Search results for: risk factor

Authors: Bahlous Afef, Bouzid Kahena, Bardkis Ahlem, Mrad Mehdi, Kalai Eya, Sonia Bahri, Abdelmoula Jaouida

Abstract:

Diabetic nephropathy is the first cause of chronic renal failure and hemodialysis use in several countries including Tunisia. The role of hypertension (HT) as major risk factor for nephropathy is undeniable. The aim of our study was to determine the relationship between blood pressure and nephropathy in a population of diabetic type 2 recently discovered. Materials and methods: We conducted a prospective study focused on 60 patients with type 2 diabetes recently discovered (<5 years). Each patient have benefited from: -a full clinical examination with measurement of blood pressure - exploring a blood-glucose control and renal function -urinary exploration with the determination of proteinuria microalbuminumie of 24 hours with a immunoturbidimetric method using Architect (ABBOTT CI 8200). Results and discussion: Hypertension was present in 46.7% of cases. Twenty patients, 35% of the study population showed nephropathy. Four of these patients (6.66% of cases) had proteinuria, while 16 (26.6% of patients) had microalbuminuria (> 30mg/24 hours). Systolic blood pressure was significantly (p < 0.05) associated with the presence of nephropathy (139 +19.44) vs. for the group with normal renal function (128.65 +15.12 mmHg). Conclusion: The etiology of diabetic nephropathy is multifactorial. However, systolic blood pressure and glycemic control remains the major risk factors. Better glycemic control and treatment of hypertension allowed preventing and slowing the progression of diabetic nephropathy.

Keywords: hypertension, nephropathy, hemodialysis, diabetes

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Authors: Ikram Slamani, Hicheme Ferdjani

Abstract:

This study focuses on analyzing a Griffith crack situated at the center of an infinite strip. The problem is reformulated as a hyper-singular integral equation and solved numerically using second-order Chebyshev polynomials. The primary objective is to calculate the stress intensity factor in mode 1, denoted as K1. The obtained results reveal the influence of the strip width and crack length on the stress intensity factor, assuming stress-free edges. Additionally, a comparison is made with relevant literature to validate the findings.

Keywords: center crack, Chebyshev polynomial, hyper singular integral equation, Griffith, infinite strip, stress intensity factor

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Authors: Lavanya Dharmendran, Shenuka Singh, Sona Baburathanam

Abstract:

The aim of the study is to understand the level of awareness in a community of a specific region of Kuwait regarding oral cancer and its screening methods so as to enhance the uptake of oral cancer screening methods. This is a cross-sectional study comprising 100 adult participants residing in the governate of Farwaniya, Kuwait. Participants of above 18 years of both genders will be selected using convenience sampling. Data collection includes the administration of a self-administered questionnaire. The questionnaire comprises three sections, each section assessing the knowledge, attitudes and practices of the participants’ opinions about oral cancer and screening methods. Data will be analyzed using Humphris Oral Cancer Knowledge Scale. Inferential statistics will be done using Chi-Square or Fisher’s exact test for categorical data. A level of p<.05 will be established as being significant. All ethical considerations, such as respect for personal confidentiality and informed consent, will be applied in this study. This study revealed that although respondents were aware of the term oral cancer, more than half of the study participants were unaware of the symptoms associated with this condition. Smoking and alcohol were identified as risk factors for oral cancer, but the majority of participants did not identify the Human Papilloma Virus (HPV) as an added risk factor. This suggests a greater need for dental practitioners to include educational strategies in routine dental visits to ensure greater awareness of oral cancer.

Keywords: oral cancer, oral screening, oral public health, oral health

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Authors: Jeries J. Abou-Hanna, Bradley Storm

Abstract:

This paper looks to reduce the complexity of determining stress intensity factors while maintaining high levels of accuracy by the use of a linearized layering approach. Many techniques for stress intensity factor determination exist, but they can be limited by conservative results, requiring too many user parameters, or by being too computationally intensive. Multiple notch geometries with various crack lengths were investigated in this study to better understand the effectiveness of the proposed method. By linearizing the average stresses in radial layers around the crack tip, stress intensity factors were found to have error ranging from -10.03% to 8.94% when compared to analytically exact solutions. This approach proved to be a robust and efficient method of accurately determining stress intensity factors.

