part of peat swamp forest areas. 55 fire points in peat swamp areas were reported from 2012 to 2016. Analytic Hierarchy Process (AHP) and Geographic Information System (GIS) methods were selected for this study. The risk fire area map was arranged on these factors; elevation, slope, aspect, precipitation, distance from the river, distance from town, and land use. The results showed that the predicted fire risk areas are found to be in appreciable reliability with past fire events. The fire risk map can be used for the planning and management of fire areas in the future.

Keywords: analytic hierarchy process, fire risk assessment, geographic information system, peat swamp forest

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Authors: A. Pontrandolfi, G. Enjolras, F. Capitanio

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The study analyses the strategies Italian farmers use to cope with the risks that face their production. We specifically explore the potential and the limitations of the economic tools for climatic risk management in agriculture of the Common Agricultural Policy 2014-2020, that foresees contributions for economic tools for risk management, in relation to farms’ needs, exposure and vulnerability of agricultural areas to climatic risk. We consider at the farm level approaches to hedge risks in terms of the use of technical tools (agricultural practices, pesticides, fertilizers, irrigation) and economic/financial instruments (insurances, etc.). We develop cross-sectional and longitudinal analyses as well as analyses of correlation that underline the main differences between the way farms adapt their structure and management towards risk. The results show a preference for technical tools, despite the presence of important public aids on economic tools such as insurances. Therefore, there is a strong need for a more effective and integrated risk management policy scheme. Synergies between economic tools and risk reduction actions of a more technical, structural and management nature (production diversification, irrigation infrastructures, technological and management innovations and formation-information-consultancy, etc.) are emphasized.

Keywords: agriculture and climate change, climatic risk management, insurance schemes, farmers' approaches to risk management

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Authors: Tya M. Arthur

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Purpose: BIPOC (Black, Indigenous, and People of Color) adolescents face racism and discrimination at a young age. These early experiences have short- and long-term impacts on their health and overall well-being. The purpose of this study was to determine the relationships between perceived racial discrimination at school and health risk behaviors and experiences of BIPOC adolescents. Methods: Data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) were analyzed. All demographic data were summarized using frequencies and chi-squared tests. A univariate and multivariate logistic regression model was used to test the relationship between perceived racial discrimination and selected health risk factors. All analyses were conducted using STATA SE 18. Results: A total of 42.2% of the BIPOC adolescents in the study indicated being treated unfairly at school due to their race. The majority of those who reported being discriminated against were Black/African American or Multiple Race-Hispanic. Asian adolescents were almost 5 times more likely to face racial discrimination at school compared to their American Indian/Alaska Native counterparts (OR = 4.86, 95% CI [2.69-8.77], p < 0.001). Other risk predictors of racial discrimination included being female (OR = 1.38, 95% CI [1.13-1.68], p = 0.002) and feeling disconnected at school (OR = 1.76, 95% CI [1.30-2.38], p < 0.001). After adjustment for health risk behaviors and experiences, BIPOC adolescents were still more likely to face racial discrimination with even higher odds. Conclusions: The results of this study highlight the depth of racial discrimination faced by BIPOC adolescents at school. Greater attention should be placed on racial discrimination as a social determinant of health and a public health crisis.

Keywords: racial discrimination, adolescents, heath risk factors, BIPOC

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Authors: Georgiana Onicescu, Yuqian Shen

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Due to the complex nature of geo-referenced data, multicollinearity of the risk factors in public health spatial studies is a commonly encountered issue, which leads to low parameter estimation accuracy because it inflates the variance in the regression analysis. To address this issue, we proposed a two-stage variable selection method by extending the least absolute shrinkage and selection operator (Lasso) to the Bayesian spatial setting, investigating the impact of risk factors to health outcomes. Specifically, in stage I, we performed the variable selection using Bayesian Lasso and several other variable selection approaches. Then, in stage II, we performed the model selection with only the selected variables from stage I and compared again the methods. To evaluate the performance of the two-stage variable selection methods, we conducted a simulation study with different distributions for the risk factors, using geo-referenced count data as the outcome and Michigan as the research region. We considered the cases when all candidate risk factors are independently normally distributed, or follow a multivariate normal distribution with different correlation levels. Two other Bayesian variable selection methods, Binary indicator, and the combination of Binary indicator and Lasso were considered and compared as alternative methods. The simulation results indicated that the proposed two-stage Bayesian Lasso variable selection method has the best performance for both independent and dependent cases considered. When compared with the one-stage approach, and the other two alternative methods, the two-stage Bayesian Lasso approach provides the highest estimation accuracy in all scenarios considered.

