Search results for: vulnerability recurrence

Authors: Serges Mendomo Meye, Li Guowei, Shen Zhenzhong

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Earthquake is one of the main loads threatening dam safety. Once the dam is damaged, it will bring huge losses of life and property to the country and people. Therefore, it is very important to research the seismic safety of the dam. Due to the complex foundation conditions, high fortification intensity, and high scientific and technological content, it is necessary to adopt reasonable methods to evaluate the seismic safety performance of concrete arch dams built and under construction in strong earthquake areas. Structural seismic vulnerability analysis can predict the probability of structural failure at all levels under different intensity earthquakes, which can provide a scientific basis for reasonable seismic safety evaluation and decision-making. In this paper, the response surface method (RSM) is applied to the seismic vulnerability analysis of arch dams, which improves the efficiency of vulnerability analysis. Based on the central composite test design method, the material-seismic intensity samples are established. The response surface model (RSM) with arch crown displacement as performance index is obtained by finite element (FE) calculation of the samples, and then the accuracy of the response surface model (RSM) is verified. To obtain the seismic vulnerability curves, the seismic intensity measure ??(?1) is chosen to be 0.1~1.2g, with an interval of 0.1g and a total of 12 intensity levels. For each seismic intensity level, the arch crown displacement corresponding to 100 sets of different material samples can be calculated by algebraic operation of the response surface model (RSM), which avoids 1200 times of nonlinear dynamic calculation of arch dam; thus, the efficiency of vulnerability analysis is improved greatly.

Keywords: high concrete arch dam, performance index, response surface method, seismic vulnerability analysis, vector-valued intensity measure

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Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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Authors: Sujata Upgupta, Prasoon Kumar Singh

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The expansion of large scale coal mining into forest areas is a potential hazard for the local biodiversity and wildlife. The objective of this study is to provide a picture of the threat that coal mining poses to the forests of the East Bokaro landscape. The vulnerable forest areas at risk have been assessed and the priority areas for conservation have been presented. The forested areas at risk in the current scenario have been assessed and compared with the past conditions using classification and buffer based overlay approach. Forest vulnerability has been assessed using an analytical framework based on systematic indicators and composite vulnerability index values. The results indicate that more than 4 km² of forests have been lost from 1973 to 2016. Large patches of forests have been diverted for coal mining projects. Forests in the northern part of the coal field within 1-3 km radius around the coal mines are at immediate risk. The original contiguous forests have been converted into fragmented and degraded forest patches. Most of the collieries are located within or very close to the forests thus threatening the biodiversity and hydrology of the surrounding regions. Based on the vulnerability values estimated, it was concluded that more than 90% of the forested grids in East Bokaro are highly vulnerable to mining. The forests in the sub-districts of Bermo and Chandrapura have been identified as the most vulnerable to coal mining activities. This case study would add to the capacity of the forest managers and mine managers to address the risk and vulnerability of forests at a small landscape level in order to achieve sustainable development.

Keywords: forest, coal mining, indicators, vulnerability

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Authors: Pranab Kumar Das

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Vulnerability assessment of buildings with irregularity in the vertical direction has been carried out in this study. The constructions of vertically irregular buildings are increasing in the context of fast urbanization in the developing countries including India. During two reconnaissance based survey performed after Nepal earthquake 2015 and Imphal (India) earthquake 2016, it has been observed that so many structures are damaged due to the vertically irregular configuration. These irregular buildings are necessary to perform safely during seismic excitation. Therefore, it is very urgent demand to point out the actual vulnerability of the irregular structure. So that remedial measures can be taken for protecting those structures during natural hazard as like earthquake. This assessment will be very helpful for India and as well as for the other developing countries. A sufficient number of research has been contributed to the vulnerability of plan asymmetric buildings. In the field of vertically irregular buildings, the effort has not been forwarded much to find out their vulnerability during an earthquake. Irregularity in vertical direction may be caused due to irregular distribution of mass, stiffness and geometrically irregular configuration. Detailed analysis of such structures, particularly non-linear/ push over analysis for performance based design seems to be challenging one. The present paper considered a number of models of irregular structures. Building models made of both reinforced concrete and brick masonry are considered for the sake of generality. The analyses are performed with both help of finite element method and computational method.The study, as a whole, may help to arrive at a reasonably good estimate, insight for fundamental and other natural periods of such vertically irregular structures. The ductility demand, storey drift, and seismic response study help to identify the location of critical stress concentration. Summarily, this paper is a humble step for understanding the vulnerability and framing up the guidelines for vertically irregular structures.