Keywords: fracture mechanics, finite element method, stress intensity factor, stress linearization

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Authors: Shu-Hui Wen, Wei-Chuan Chang, Hsien-Chang Wu

Abstract:

Background: Little is known about the benefits and risks of use of Chinese herbal medicine (CHM) in conditions related to hormone therapy (HT) use on the risk of ischemic stroke (IS). The aim of this study is to explore the risk of IS in menopausal women treated with HT and CHM. Materials and methods: A total of 32,441 menopausal women without surgical menopause aged 40- 65 years were selected from 2003 to 2010 using the 2-million random samples of the National Health Insurance Research Database in Taiwan. According to the medication usage of HT and CHM, we divided the current and recent users into two groups: an HT use-only group (n = 4,989) and an HT/CHM group (n = 9,265). Propensity-score matching samples (4,079 pairs) were further created to deal with confounding by indication. The adjusted hazard ratios (HR) of IS during HT or CHM treatment were estimated by the robust Cox proportional hazards model. Results: The incidence rate of IS in the HT/CHM group was significantly lower than in the HT group (4.5 vs. 12.8 per 1000 person-year, p < 0.001). Multivariate analysis results indicated that additional CHM use was significant with a lower risk of IS (HR = 0.3; 95% confidence interval, 0.21-0.43). Further subgroup analyses and sensitivity analyses had similar findings. Conclusion: We found that combined use of HT and CHM was associated with a lower risk for IS than HT use only. Further study is needed to examine possible mechanism underlying this association.

Keywords: Chinese herbal medicine, hormone therapy, ischemic stroke, menopause

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Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

Abstract:

Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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Authors: Marcus Bellett-Travers

Abstract:

Different modelling approaches have been used to determine or predict yield of crops in different geographies. Central to the methodologies are the presumption that it is the absolute yield of the crop in a given location that is of the highest priority to those requiring information on crop productivity. Most individuals, companies and organisations within the agri-food sector need to be able to balance the supply of crops with the demand for them. Different modelling approaches have been used to determine and predict crop yield. The growing need to ensure certainty of supply and stability of prices requires an approach that describes the risk in producing a crop. A review of current methodologies to evaluate the risk to food production from changes in the weather and climate is presented.

Keywords: crop production, risk, climate, modelling

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Authors: Rawan Masarwa, Merav Ben Natan, Yaron Berkovich

Abstract:

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: Suraj Sam Issaka, Anita Asamoah, Abass Gibrilla, Joseph Richmond Fianko

Abstract:

Polycyclic aromatic hydrocarbons (PAHs) are a group of organic compounds that can form in edible oils during repeated frying and accumulate in fried foods. This study assesses the chances of health risks (carcinogenic and non-carcinogenic) due to PAHs levels in popular finger foods (bean cakes, plantain chips, doughnuts) fried in edible oils (mixed vegetable, sunflower, soybean) from the Ghanaian market. Employing probabilistic health risk assessment that considers variability and uncertainty in exposure and risk estimates provides a more realistic representation of potential health risks. Monte Carlo simulations with 10,000 iterations were used to estimate carcinogenic, mutagenic, and non-carcinogenic risks for different age groups (A: 6-10 years, B: 11-20 years, C: 20-70 years), food types (bean cake, plantain chips, doughnut), oil types (soybean, mixed vegetable, sunflower), and re-usage frying oil frequencies (once, twice, thrice). Our results suggest that, for age Group A, doughnuts posed the highest probability of carcinogenic risk (91.55%) exceeding the acceptable threshold, followed by bean cakes (43.87%) and plantain chips (7.72%), as well as the highest probability of unacceptable mutagenic risk (89.2%), followed by bean cakes (40.32%). Among age Group B, doughnuts again had the highest probability of exceeding carcinogenic risk limits (51.16%) and mutagenic risk limits (44.27%). At the same time, plantain chips exhibited the highest maximum carcinogenic risk. For adults age Group C, bean cakes had the highest probability of unacceptable carcinogenic (50.88%) and mutagenic risks (46.44%), though plantain chips showed the highest maximum values for both carcinogenic and mutagenic risks in this age group. Also, on non-carcinogenic risks across different age groups, it was found that age Group A) who consumed doughnuts had a 68.16% probability of a hazard quotient (HQ) greater than 1, suggesting potential cognitive impairment and lower IQ scores due to early PAH exposure. This group also faced risks from consuming plantain chips and bean cake. For age Group B, the consumption of plantain chips was associated with a 36.98% probability of HQ greater than 1, indicating a potential risk of reduced lung function. In age Group C, the consumption of plantain chips was linked to a 35.70% probability of HQ greater than 1, suggesting a potential risk of cardiovascular diseases.