Keywords: Lasso, Bayesian analysis, spatial analysis, variable selection

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Authors: Krzysztof J. Czarnocki, F. Silveira, E. Czarnocka, K. Szaniawska

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Research background: Problems related to the occupational health and decreasing level of safety occur commonly in the construction industry. Important factor in the occupational safety in construction industry is scaffold use. All scaffolds used in construction, renovation, and demolition shall be erected, dismantled and maintained in accordance with safety procedure. Increasing demand for new construction projects unfortunately still is linked to high level of occupational accidents. Therefore, it is crucial to implement concrete actions while dealing with scaffolds and risk assessment in construction industry, the way on doing assessment and liability of assessment is critical for both construction workers and regulatory framework. Unfortunately, professionals, who tend to rely heavily on their own experience and knowledge when taking decisions regarding risk assessment, may show lack of reliability in checking the results of decisions taken. Purpose of the article: The aim was to indicate crucial parameters that could be modeling with Risk Assessment Model (RAM) use for improving both building enterprise productivity and/or developing potential and safety climate. The developed RAM could be a benefit for predicting high-risk construction activities and thus preventing accidents occurred based on a set of historical accident data. Methodology/Methods: A RAM has been developed for assessing risk levels as various construction process stages with various work trades impacting different spheres of enterprise activity. This project includes research carried out by teams of researchers on over 60 construction sites in Poland and Portugal, under which over 450 individual research cycles were carried out. The conducted research trials included variable conditions of employee exposure to harmful physical and chemical factors, variable levels of stress of employees and differences in behaviors and habits of staff. Genetic modeling tool has been used for developing the RAM. Findings and value added: Common types of trades, accidents, and accident causes have been explored, in addition to suitable risk assessment methods and criteria. We have found that the initial worker stress level is more direct predictor for developing the unsafe chain leading to the accident rather than the workload, or concentration of harmful factors at the workplace or even training frequency and management involvement.

Keywords: safety climate, occupational health, civil engineering, productivity

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Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia A. El Banna, Mones M. Abu Shady, Muhammad Al-Tohamy, Manal Mouhamed Ali, Mehrevan M. Abd El-Moniem, Mona Anwar

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Association between vitamin D, adiponectin and obesity is a matter of debate, as they play important role in linking obesity with different cardiometabolic risk factors. Objectives: Evaluation of the association between metabolic risk factors with both adiponectin and vitamin D levels and that between adiponectin and vitamin D among obese Egyptian children. Subjects and Methods: This case-control cross-sectional study consisted of 65 obese and 30 healthy children, aged 8-11 years. 25-hydroxy vitamin D (25(OH) D) level, serum adiponectin, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) were measured. Results: The mean 25(OH) D levels in the obese and control groups were 29.9± 10.3 and 39.7 ± 12.7 ng/mL respectively (P < 0.001). The mean 25(OH) D and adiponectin levels in the obese were lower than that in the control group (P < 0.0001). 25(OH) D were inversely correlated with body mass index (BMI), triglyceride, total cholesterol and LDL-cholesterol (LDL-C), while adiponectin level were inversely correlated with systolic blood pressure (SBP), and diastolic blood pressure (DBP), and positively correlated with HDL-C. However, there is no relation between 25(OH) D and adiponectin levels among obese children and total sample. Conclusion: In spite of strong association between vitamin D and adiponectin levels with metabolic risk factors and obesity, there is no relation between 25(OH) D and adiponectin levels. In obese children, there are significant negative correlations between 25(OH) D with lipid profile, and between adiponectin levels with blood pressure. At certain adiponectin level, the relation between it and BMI disappears.

Keywords: 25-hydroxy vitamin D, adiponectin, lipid profile, blood pressure, children

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Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

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Globally, the death rate from cardiovascular disease has risen over the past 20 years, but especially in low and middle-income countries (LMICS), reports the World Health Organization (WHO). Around 17.5 million deaths, or 31% of all deaths worldwide in 2012, were attributed to CVD, 80% of which occurred in low- and middle-income nations, and eighty five percent of all worldwide disability is attributable to cardiovascular disease. This study assessed the dietary habit and Cardiovascular Risk factors among the patients of coronary artery disease against matched controls. The research was a case-control study. Sample size for this case-control study was 410 CAD cases and 410 healthy controls. The case-control ratio was 1:1. Patients diagnosed with coronary artery disease were recruited from the outpatient departments and emergency rooms of four hospitals in Pakistan. The ages of people who were diagnosed with coronary artery disease were not significantly different from (mean 57.97 7.39 years) the healthy controls (mean 57.12 6.73 years). In order to determine the relationship between food consumption and the two binary outcomes, logistic regression analysis was carried out. Chicken (0.340 (0.245-0.47), p-value 0.0001), beef (0.38 (0.254-0.56), p-value 0.0001), eggs (0.297 (0.208-0.426), p-value 0.0001), and junk food (0.249 (0.167-0.372), p-value 0.0001)) were protective, while yogurt consumption more than twice weekly was risk. Conclusion: In conclusion, poor dietary habits are closely linked to the risk of CAD. Investigations based on dietary trends offer vital and practical knowledge about societal patterns.