Keywords: ductility, stress concentration, vertically irregular structure, vulnerability

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Authors: Benhammadi Hocine, Chaffai Hicham

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Urban development is often dependent on adequate land for expansion, except that sometimes these areas have vulnerability. This is the case of karst regions characterized by carbonate geological formations marked by the presence of cavities and cracks. The impact of climate variability in Cheria area marked by a growing shortage of rainfall, the impact resulted in the development of the vulnerability of these structures. This vulnerability has led to the appearance of collapse phenomena as well in both agricultural and urban areas. Two phenomena have emerged to explain the collapses, the first is assigned a filling process in the cavities, and the second is due to a weakening of the resistance that collapses limestone slab shear phenomenon. In urban areas, the weight of the buildings has increased the load on the limestone slab and accelerated the collapse. The analysis of the environmental process is in the context of our modest work, after which we indicate the appropriate methods for management policy of urban expansion. This management more preventive (upstream), much less expensive than remedial solutions (downstream) needed after the event and sometimes ineffective.

Keywords: Cheria, urban, climate variability, vulnerability karst collapse, extension, management

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Authors: Mona Nada, Fahmy Fahmy

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Background: Pleomorphic dermal sarcoma is a rare form of skin cancer affecting cutaneous layer and, in some cases associated with recurrence and metastasis, very commonly to seen in elderly patient affecting the area of head and neck. Pleomorphic dermal sarcoma rises in ultraviolet light exposed areas. The symptoms and severity of this kind of skin cancer varies according to histological factors. The differentiation of Pleomorphic dermal sarcoma needs extensive immunohistochemistry, as the diagnosis depends mainly on exclusion to rule out other malignancy like poorly differentiated squamous cell carcinoma, melanoma, angiosarcoma and leiomyosarcoma. Objective: assessing the management of Pleomorphic dermal sarcoma in our unit and compared to the updated guidelines. Design: Retrospective study Collection of patient data from medical records at countess of Chester plastic surgery unit of the last 5 years, all histologically confirmed Pleomorphic dermal sarcoma (2017-2023). Data were collected confirmed to be Pleomorphic dermal sarcoma were included in the study. The data collected: clinical description of the lesions at first presentation, operation time, multidisciplinary team discussion, plan, referral as well as second operation and investigation done. With comparison of histological examination, immunohistochemistry staining, the excision and rate of recurrence. Results: data collected N19 from (2017-2023) showed the disease predominantly affecting males and the lesion mainly in head and neck, the diagnosis needed extensive immunohistochemistry to differentiate between other malignancy. recurrence present in numbers of the cases which managed after multidisciplinary team discussion either by excision or radiotherapy. Conclusion: Pleomorphic dermal sarcoma is a rare malignancy which needs more understanding and avoid missing as it is aggressive form of skin cancer, there is a chance of metastasis and recurrence which makes it very important to understand the process of development of the cancer and frequent review of the management guidelines.

Keywords: pleomorphic dermal sarcoma, recurrence, radiotherapy, surgical

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Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

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Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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Authors: T. Dubayova

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Slovak, as well as foreign authors, believe that the influence of non-cognitive factors on a student's academic success or failure is unquestionable. The aim of this paper is to establish a link between the mental vulnerability and coping strategies used by 4^th grade elementary school students in dealing with stressful situations and their academic performance, which was used as a simple quantitative indicator of academic success. The research sample consists of 320 students representing the standard population and 60 students with special education needs (SEN), who were assessed by the Strengths and Difficulties Questionnaire (SDQ) by their teachers and the Children’s Coping Strategies Checklist (CCSC-R1) filled in by themselves. Students with SEN recorded an extraordinarily high frequency of mental vulnerability (34.5 %) than students representing the standard population (7 %). The poorest academic performance of students with SEN was associated with the avoidance behavior displayed during stressful situations. Students of the standard population did not demonstrate this association. Students with SEN are more likely to display mental health problems than students of the standard population. This may be caused by the accumulation of and frequent exposure to situations that they perceive as stressful.

Keywords: coping, mental vulnerability, pupil with special education needs, school performance, school success

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Authors: Liang Weichien

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Without adequate information and mitigation plan for natural disaster, the risk to urban populated areas will increase in the future as populations grow, especially in Taiwan. Taiwan is recognized as the world's high-risk areas, where an average of 5.7 times of floods occur per year should seek to strengthen coherence and consensus in how cities can plan for flood and climate change. Therefore, this study aims at understanding the vulnerability to flooding in Taipei city, Taiwan, by creating indicators and calculating the vulnerability of each study units. The indicators were grouped into sensitivity and adaptive capacity based on the definition of vulnerability of Intergovernmental Panel on Climate Change. The indicators were weighted by using Principal Component Analysis. However, current researches were based on the assumption that the composition and influence of the indicators were the same in different areas. This disregarded spatial correlation that might result in inaccurate explanation on local vulnerability. The study used Geographically Weighted Principal Component Analysis by adding geographic weighting matrix as weighting to get the different main flood impact characteristic in different areas. Cross Validation Method and Akaike Information Criterion were used to decide bandwidth and Gaussian Pattern as the bandwidth weight scheme. The ultimate outcome can be used for the reduction of damage potential by integrating the outputs into local mitigation plan and urban planning.