Keywords: PAHs, fried foods, carcinogenic risk, non-carcinogenic risk, Monte Carlo simulations

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Authors: Josué Alfredo Tomas Machaca Fajardo, Jhon Elvis Chahua Janampa, Pedro Rau Lavado

Abstract:

A flood vulnerability index was developed for the Piura River watershed in northern Peru using Principal Component Analysis (PCA) to assess flood risk. The official methodology to assess risk from natural hazards in Peru was introduced in 1980 and proved effective for aiding complex decision-making. This method relies in part on decision-makers defining subjective correlations between variables to identify high-risk areas. While risk identification and ensuing response activities benefit from a qualitative understanding of influences, this method does not take advantage of the advent of national and international data collection efforts, which can supplement our understanding of risk. Furthermore, this method does not take advantage of broadly applied statistical methods such as PCA, which highlight central indicators of vulnerability. Nowadays, information processing is much faster and allows for more objective decision-making tools, such as PCA. The approach presented here develops a tool to improve the current flood risk assessment in the Peruvian basin. Hence, the spatial analysis of the census and other datasets provides a better understanding of the current land occupation and a basin-wide distribution of services and human populations, a necessary step toward ultimately reducing flood risk in Peru. PCA allows the simplification of a large number of variables into a few factors regarding social, economic, physical and environmental dimensions of vulnerability. There is a correlation between the location of people and the water availability mainly found in rivers. For this reason, a comprehensive vision of the population location around the river basin is necessary to establish flood prevention policies. The grouping of 5x5 km gridded areas allows the spatial analysis of flood risk rather than assessing political divisions of the territory. The index was applied to the Peruvian region of Piura, where several flood events occurred in recent past years, being one of the most affected regions during the ENSO events in Peru. The analysis evidenced inequalities for the access to basic services, such as water, electricity, internet and sewage, between rural and urban areas.

Keywords: assess risk, flood risk, indicators of vulnerability, principal component analysis

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Authors: Chokri Slim

Abstract:

The objective of this research is attempting to respond to this question: Is there a significant difference between the regression model and statistical learning models in predicting credit risk management? A Multiple Linear Regression (MLR) model was compared with neural networks including Multi-Layer Perceptron (MLP), and a Support vector regression (SVR). The population of this study includes 50 listed Banks in Tunis Stock Exchange (TSE) market from 2000 to 2016. Firstly, we show the factors that have significant effect on the quality of loan portfolios of banks in Tunisia. Secondly, it attempts to establish that the systematic use of objective techniques and methods designed to apprehend and assess risk when considering applications for granting credit, has a positive effect on the quality of loan portfolios of banks and their future collectability. Finally, we will try to show that the bank governance has an impact on the choice of methods and techniques for analyzing and measuring the risks inherent in the banking business, including the risk of non-repayment. The results of empirical tests confirm our claims.

Keywords: credit risk management, multiple linear regression, principal components analysis, artificial neural networks, support vector machines

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Authors: Bella Llego

Abstract:

This study aims to investigate the motivating and de-motivating factors that affect the learning ability of students attending the English Learning Center in Thailand. The subjects of this research were 20 students from the Hana Semiconductor Co., Limited. The data were collected by using questionnaire and analyzed using the SPSS program for the percentage, mean and standard deviation. The research results show that the main motivating factor in learning English at Hana Semiconductor Co., Ltd. is that it would help the employees to communicate with foreign customers and managers. Other reasons include the need to read and write e-mails, and reports in English, as well as to increase overall general knowledge. The main de-motivating factor is that there is a lot of vocabulary to remember when learning English. Another de-motivating factor is that when homework is given, the students have no time to complete the tasks required of them at the end of the working day.

Keywords: de-motivating, English learning center, motivating, student communicate

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Authors: Sami Mestiri, Abdeljelil Farhat

Abstract:

The aim of this current paper is to predict the credit risk of banks in Tunisia, over the period (2000-2005). For this purpose, two methods for the estimation of the logistic regression model with random effects: Penalized Quasi Likelihood (PQL) method and Gibbs Sampler algorithm are applied. By using the information on a sample of 528 Tunisian firms and 26 financial ratios, we show that Bayesian approach improves the quality of model predictions in terms of good classification as well as by the ROC curve result.