Keywords: dietary habbits, cardiovasculardisease, CVD risk factors, hypercholesterolemia

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Authors: Luna Degife, Desalegn Belay, Yoseph Worku, Tigist Tesfaye, Assefa Tufa, Abyot Bekele, Zegeye Hailemariam, Abay Hagos

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Half of the world’s population is at risk of Dengue Fever (DF), a highly under-recognized and underreported mosquito-borne viral disease with high prevalence in the tropical and subtropical regions. Globally, an estimated 50 to 200 million cases and 20, 000 DF deaths occur annually as per the world health organization report. In Ethiopia, the first outbreak occurred in 2013 in Diredawa administration city. Afterward, three outbreaks have been reported from the eastern part of the country. We received a report of the fifth DF outbreak for Ethiopia and the second for Diredawa city on October 4, 2015. We conducted the investigation to confirm the outbreak, identify the risk factors for the repeatedly occurrence of the disease and implement control measures. We conducted un- matched case-control study and defined a suspected DF case as any person with fever of 2-7 days and 2 or more of the following: a headache, arthralgia, myalgia, rash, or bleeding from any part of the body. Controls were residents of Diredawa city without DF symptoms. We interviewed 70 Cases and 140 controls from all health facilities in Diredawa city from October 7 to 15; 2015. Epi Info version 7.1.5.0 was used to analyze the data and multivariable logistic regression was conducted to assess risk factors for DF. Sixty-nine blood samples were collected for Laboratory confirmation.The mean age for cases was 23.7±9.5 standard deviation (SD) and for controls 31.2±13 SD. Close contact with DF patient (Adjusted odds ratio (AOR)=5.36, 95% confidence interval(CI): 2.75-10.44), nonuse of long-lasting insecticidal nets (AOR=2.74, 95% CI: 1.06-7.08) and availability of stagnant water in the village (AOR=3.61, 95% CI:1.31-9.93) were independent risk factors associated with higher rates of the disease. Forty-two samples were tested positive. Endemicity of DF is becoming a concern for Diredawa city after the first outbreak. Therefore, effective vector control activities need to be part of long-term preventive measures.

Keywords: dengue fever, Diredawa, outbreak, risk factors, second

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Authors: Sunita Patel

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Cardiovascular diseases are the leading cause of morbidity as well as mortality in India. Objective of this study is to examine CVDs prevalence and identify their behavioral and cultural risk factors with the help of SAGE-2007 data conducted on 6th states in India. Findings reveal that 18.3% of people diagnosed with CVDs in India. Higher disease occurs in an increasing rate between ages of 30-39 having OR 2.45 (CI: 1.66-3.63) and 70+ age OR 7.45 (CI: 4.82-11.49) times higher compare to 18-29 age group respectively. Wealth quintile higher CVD occurs as 3rd in 60% (CI: 1.16-2.21) and in richest 5th quintile 58% (CI: 1.13-2.21) contrast to lowest quintile. Relative risk depicted that 22.4% in moderate and 44% in vigorous activity have less chance of diseases compare to who performed no work and those who consumed alcohol. Results reveal that policy prospect should be recommended and that it would be beneficial for awareness of people and their future.

Keywords: behavioral risk, cultural risk, cardio-vascular diseases, wealth quintile

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Authors: Olga Plaza, Katarzyna Kosinska-Kaczynska, Stepan Feduniw, Dominika Pazdzior, Kinga Zebrowska, Katarzyna Kwiatkowska

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Introduction: The main causes of depression among pregnant women remain unclear. However, it is clear that pregnancy carries a higher risk of depression occurrence. Left untreated, prenatal depression can be a cause of serious both maternal and neonatal complications. Aim of the study: The aim of the study was to define potential risk factors of prenatal depression and to assess the frequency of its occurrence among pregnant women. Material and Methods: A prospective cross-sectional study was performed among 346 women. The self- composed questionnaire consisting of 46 questions, was distributed via the Internet between November 2017 and March 2018. The questionnaire contained the Edinburgh Postnatal Depression Scale (EPDS), in which the results of 13 and more points (out of 30) suggested possible prenatal depression. Statistical analysis was performed with Chi2 Pearson. P value < 0.05 was considered significant. Results: 37.57% (n=130) of women had a score of 13 or more points. Women with depressive symptoms (DS) reported lack of support from the partner (46.9% vs. 16.2%; p < 0.001) as well as other family members (40.8% vs. 14.4%; p < 0.001), current pregnancy being unplanned (21.5% vs. 12.5%; p=0.014) and low socio-economic status (10% vs. 0.9%; p < 0.001). Both early and advanced maternal age seemed to play a role in occurrence of DS: in women aged 17-24 40.8% declared symptoms (vs 28.7%; p < 0.01), in mothers aged ≥37 6.2% did (vs 0.5%; p < 0.001). Smoking during pregnancy was also more frequent among patients with DS (31.5% vs. 18.1%; p=0.004). Previous diagnosis of depression or other mood disorders significantly increased a chance of DS occurrence (respectively- 17.7% vs. 4.6%; p < 0.001 and 49.2% vs. 25%; p<0.001). Parental diagnosis of mood disorders and other mental disorders was also more frequent in this group of patients (respectively- 24.6% vs. 15.7%; p= 0.026 and 26.4% vs. 9.7%; p < 0.001). Only 23.8% of women with DS sought help from healthcare professionals, with 21.5% receiving pharmacological treatment. Conclusions: Pregnant women often report having DS. Evaluation of risk factors of DS and possible prenatal depression is essential in proper screening for depression among pregnant women.