Keywords: flood vulnerability, geographically weighted principal components analysis, GWPCA, highly urbanized area, spatial correlation

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Authors: Marina Aferiba Tandoh, Elsie Odei

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Peptic Ulcer Disease (PUD) is amongst the commonest gastrointestinal problems that require emergency treatment in order to preserve life. The prevalence of PUD is increasing within the Ghanaian population, deepening the need to identify factors that are associated with its occurrence. This cross-sectional study assessed the nutritional status, socioeconomic and lifestyle factors associated with PUD among patients attending the Out-Patient Department of the Tema General Hospital of Ghana. A food frequency questionnaire and a three-day, 24-hour recall were used to assess the dietary intakes of study participants. A standardized questionnaire was used to obtain information on the participants’ socio-demographic characteristics, lifestyle as well as medical history. The data was analyzed using SPSS version 22. The mean age of study participants was 32.8±15.41years. Females were significantly higher (61.4%) than males (38.6%) (p < 0.001). All participants had received some form of education, with tertiary education being the highest (52.6%). The majority of them managed their condition with medications only (86%), while 10.5% managed it with a combination of medications and diet. The rest were either by dietary counseling only (1.8%), or surgery only (1.8%). or herbal medicines (29.3%), which were made from home (7.2%) or bought from a medical store (10.8%). Most of the participants experienced a recurrence of the disease (42.1%). For those who had ever experienced recurrences of the disease, it happened when they ate acidic foods (1.8%), ate bigger portions (1.8%), starved themselves (1.8%), or were stressed (1.8%). Others also had triggers when they took certain medications (1.8%) or ate too much pepper (1.8%). About 49% of the participants were either overweight or obese with a recurrence of PUD (p>0.05). Obese patients had the highest rate of PUD recurrences (41%). Drinking alcohol was significantly associated with the recurrence of PUD (χ2= 5.243, p=0.026). Other lifestyles, such as weed smoking, fasting, and use of herbal medicine and NSAIDs did not have any significant association with the disease recurrence. There was no significant correlation between the various dietary patterns and anthropometric parameters except dietary pattern one (salty snacks, regular soft drinks, milk, sweetened yogurt, ice cream, and cooked vegetables), which had a positive correlation with weight (p=0.002) and BMI (p=0.038). PUD patients should target weight reduction actions and reduce alcohol intake as measures to control the recurrence of the disease. Nutrition Education among this population must be promoted to minimize the recurrence of PUD.

Keywords: Dietary patterns, lifestyle factors, nutritional status, peptic ulcer disease

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Authors: Xiong Xie, Yuhang Chen

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Vulnerability discovery technology is a significant field of the current. In this paper, a fuzzy framework based on concolic execution has been proposed. Fuzzy test and symbolic execution are widely used in the field of vulnerability discovery technology. But each of them has its own advantages and disadvantages. During the path generation stage, path traversal algorithm based on generation is used to get more accurate path. During the constraint solving stage, dynamic concolic execution is used to avoid the path explosion. If there is external call, the concolic based on function summary is used. Experiments show that the framework can effectively improve the ability of triggering vulnerabilities and code coverage.

Keywords: concolic execution, constraint solving, fuzzy test, vulnerability discovery

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Authors: Johann Van Niekerk

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The disciplines of conducting (instrumental or choral) and of singing presume a willingness toward an open posture and, in many cases, demand it for effective communication and technique. Yet, this very openness, with the "spread-eagle" gesture as an extreme, is oftentimes counterintuitive for musicians and within the trajectory of human evolution. Conversely, it is in this very gesture of "taking up space" that confidence-gaining techniques such as the popular "power pose" are based. This paper consists primarily of a literature review, exploring the topics of physical openness and vulnerability, considering the semiotics of the "spread-eagle" and its accompanying letter X. A major finding of this research is the discrepancy between evolutionary instinct towards physical self-protection and “folding in” and the demands of the discipline of physical and gestural openness, expansiveness and vulnerability. A secondary finding is ways in which encouragement of confidence-gaining techniques may be more effective in obtaining the required results than insistence on vulnerability, which is influenced by various cultural contexts and socialization. Choral conductors and music educators are constantly seeking ways to promote engagement and healthy singing. Much of the information and direction toward this goal is gleaned by students from conducting gestures and other pedagogies employed in the rehearsal. The findings of this research provide yet another avenue toward reaching the goals required for sufficient and effective teaching and artistry on the part of instructors and students alike.