Keywords: forecasting, credit risk, Penalized Quasi Likelihood, Gibbs Sampler, logistic regression with random effects, curve ROC

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Authors: Peng Li, Chuanri Li, Tao Li

Abstract:

Reliability allocation is quite important during early design and development stages for a system to apportion its specified reliability goal to subsystems. This paper improves the reliability fuzzy allocation method and gives concrete processes on determining the factor set, the factor weight set, judgment set, and multi-grade fuzzy comprehensive evaluation. To determine the weight of factor set, the modified trapezoidal numbers are proposed to reduce errors caused by subjective factors. To decrease the fuzziness in the fuzzy division, an approximation method based on linear programming is employed. To compute the explicit values of fuzzy numbers, centroid method of defuzzification is considered. An example is provided to illustrate the application of the proposed reliability allocation method based on fuzzy arithmetic.

Keywords: reliability allocation, fuzzy arithmetic, allocation weight, linear programming

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Authors: Florian Lienert, Peter Costa, Caroline Aurensan, Elaine Melander

Abstract:

Introduction: Rabies pre-exposure prophylaxis (PrEP) can be given before travel and simplifies post-exposure prophylaxis (PEP). We studied the knowledge about rabies, the uptake of PrEP, and reasons for deciding for or against PrEP in at-risk travelers. We also examined how healthcare professionals (HCPs) counsel on rabies prevention. Methods: On behalf of Bavarian Nordic, Ipsos MORI conducted two online surveys in the USA. Fieldwork from February 24th to April 23rd, 2021, 689 participants aged 18-85 years, visited one of 91 endemic rabies countries in the past 3 years for at least one week, involved in at least 1 of 7 at-risk activities, heard of rabies, positive towards vaccination and chose to take part (surveyed travelers). Secondly, 76 HCPs, with responsibility for advising/ making decisions about vaccination requirements for their patients, personally recommend or prescribe vaccines for rabies, positive towards vaccination and chose to take part (surveyed HCPs). Results: A minority (36%) of surveyed travelers classified rabies as a life-threatening disease. A third of surveyed HCPs (37%) did not discuss rabies vaccination with at-risk travelers, 18% discussed only PEP, 23% only PrEP and 22% both. A minority (21%) of surveyed travelers reported having received rabies vaccination since they were 18. Among those participants (n=145), the most common reasons for deciding to get PrEP were for their own peace of mind (35%) and following an HCP recommendation (32%). Of those who decided not to receive the rabies vaccine (n=319), the most common reasons were that they did not think their risk of rabies was sufficient (23%) and that the HCP did not suggest it (23%). Conclusions: The survey demonstrated knowledge gaps around rabies and low PrEP coverage among surveyed travelers. It also highlighted the role of HCP recommendations and showed that most HCPs did not discuss PrEP with at-risk travelers.

Keywords: rabies, pre-exposure prophylaxis, travel, travel health, post-travel care, rabies treatment, vaccine, post-exposure, prophylaxis, at-risk, education, PrEP, PEP

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Authors: Brandon Knopp, Matthew Harris

Abstract:

Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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Authors: Austyn Snowden

Abstract:

Aim: To examine the construct validity of the Trait Emotional Intelligence Questionnaire Short form. Background: Emotional intelligence involves the identification and regulation of our own emotions and the emotions of others. It is therefore a potentially useful construct in the investigation of recruitment and retention in nursing and many questionnaires have been constructed to measure it. Design: Secondary analysis of existing dataset of responses to TEIQue-SF using concurrent application of Rasch analysis and confirmatory factor analysis. Method: First year undergraduate nursing and computing students completed Trait Emotional Intelligence Questionnaire-Short Form. Responses were analysed by synthesising results of Rasch analysis and confirmatory factor analysis.