Keywords: obstetrics, polish women, prenatal care, prenatal depression, risk factors

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Authors: Najeebah Almahmeed

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Risk Management is an evolving subject among organizations that include corporations, governments, non-governmental organizations, and not-for-profit corporations. In order to enhance awareness around the importance of Risk Management and make sure everyone is using it in their day-to-day job, the Risk Culture topic has emerged and gained importance not only in the Finance Sector but also in the National Oil Companies in Kuwait. Risk Culture can be defined as the shared beliefs, attitudes, and behaviors within a company that guide its approach to managing risks. It acts as a connecting force that links policies, procedures, and individuals, influencing how risks are understood and tackled through activities. In this research, benefits of Risk Culture are shared, guidelines are presented to promote a risk aware culture, and fully embed and enforce Risk-based processes and procedures. Moreover, this research demonstrates methodologies of measuring the Risk Culture using specific dimensions and clusters.

Keywords: clusters, dimensions, national oil companies, risk culture, risk management

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Authors: Leonard Simoni, Ilir Alimehmeti, Ervina Shirka, Endri Hasimi, Ndricim Kallashi, Verona Beka, Suerta Kabili, Artan Goda

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Background: Diabetes Mellitus type 2, small vessel calibre, stented length of vessel, complex lesion morphology, and prior bypass surgery have resulted risk factors for In-Stent Restenosis (ISR). However, there are some contradictory results about body mass index (BMI) as a risk factor for ISR. Purpose: We want to identify clinical, lesional and procedural factors that can predict clinical ISR in our patients. Methods: Were enrolled 759 patients who underwent first-time elective PCI with Bare Metal Stents (BMS) from September 2011 to December 2013 in our Department of Cardiology and followed them for at least 1.5 years with a median of 862 days (2 years and 4 months). Only the patients re-admitted with ischemic heart disease underwent control coronary angiography but no routine angiographic control was performed. Patients were categorized in ISR and non-ISR groups and compared between them. Multivariate analysis - Binary Logistic Regression: Forward Conditional Method was used to identify independent predictive risk factors. P was considered statistically significant when <0.05. Results: ISR compared to non-ISR individuals had a significantly lower BMI (25.7±3.3 vs. 26.9±3.7, p=0.004), higher risk anatomy (LM + 3-vessel CAD) (23% vs. 14%, p=0.03), higher number of stents/person used (2.1±1.1 vs. 1.75±0.96, p=0.004), greater length of stents/person used (39.3±21.6 vs. 33.3±18.5, p=0.01), and a lower use of clopidogrel and ASA (together) (95% vs. 99%, p=0.012). They also had a higher, although not statistically significant, prevalence of Diabetes Mellitus (42% vs. 32%, p=0.072) and a greater number of treated vessels (1.36±0.5 vs. 1.26±0.5, p=0.08). In the multivariate analysis, Diabetes Mellitus type 2 and multiple stents used were independent predictors risk factors for In-Stent Restenosis, OR 1.66 [1.03-2.68], p=0.039, and OR 1.44 [1.16-1.78,] p=0.001, respectively. On the other side higher BMI and use of clopidogrel and ASA together resulted protective factors OR 0.88 [0.81-0.95], p=0.001 and OR 0.2 [0.06-0.72] p=0.013, respectively. Conclusion: Diabetes Mellitus and multiple stents are strong predictive risk factors, whereas the use of clopidogrel and ASA together are protective factors for clinical In-Stent Restenosis. Paradoxically High BMI is a protective factor for In-stent Restenosis, probably related to a larger diameter of vessels and consequently a larger diameter of stents implanted in these patients. Further studies are needed to clarify this finding.

Keywords: body mass index, diabetes mellitus, in-stent restenosis, percutaneous coronary intervention

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Authors: Yuan Tian, Benhe Gao

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This paper aims to investigate a two stage supply chain of one leading supplier and one following retailer that experiences two factors perturbation out of supplier's production cost, retailer's marginal cost and retail price in stochastic demand environment. Granted that risk neutral condition has long been discussed, little attention has been given to disruptions under the premise of risk neutral supplier and risk aversion retailer. We establish the optimal order quantity and revealed the profit distribution coefficient in risk-neutral static model, make adjustment under disruption scenario, and then select utility function method for risk aversion model. Using buy-back contract policy, the improvement of parameters can achieve channel coordination where Pareto optimal is realized.