Keywords: emotional intelligence, rasch analysis, factor analysis, nurse recruiters

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Authors: Mehrdad Sheikhvatan, Mohammad Ali Boroumand, Mehrdad Behmanesh, Shayan Ziaee

Abstract:

Contradictory results have been obtained regarding the role of integrin, beta 3 (ITGB3) gene polymorphisms in occurrence of acute myocardial infarction (MI) in patients with coronary artery disease (CAD). Hence, we aimed to assess the association between 1565C/T polymorphism of ITGB3 gene and increased risk for acute MI in patients who suffered premature CAD in Iranian population. Our prospective study included 1000 patients (492 men and 508 women aged 21 to 55 years) referred to Tehran Heart center during a period of four years from 2008 to 2011 with the final diagnosis of premature CAD and classified into two groups with history of MI (n = 461) and without of MI (n = 539). The polymorphism variants were determined by PCR-RFLP technique by entering 10% of randomized samples and then genotyping of the polymorphism was also conducted by High Resolution Melting (HRM) method. Among study samples, 640 were followed with a median follow-up time 45.74 months for determining association of long-term major adverse cardiac events (MACE) and genotypes of polymorphisms. There was no significant difference in the frequency of 1565C/T polymorphism between the MI and non-MI groups. The frequency of wild genotype was 69.2% and 72.2%, the frequency of homozygous genotype was 21.3% and 18.4%, and the frequency of mutant genotype was 9.5% and 9.5%, respectively (p=0.505). Results were also similar when adjusted for covariates in a multivariate logistic regression model. No significant difference was also found in total-MACE free survival rate between the patients with different genotypes of 1565C/T polymorphism in both MI and non-MI group. The carriage of the 1565C/T polymorphism of ITGB3 gene seems unlikely to be a significant risk factor for the development of MI in Iranian patients with premature CAD. The presence of this ITGB3 gene polymorphism may not also predict long-term cardiac events.

Keywords: coronary artery disease, myocardial infarction, gene, integrin, beta 3, polymorphism

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Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

Abstract:

Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in the control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, and the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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Authors: Haykal. Kay-Anne

Abstract:

The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.

Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment

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Authors: Leandi Steenkamp

Abstract:

The sectional title industry has been a part of the property landscape in South Africa for almost half a century, and plays a significant role in addressing the housing problem in the country. Stakeholders such as owners and investors in sectional title property are in most cases not directly involved in the management thereof, and place reliance on the audited annual financial statements of bodies corporate for decision-making purposes. Although the industry seems to be highly regulated, the legislation regarding accounting and auditing of sectional title is vague and ambiguous. Furthermore, there are no industry-specific auditing and accounting standards to guide accounting and auditing practitioners in performing their work and industry financial benchmarks are not readily available. In addition, financial pressure on sectional title schemes is often very high due to the fact that some owners exercise unrealistic pressure to keep monthly levies as low as possible. All these factors have an impact on the business risk as well as audit risk of bodies corporate. Very little academic research has been undertaken on the sectional title industry in South Africa from an accounting and auditing perspective. The aim of this paper is threefold: Firstly, to discuss the findings of a literature review on uncertainties, ambiguity and confusing aspects in current legislation regarding the audit of a sectional title property that may cause or increase audit and business risk. Secondly, empirical findings of risk-related aspects from the results of interviews with three groups of body corporate role-players will be discussed. The role-players were body corporate trustee chairpersons, body corporate managing agents and accounting and auditing practitioners of bodies corporate. Specific reference will be made to business risk and audit risk. Thirdly, practical recommendations will be made on possibilities of closing the audit expectation gap, and further research opportunities in this regard will be discussed.

Keywords: assurance, audit, audit risk, body corporate, corporate governance, sectional title

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Authors: Haseen Siddiqui, Sanjay M. Mahajani

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Various important reactions in chemical and metallurgical industries fall in the category of gas-solid reactions. These reactions can be categorized as catalytic and non-catalytic gas-solid reactions. In gas-solid reaction systems, heat and mass transfer limitations put an appreciable influence on the rate of the reaction. The consequences can be unavoidable for overlooking such effects while collecting the reaction rate data for the design of the reactor. Pyrolysis reaction comes in this category that involves the production of gases due to the interaction of heat and solid substance. Pyrolysis is also an important step in the gasification process and therefore, the gasification reactivity majorly influenced by the pyrolysis process that produces the char, as a feed for the gasification process. Therefore, in the present study, a non-isothermal transient 1-D model is developed for a single biomass pellet to investigate the effect of heat and mass transfer limitations on the rate of pyrolysis reaction. The obtained set of partial differential equations are firstly discretized using the concept of ‘method of lines’ to obtain a set of ordinary differential equation with respect to time. These equations are solved, then, using MATLAB ode solver ode15s. The model is capable of incorporating structural changes, porosity variation, variation in various thermal properties and various pellet shapes. The model is used to analyze the effectiveness factor for different values of Lewis number and heat of reaction (G factor). Lewis number includes the effect of thermal conductivity of the solid pellet. Higher the Lewis number, the higher will be the thermal conductivity of the solid. The effectiveness factor was found to be decreasing with decreasing Lewis number due to the fact that smaller Lewis numbers retard the rate of heat transfer inside the pellet owing to a lower rate of pyrolysis reaction. G factor includes the effect of the heat of reaction. Since the pyrolysis reaction is endothermic in nature, the G factor takes negative values. The more the negative value higher will be endothermic nature of the pyrolysis reaction. The effectiveness factor was found to be decreasing with more negative values of the G factor. This behavior can be attributed to the fact that more negative value of G factor would result in more energy consumption by the reaction owing to a larger temperature gradient inside the pellet. Further, the analytical expressions are also derived for gas and solid concentrations and effectiveness factor for two limiting cases of the general model developed. The two limiting cases of the model are categorized as the homogeneous model and unreacted shrinking core model.

Keywords: effectiveness factor, G-factor, homogeneous model, lewis number, non-catalytic, shrinking core model

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Authors: M. Wisnu Pamungkas, Patrianef Darwis

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Introduction: Critical limb ischemia (CLI) is a vascular disease that has a significant amputation and mortality risk with diabetes mellitus, the most significant risk factor in CLI, is very common among Indonesian. Endovascular intervention (EVI) is preferred in treating CLI because it is noninvasive and effective. Balloon angioplasty and stent angioplasty are the most common method of EVI in Indonesia. This study aims to compare the effectiveness of balloon angioplasty and stent angioplasty on wound healing in CLI. Method: A cross-sectional study enrolled 90 subjects of CLI who underwent endovascular intervention using balloon angioplasty and stent angioplasty from January 2013 to July 2017 in dr. Cipto Mangunkusumo General Hospital, Jakarta. The wound healing period between balloon angioplasty dan stent angioplasty was analyzed using unpaired T-test with p<0,05 considered as statistically significant. Data of intervention method wound healing period, and subjects characteristic data (age, amputation, BMI, smoking habit, DM, occlusion site, and blood profile) were obtained. Result: The wound healing period in balloon angioplasty and stent angioplasty distributed normally. Mean value of wound healing period in balloon angioplasty and stent angioplasty are 84,8+/-2,423 and 59,93 +/- 2,423 days with a mean difference of 25 days. The difference in wound healing period in both groups is statically significant (p<0,05). The amputation event in balloon angioplasty and stent angioplasty is 22 and 16 event with no difference statistically. Conclusion: Stent angioplasty is a better method than balloon angioplasty for wound healing in patients with CLI.

Keywords: critical limb ischemia, endovascular intervention, wound healing, angioplasty

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Authors: Mehravar Javid, James Sexton, Farzaneh Amani, Kainaz Patravala

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Self-expansion is a procedure through which people expand the dimensions of their self-concept by incorporating novel content into their sense and experience of identity. Greater self-expansion predicts positive consequences for individuals and romantic relationships. The self-expansion questionnaire (SEQ) originally developed by Lewandowski & Aron (2002) assumes that self-expansion is constituted of key components from the self-expansion model. This study aimed to confirm the factor structure of SEQ and adapt the questions of the scale to the Iranian culture. The sample included 190 participants who responded to 14 items and were selected by simple random sampling. Using Amos-21 and SPSS-21, descriptive statistics, Pearson correlation and Confirmatory Factor Analysis (CFA) were calculated. Cronbach’s alpha coefficient for total SEQ items was 0.92. Results of CFA supported the factor structure SEQ [RMSEA=0.08, GFI=0.88 and CFI=0.92] that showed the model has a good fit and also all the items of SEQ, have a high correlation and have a direct and significant relationship. So, the SEQ demonstrated acceptable psychometric properties in Tehran University students. Looking forward, it would be interesting and exciting to see the implications of the scale as applied to romantic relationships.