Keywords: supply chain coordination, disruption management, buy-back contract, lose aversion

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Authors: C. L. Wu, W. W. Tseng

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From the National Health Insurance (NHI) system was introduced in Taiwan in 2000, there have been some problems in transformed small-scale hospitals, such as mobility of patients, shortage of nursing staff, medical pipelines breaking fire compartments and insufficient fire protection systems. Due to shrinking of the funding scale and the aging society, fire safety in small-scale hospitals has recently given cause for concern. The aim of this study is to determine fire risk index for small-scale hospital through a systematic approach The selection of fire safety mitigation methods can be regarded as a multi-attribute decision making process which must be guaranteed by expert groups. First of all, identify and select safety related factors and identify evaluation criteria through literature reviews and experts group. Secondly, application of the Fuzzy Analytic Hierarchy Process method is used to ascertain a weighted value which enables rating of the importance each of the selected factors. Overall, Sprinkler type and Compartmentation are the most crucial indices in mitigating fire, that is to say, structural approach play an important role to decrease losses in fire events.

Keywords: Fuzzy Delphi Method, fuzzy analytic hierarchy, process risk assessment, fire events

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Authors: Alba Ballester Ciuró, Marc Pares Franzi

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While coming decades are likely to see a higher flood risk in Europe and greater socio-economic damages, traditional flood risk management has become inefficient. In response to that, new approaches such as capacity building and public participation have recently been incorporated in natural hazards mitigation policy (i.e. Sendai Framework for Action, Intergovernmental Panel on Climate Change reports and EU Floods Directive). By integrating capacity building and public participation, we present a research concerning the promotion of participatory social capacity building actions for flood risk mitigation at the local level. Social capacities have been defined as the resources and abilities available at individual and collective level that can be used to anticipate, respond to, cope with, recover from and adapt to external stressors. Social capacity building is understood as a process of identifying communities’ social capacities and of applying collaborative strategies to improve them. This paper presents a proposal of systematization of participatory social capacity building process for flood risk mitigation, and its implementation in a high risk of flooding area in the Ebro river basin: Ribera Alta del Ebro. To develop this process, we designed and tested a tool that allows measuring and building five types of social capacities: knowledge, motivation, networks, participation and finance. The tool implementation has allowed us to assess social capacities in the area. Upon the results of the assessment we have developed a co-decision process with stakeholders and flood risk management authorities on which participatory activities could be employed to improve social capacities for flood risk mitigation. Based on the results of this process, and focused on the weaker social capacities, we developed a set of participatory actions in the area oriented to general public and stakeholders: informative sessions on flood risk management plan and flood insurances, interpretative river descents on flood risk management (with journalists, teachers, and general public), interpretative visit to the floodplain, workshop on agricultural insurance, deliberative workshop on project funding, deliberative workshops in schools on flood risk management (playing with a flood risk model). The combination of obtaining data through a mixed-methods approach of qualitative inquiry and quantitative surveys, as well as action research through co-decision processes and pilot participatory activities, show us the significant impact of public participation on social capacity building for flood risk mitigation and contributes to the understanding of which main factors intervene in this process.

Keywords: flood risk management, public participation, risk reduction, social capacities, vulnerability assessment

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Authors: Carly Madge, Melanie Zurba, Ryan Bullock

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The Boreal Forest has experienced some of the most drastic climate change-induced temperature rises in Canada, with average winter temperatures increasing by 3°C since 1948. One of the main concerns of the province of Saskatchewan, and particularly wildfire managers, is the increased risk of wildfires due to climate change. With these concerns in mind Sakaw Askiy Management Inc., a forestry corporation located in Prince Albert, Saskatchewan with operations in the Boreal Forest biome, is developing wildfire risk reduction strategies that are supported by the shareholders of the corporation as well as the stakeholders of the Prince Albert Forest Management Area (which includes citizens, hunters, trappers, cottage owners, and outfitters). In the past, wildfire management strategies implemented through harvesting have been received with skepticism by some community members of Prince Albert. Engagement of the stakeholders of the Prince Albert Management Area through the development of the wildfire risk reduction strategies aims to reduce this skepticism and rebuild some of the trust that has been lost between industry and community. This research project works with the framework of social learning, which is defined as the learning that occurs when individuals come together to form a group with the purpose of understanding environmental challenges and determining appropriate responses to them. The project evaluates the social learning processes that occur through the development of the risk reduction strategies and how the learning has allowed Sakaw to work towards implementing the strategies into their forest harvesting plans. The incorporation of wildfire risk reduction strategies works to increase the adaptive capacity of Sakaw, which in this case refers to the ability to adjust to climate change, moderate potential damages, take advantage of opportunities, and cope with consequences. Using semi-structured interviews and wildfire workshop meetings shareholders and stakeholders shared their knowledge of wildfire, their main wildfire concerns, and changes they would like to see made in the Prince Albert Forest Management Area. Interviews and topics discussed in the workshops were inductively coded for themes related to learning, adaptive capacity, areas of concern, and preferred methods of wildfire risk reduction strategies. Analysis determined that some of the learning that has occurred has resulted through social interactions and the development of networks oriented towards wildfire and wildfire risk reduction strategies. Participants have learned new knowledge and skills regarding wildfire risk reduction. The formation of wildfire networks increases access to information on wildfire and the social capital (trust and strengthened relations) of wildfire personnel. Both factors can be attributed to increases in adaptive capacity. Interview results were shared with the General Manager of Sakaw, where the areas of concern and preferred strategies of wildfire risk reduction will be considered and accounted for in the implementation of new harvesting plans. This research also augments the growing conceptual and empirical evidence of the important role of learning and networks in regional wildfire risk management efforts.