Keywords: validity, reliability, confirmatory factor analysis, self-expansion questionnaire

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Authors: I. Caldas, T. Duarte

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Avoidant Restrictive Food Intake Disorder (ARFID) was included for the first time in DSM-5, replacing the old diagnosis of DSM-4 'Early Childhood Eating Disorder'. An ARFID is characterized by a restrictive/avoidant eating pattern that can lead to severe nutritional deficiency, weight loss, nutritional supplementation dependence, and poor psychosocial functioning. This eating pattern is associated with decreased interest in food, worries about food characteristics or the act of ingestion, and lack of concern with weight or body image. This paper aims to understand the impact of this new diagnosis in other Eating Disorders (ED) prevalence, as well as to compare their therapeutic approaches. Methodology: Literature reviewed by PubMed with the following keywords: 'ARFID', 'Prevalence', and 'Eating Disorders'. We selected articles related to this theme, written since 2016. Results: In a population of children hospitalized with ED, 5% to 14% was diagnosed with ARFID, and, as outpatient treatment, the prevalence was 22%. People diagnosed with ARFID have more prevalence of other comorbidities, especially autism spectrum, are younger, and are more often male. Regarding the treatment of ARFID, it most often required nasogastric feeding, and with less suffering associated with this procedure, compared to AN. Despite these differences, 12% of patients diagnosed with ARFID transited to AN during treatment, suggesting that the first pathology may be a risk factor for the development of AN. Conclusions: The differences identified between ARFID and the other EDs are important when analyzed as differential diagnostic hypotheses and therapeutic approaches. Further study is necessary regarding its prevalence, risk factors, and treatment.

Keywords: avoidant restrictive food intake disorder, ARFID, differential diagnoses, eating disorders, prevalence

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Authors: Saeed Yazdani, Sima Mohamadi Amidabadi, Amir Mohamadi Nejsd, Farahnaz Nekoofar

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As a result of uncertainty and doubts about the quantity of agricultural products, greater significance has been attached to risk management in the agricultural sector. Normally, farmers seek to minimize risks, and crop diversity has always been a means to reduce risk. The study at hand seeks to explore the long-term impact of crop diversity on income risk reduction. The timeframe of the study is 1998 to 2018. Initially, the Herfindahl index was used to estimate crop diversity in different periods, and next, the Hodrick-Prescott filter was applied to estimate income risk both in nominal and real terms. Finally, using the vector error correction model (VECM), the long-term impact of crop diversity on two modes of risk for the farmer's income has been estimated. Given the long-term pattern’s results, it is evident that in the long run, crop diversity can reduce income fluctuations in two nominal and real terms. Moreover, results showed that in case the fluctuation shock affects the agricultural income in the short run, to balance out the shock in nominal and real terms, 4 and 3 cycles are needed, respectively. In other words, in each cycle, 25% and 33% of the shock impact can be removed, respectively. Thus, as the results of the error correction coefficient showed, policies need to be put in place to prevent income shocks. In case of a shock, they need to be balanced out in a four-year period, taking inflation into account, and in a three-year period irrespective of the inflation, and reparative policies such as insurance services should be developed.

Keywords: risk, long-term model, Herfindahl index, time series model, vector error correction model

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Authors: Sari F. Alkhatib, Chang Je Park, Gyuhong Roh, Daeseong Jo

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The iterative scheme which is used to treat buildup factors for stratified shields of three-layers or more is being investigated here using the layer-splitting technique. The second layer in a double-layer shield was split into two equivalent layers and the scheme was implemented on the new 'three-layer' shield configuration. The results of such manipulation for water-lead and water-iron shields combinations are presented here for 1 MeV photons. It was found that splitting the second layer introduces some deviation on the overall buildup factor. This expected deviation appeared to be higher in the case of low Z layer followed by high Z. However, the iterative scheme showed a great consistency and strong coherence with the introduced changes.

Keywords: build-up factor, iterative scheme, stratified shields, radiation protection

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Authors: Alev Atak

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In this paper, we aim to create a financial sentiment index by investigating the company’s voluntary information disclosures. We retrieve structured content from BIST 100 companies’ financial reports for the period 1998-2018 and extract relevant financial information for sentiment analysis through Natural Language Processing. We measure strategy-related disclosures and their cross-sectional variation and classify report content into generic sections using synonym lists divided into four main categories according to their liquidity risk profile, risk positions, intra-annual information, and exposure to risk. We use Word Error Rate and Cosin Similarity for comparing and measuring text similarity and derivation in sets of texts. In addition to performing text extraction, we will provide a range of text analysis options, such as the readability metrics, word counts using pre-determined lists (e.g., forward-looking, uncertainty, tone, etc.), and comparison with reference corpus (word, parts of speech and semantic level). Therefore, we create an adequate analytical tool and a financial dictionary to depict the importance of granular financial disclosure for investors to identify correctly the risk-taking behavior and hence make the aggregated effects traceable.