Keywords: adaptive capacity, community-engagement, social learning, wildfire risk reduction

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Authors: Dana Cassandra Winkler, Delia Leiding, Rene Bergs, Franziska Kaiser, Ramona Kirchhart, Ute Habel

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Background: Violence is a multidimensional phenomenon, affecting people of every age, socio-economic status and gender. Nevertheless, most studies primarily focus on men perpetrating women. Aim of the present study is to identify the likelihood of mental and somatic disorders and risk-taking behavior in male violence affected. In addition, the relationship between age of violence experience and the risk for health-related problems was analyzed. Method: On the basis of current evidence, a questionnaire was developed focusing on demographic background, health status, risk-taking behavior, and active and passive violence exposure. In total, 5221 males (Mean: 56,1 years, SD: 17,6) were consulted. To account for the time of violence experience in an efficient way, age clusters ‘0-12 years’, ‘13-20 years’, ‘21-35 years’, ‘36-65 years’ and ‘over 65 years’ were defined. A binary logistic regression was calculated to reveal differences in violence-affected and non-violence affected males regarding health and risk-taking factors. Males who experienced violence on a daily/ almost daily basis vs. males who reported violence occurrence once/ several times a month/ year were compared with respect to health factors and risk-taking behavior. Data of males, who indicated active and passive violence exposure, were analyzed by a chi²-analysis, to investigate a possible relation between the age of victimization and violence perpetration. Findings: Results imply that general violence experience, independent of active and passive violence exposure increases the likelihood in favor of somatic-, psychosomatic- and mental disorders as well as risk-taking behavior in males. Experiencing violence on a daily or almost daily basis in childhood and adolescence may serve as a predictor for increased health problems and risk-taking behavior. Furthermore, the violence experience and perpetration occur significantly within the same age cluster. This underlines the importance of a near-term intervention to minimize the risk, that victims become perpetrators later. Conclusion: The present study reveals predictors concerning health risk factors as well as risk-taking behavior in males with violence exposure. The results of this study may underscore the benefit of intervention and regular health care approaches in violence-affected males and underline the importance of acknowledging the overlap of violence experience and perpetration for further research.

Keywords: health disease, male, mental health, prevalence, risk-taking behavior, violence

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Authors: Juliza Hidayati, Yesie M. Sinuhaji, Sawarni Hasibuan

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A company producing drinking water through many incompatibility issues that affect supply chain performance. The study was conducted to determine the factors that affect the performance of the supply chain and improve it. To obtain the dominant factors affecting the performance of the supply chain used Analytic Network Process, while to improve performance is done by using Kaizen. Factors affecting the performance of the supply chain to be a reference to identify the cause of the non-conformance. Results weighting using ANP indicates that the dominant factor affecting the level of performance is the precision of the number of shipments (15%), the ability of the fulfillment of the booking amount (12%), and the number of rejected products when signing (12%). Incompatibility of the factors that affect the performance of the supply chain are identified, so that found the root cause of the problem is most dominant. Based on the weight of Risk Priority Number (RPN) gained the most dominant root cause of the problem, namely the poorly maintained engine, the engine worked for three shifts, machine parts that are not contained in the plant. Improvements then performed using the Kaizen method of systematic and sustainable.

Keywords: analytic network process, booking amount, risk priority number, supply chain performance

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Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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Authors: A. Samer Ezeldin, Jwanda M. El Sarag

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Variation orders are of great importance in any construction project. Variation orders are defined as any change in the scope of works of a project that can be an addition omission, or even modification. This paper investigates the variation orders that occur during construction projects in Egypt. The literature review represents a comparison of causes of variation orders among Egypt, Tanzania, Nigeria, Malaysia and the United Kingdom. A classification of occurrence of variation orders due to owner related factors, consultant related factors and other factors are signified in the literature review. These classified events that lead to variation orders were introduced in a survey with 19 events to observe their frequency of occurrence, and their time and cost impacts. The survey data was obtained from 87 participants that included clients, consultants, and contractors and a database of 42 scenarios was created. A model is then developed to help assist project managers in predicting the frequency of variations and account for a budget for any additional costs and minimize any delays that can take place. Two experts with more than 25 years of experience were given the model to verify that the model was working effectively. The model was then validated on a residential compound that was completed in July 2016 to prove that the model actually produces acceptable results.

Keywords: construction, cost impact, Egypt, time impact, variation orders

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Authors: Rawan Masarwa, Merav Ben Natan, Yaron Berkovich

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Background: Hip fracture repair surgery carries a certain mortality risk, yet evidence suggests that orthopedic surgeons often refrain from discussing this issue with patients prior to surgery. Aim: This study aims to examine whether orthopedic surgeons address the issue of one-year post-surgery mortality before hip fracture repair surgery and to explore the factors influencing this decision. Method: The study uses a cross-sectional design, administering validated digital questionnaires to 150 orthopedic surgeons. Results: A minority of orthopedic surgeons reported consistently informing patients about the risk of mortality in the year following hip fracture surgery. The primary reasons for not discussing this risk were a desire to avoid frightening patients, time constraints, and concerns about undermining patient hope. Surgeons reported a medium-high level of perceived self-efficacy, with higher self-efficacy linked to a reduced likelihood of discussing one-year mortality risk. In contrast, older age and holding a specialist status in orthopedic surgery were associated with a higher likelihood of discussing this risk with patients. Conclusions: The findings suggest a need for interventions to address communication barriers and ensure consistent provision of essential information to patients undergoing hip fracture surgery. Additionally, they emphasize the importance of considering individual factors such as self-efficacy, age, and expertise in developing strategies to enhance patient-provider communication in orthopedic care settings.

Keywords: orthopedic surgeons, hip fracture surgery, mortality risk communication, patient information

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Authors: Amichai Ben ari, Daniella Margalit

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Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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Authors: Ndou Rembuluwani Moddy, Daniel Ter Goon, Takalani Grace Tshitangano, Lindelani Fhumudzani Mushaphi

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Obesity is a global public health problem. The study aimed to determine the risk factors associated with and the consequences of obesity among residents of Tshikota, Makhado Municipality, Limpopo Province, South Africa. A cross-sectional study involving 318 randomly selected adults aged 18-45 years residing at Tshikota, Makhado Local Municipality, South Africa. Sociodemographic information includes age, gender, educational level, occupation, behavioral lifestyle, environmental, psychological, and family history. Anthropometric, blood pressure, and blood glucose measurements followed standard procedure. The prevalence of obesity and overweight was 35.5% and 28.6%, respectively. About 75.2% of obese do not engage in physical activity. Most participants (63.5%) take meals three times a day, and 19.2% do not skip breakfast. Most participants do not have access to fruits and vegetables. Participants who were pre-hypertensive were 92(28.9%) and 32(10.1%) were in Stage 1 hypertension. Of the participants with Class 1 obesity, 40.9% were pre-hypertensive, and 15.2% were in Stage 1 hypertension. In Class 2 obesity, 37.8% were pre-hypertensive, and 26.7% were in Stage 1 hypertension. There was a significant difference between BMI and blood pressure among participants (p=0.00). About 6.1% of the participants in Class 1 obesity were at high risk, and 3.0% were at very high risk of glucose levels. Regarding cholesterol levels, 65 (20.4%) were at borderline, and 17(5.3%) were at high risk. There was no significant difference in BMI and cholesterol levels among participants (p= 0.20). The prevalence of obesity and overweight was high among residents of this setting. Age, marital and educational status, and employment were significantly associated with obesity. An obesity awareness campaign is crucial, and the availability of supermarkets and full-service grocery stores would provide accessibility to healthy food such as fruits and vegetables.

Keywords: obesity, overweight, risk factors, adults.

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Authors: Atheer Al-Nuaimi, Harry Evdorides

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Daily, many individuals die or get harmed on streets around the globe, which requires more particular solutions for transport safety issues. International road assessment program (iRAP) is one of the models that are considering many variables which influence road user’s safety. In iRAP, roads have been partitioned into five-star ratings from 1 star (the most reduced level) to 5 star (the most noteworthy level). These levels are calculated from risk factors which represent the effect of the geometric and traffic conditions on rod safety. The result of iRAP philosophy are the countermeasures that can be utilized to enhance safety levels and lessen fatalities numbers. These countermeasures can be utilized independently as a single treatment or in combination with other countermeasures for a section or an entire road. There is a general understanding that the efficiency of a countermeasure is liable to reduction when it is used in combination with various countermeasures. That is, crash diminishment estimations of single countermeasures cannot be summed easily. In the iRAP model, the fatalities estimations are calculated using a specific methodology. However, this methodology suffers overestimations. Therefore, this study has developed a calibration method to estimate fatalities numbers more accurately.

Keywords: crash risk factors, international road assessment program, low-income countries, road safety