Keywords: financial sentiment, machine learning, information disclosure, risk

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Authors: H. E. Elzain, S. Y. Chung, V. Senapathi, Kye-Hun Park

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Groundwater is considered a significant source for drinking and irrigation purposes in Miryang city, and it is attributed to a limited number of a surface water reservoirs and high seasonal variations in precipitation. Population growth in addition to the expansion of agricultural land uses and industrial development may affect the quality and management of groundwater. This research utilized multidisciplinary approaches of geostatistics such as multivariate statistics, factor analysis, cluster analysis and kriging technique in order to identify the hydrogeochemical process and characterizing the control factors of the groundwater geochemistry distribution for developing risk maps, exploiting data obtained from chemical investigation of groundwater samples under the area of study. A total of 79 samples have been collected and analyzed using atomic absorption spectrometer (AAS) for major and trace elements. Chemical maps using 2-D spatial Geographic Information System (GIS) of groundwater provided a powerful tool for detecting the possible potential sites of groundwater that involve the threat of contamination. GIS computer based map exhibited that the higher rate of contamination observed in the central and southern area with relatively less extent in the northern and southwestern parts. It could be attributed to the effect of irrigation, residual saline water, municipal sewage and livestock wastes. At wells elevation over than 85m, the scatter diagram represents that the groundwater of the research area was mainly influenced by saline water and NO3. Level of pH measurement revealed low acidic condition due to dissolved atmospheric CO2 in the soil, while the saline water had a major impact on the higher values of TDS and EC. Based on the cluster analysis results, the groundwater has been categorized into three group includes the CaHCO3 type of the fresh water, NaHCO3 type slightly influenced by sea water and Ca-Cl, Na-Cl types which are heavily affected by saline water. The most predominant water type was CaHCO3 in the study area. Contamination sources and chemical characteristics were identified from factor analysis interrelationship and cluster analysis. The chemical elements that belong to factor 1 analysis were related to the effect of sea water while the elements of factor 2 associated with agricultural fertilizers. The degree level, distribution, and location of groundwater contamination have been generated by using Kriging methods. Thus, geostatistics model provided more accurate results for identifying the source of contamination and evaluating the groundwater quality. GIS was also a creative tool to visualize and analyze the issues affecting water quality in the Miryang city.

Keywords: groundwater characteristics, GIS chemical maps, factor analysis, cluster analysis, Kriging techniques

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Authors: Gavin Quibell, Martin Kleynhans, Margot Soler

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The Sendai Framework notes that disaster risk reduction is essential for sustainable development, and Disaster Risk Reduction is included in 3 of the Sustainable Development Goals (SDGs), and 4 of the SDG targets. However, apart from promoting better governance and resourcing of disaster management agencies, little guidance is given how low-income nations can balance investments across the SDGs to achieve sustainable development in an increasingly climate vulnerable world with increasing prevalence of flood and drought disasters. As one of the world’s poorest nations, Malawi must balance investments across all the SDGs. This paper explores how Malawi’s National Guidelines for Community-based Flood Risk Management integrate sustainable development and flood management objectives at different administrative levels. While Malawi periodically suffers from large, widespread flooding, the greatest impacts are felt through the smaller annual floods and flash floods. The Guidelines address this through principles that recognize that while the protection of human life is the most important priority for flood risk management, addressing the impacts of floods on the rural poor and the economy requires different approaches. The National Guidelines are therefore underpinned by the following; 1. In the short-term investments in flood risk management must focus on breaking the poverty – vulnerability cycle; 2. In the long-term investments in the other SDGs will have the greatest flood risk management benefits; 3. If measures are in place to prevent loss of life and protect strategic infrastructure, it is better to protect more people against small and medium size floods than fewer people against larger floods; 4. Flood prevention measures should focus on small (1:5 return period) floods; 5. Flood protection measures should focus on small and medium floods (1:20 return period) while minimizing the risk of failure in larger floods; 6. The impacts of larger floods ( > 1:50) must be addressed through improved preparedness; 7. The impacts of climate change on flood frequencies are best addressed by focusing on growth not overdesign; and 8. Manage floods and droughts conjunctively. The National Guidelines weave these principles into Malawi’s approach to flood risk management through recommendations for planning and implementing flood prevention, protection and preparedness measures at district, traditional authority and village levels.

Keywords: flood risk management in low-income countries, sustainable development, investments in prevention, protection and preparedness, community-based flood risk management, Malawi

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