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Authors: Leslie M. Gutman

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Conduct problems (CP) represent a major dilemma, with wide-ranging and long-lasting individual and societal impacts. Children experience heterogeneous patterns of conduct problems; based on the age of onset, developmental course and related risk factors from around age 3. Early childhood represents a potential window for intervention efforts aimed at changing the trajectory of early starting conduct problems. Using the UK Millennium Cohort Study (n = 17,206 children), this study (a) identifies trajectories of conduct problems from ages 3 to 14 years and (b) assesses the cumulative and interactive effects of individual, family and socioeconomic risk factors from ages 9 months to 14 years. The same factors according to three domains were assessed, including child (i.e., low verbal ability, hyperactivity/inattention, peer problems, emotional problems), family (i.e., single families, parental poor physical and mental health, large family size) and socioeconomic (i.e., low family income, low parental education, unemployment, social housing). A cumulative risk score for the child, family, and socioeconomic domains at each age was calculated. It was then examined how the cumulative risk scores explain variation in the trajectories of conduct problems. Lastly, interactive effects among the different domains of cumulative risk were tested. Using group-based trajectory modeling, four distinct trajectories were found including a ‘low’ problem group and three groups showing childhood-onset conduct problems: ‘school-age onset’; ‘early-onset, desisting’; and ‘early-onset, persisting’. The ‘low’ group (57% of the sample) showed a low probability of conducts problems, close to zero, from 3 to 14 years. The ‘early-onset, desisting’ group (23% of the sample) demonstrated a moderate probability of CP in early childhood, with a decline from 3 to 5 years and a low probability thereafter. The ‘early-onset, persistent’ group (8%) followed a high probability of conduct problems, which declined from 11 years but was close to 70% at 14 years. In the ‘school-age onset’ group, 12% of the sample showed a moderate probability of conduct problems from 3 and 5 years, with a sharp increase by 7 years, increasing to 50% at 14 years. In terms of individual risk, all factors increased the likelihood of being in the childhood-onset groups compared to the ‘low’ group. For cumulative risk, the socioeconomic domain at 9 months and 3 years, the family domain at all ages except 14 years and child domain at all ages were found to differentiate childhood-onset groups from the ‘low’ group. Cumulative risk at 9 months and 3 years did not differentiate between the ‘school-onset’ group and ‘low’ group. Significant interactions were found between the domains for the ‘early-onset, desisting group’ suggesting that low levels of risk in one domain may buffer the effects of high risk in another domain. The implications of these findings for preventive interventions will be highlighted.

Keywords: conduct problems, cumulative risk, developmental trajectories, early childhood, adolescence

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Authors: Ireneusz Majsterek, Karolina Przybylowska, Lukasz Dziki, Adam Dziki, Jacek Kabzinski

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Colorectal cancer (CRC) is one of the deadliest cancers. Every year we see an increase in the number of cases, and in spite of intensive research etiology of the disease remains unknown. For many years, researchers are seeking to associate genetic factors with an increased risk of CRC, so far it has proved to be a compelling link between the MMR system of DNA repair and hereditary nonpolyposis colorectal cancers (HNPCC). Currently, research is focused on finding the relationship between the remaining DNA repair systems and an increased risk of developing colorectal cancer. The aim of the study was to determine the relationship between gene polymorphisms Ser835Ser of XPF gene and Gly23Ala of XPA gene–elements of NER DNA repair system, and modulation of the risk of colorectal cancer in the Polish population. Determination of the molecular basis of carcinogenesis process and predicting increased risk will allow qualifying patients to increased risk group and including them in preventive program. We used blood collected from 110 patients diagnosed with colorectal cancer. The control group consisted of equal number of healthy people. Genotyping was performed by TaqMan method. The obtained results indicate that the genotype 23Gly/Ala of XPA gene is associated with an increased risk of colorectal cancer, while 23Ala/Ala as well as TCT allele of Ser835Ser of XPF gene may reduce the risk of CRC.

Keywords: NER, colorectal cancer, XPA, XPF, polymorphisms

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Authors: Muhammad Saleem

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Background: Inattentive food choices and engagement in excessive physical activities by male athletes can potentially lead to adverse health consequences. Objective: The aim was to ascertain the occurrence of risk factors associated with the Male Athlete Triad among young elite athletes in Pakistan. Methodology: In 2018, a cross-sectional study based on questionnaires was conducted at the Pakistan Sports Board. The study aimed to explore the risk factors related to the Male Athlete Triad in young elite athletes who were part of national training camps in major metropolitan areas. The study included proficient male elite athletes aged 18 to 25 years, capable of understanding the English questionnaire. The athletes completed a survey encompassing aspects like demographic information, educational background, Body Mass Index (BMI), sports involvement, and hours of participation. Additionally, they filled out the Eating Attitude Test-26 (EAT-26) and questionnaires assessing risks of amenorrhea and low bone mineral density. The prevalence of risk factors for each of the three components was individually evaluated. The collected data underwent analysis using SPSS-20, with descriptive statistics being applied. Results: The study comprised a sample of 90 elite athletes (mean age: 23.57 ± 2.37 years, mean BMI: 21.97 ± 1.90) engaged in various sports. The EAT-26 results indicated that 50% of athletes were at risk of developing an eating disorder. Moreover, 83.3% exhibited disordered eating behaviors that necessitated referral. Risks for amenorrhea were observed in 15% of the participants, and regarding low bone mineral density, notable risks were absent except for the consumption of caffeinated beverages, which was noted in 51.7% of participants. Conclusion: The study identified a significant prevalence of disordered eating risk among male elite athletes in Pakistan. However, the risks associated with amenorrhea and low bone mineral density were not a major concern in this particular group.

Keywords: Pakistan, osteoporosis, female athlete triad, bone mineral density, athlete, amenorrhea, eating disorders

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