Keywords: conducting, gesture, music, pedagogy, posture, vulnerability

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Authors: Amritee Bora, B. S. Mipun

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Land degradation is often used to describe the land environmental phenomena that reduce land’s original productivity both qualitatively and quantitatively. The study of land degradation vulnerability primarily deals with “Environmentally Sensitive Areas” (ESA) and the amount of topsoil loss due to erosion. In many studies, it is observed that the assessment of the existing status of land degradation is used to represent the vulnerability. Moreover, it is also noticed that in most studies, the primary emphasis of land degradation vulnerability is to assess its sensitivity to soil erosion only. However, the concept of land degradation vulnerability can have different objectives depending upon the perspective of the study. It shows the extent to which changes in land use land cover can imprint their effect on the land. In other words, it represents the susceptibility of a piece of land to degrade its productive quality permanently or in the long run. It is also important to mention that the vulnerability of land degradation is not a single factor outcome. It is a probability assessment to evaluate the status of land degradation and needs to consider both biophysical and human induce parameters. To avoid the complexity of the previous models in this regard, the present study has emphasized on to generate a simplified model to assess the land degradation vulnerability in terms of its current human population pressure, land use practices, and existing biophysical conditions. It is a “Mixed-Method” termed as the land degradation vulnerability index (LDVi). It was originally inspired by the MEDALUS model (Mediterranean Desertification and Land Use), 1999, and Farazadeh’s 2007 revised version of it. It has followed the guidelines of Space Application Center, Ahmedabad / Indian Space Research Organization for land degradation vulnerability. The model integrates the climatic index (Ci), vegetation index (Vi), erosion index (Ei), land utilization index (Li), population pressure index (Pi), and cover management index (CMi) by giving equal weightage to each parameter. The final result shows that the very high vulnerable zone primarily indicates three (3) prominent circumstances; land under continuous population pressure, high concentration of human settlement, and high amount of topsoil loss due to surface runoff within the study sites. As all the parameters of the model are amalgamated with equal weightage further with the help of regression analysis, the LDVi model also provides a strong grasp of each parameter and how far they are competent to trigger the land degradation process.

Keywords: population pressure, land utilization, soil erosion, land degradation vulnerability

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Authors: Joshua Harrell, Gideon Osei Bonsu, Susan Garza, Clarence Conner, Da’Neisha Harris, Emma Bukoswki, Zohreh Safari

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The Social Vulnerability Index (SVI) stands as a pivotal tool for gauging community resilience amidst diverse stressors, including pandemics like COVID-19. This paper synthesizes recent research and underscores the significance of SVI in elucidating the differential impacts of crises on communities. Drawing on studies by Fox et al. (2023) and Mah et al. (2023), we delve into the application of SVI alongside emerging data sources to uncover nuanced insights into community vulnerability. Specifically, we explore the utilization of SVI in conjunction with mobility data from platforms like SafeGraph to probe the intricate relationship between social vulnerability and mobility dynamics during the COVID-19 pandemic. By leveraging 16 community variables derived from the American Community Survey, including socioeconomic status and demographic characteristics, SVI offers actionable intelligence for guiding targeted interventions and resource allocation. Building upon recent advancements, this paper contributes to the discourse on harnessing AI techniques to mitigate health disparities and fortify public health resilience in the face of pandemics and other crises.

Keywords: social vulnerability index, mobility dynamics, data analytics, health equity, pandemic preparedness, targeted interventions, data integration

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Authors: S. Vavias, T. R. Brewer, T. S. Farewell

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Coastal floods have been identified as an important natural hazard that can cause significant damage to the populated built-up areas, related infrastructure and also ecosystems and habitats. This study attempts to fill the gap associated with the development of preliminary assessments of coastal flood vulnerability for compliance with the EU Directive on the Assessment and Management of Flood Risks (2007/60/EC). In this context, a methodology has been created by taking into account three major parameters; the maximum wave run-up modelled from historical weather observations, the highest tide according to historic time series, and the sea level rise projections due to climate change. A high resolution digital terrain model (DTM) derived from LIDAR data has been used to integrate the estimated flood events in a GIS environment. The flood vulnerability map created shows potential risk areas and can play a crucial role in the coastal zone planning process. The proposed method has the potential to be a powerful tool for policy and decision makers for spatial planning and strategic management.

Keywords: coastal floods, vulnerability mapping, climate change, extreme weather events

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Authors: Pubudu K. Hitigala Kaluarachchilage, Champike Attanayake, Sasith Rajasooriya, Chris P. Tsokos

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Operating system (OS) security is a key component of computer security. Assessing and improving OSs strength to resist against vulnerabilities and attacks is a mandatory requirement given the rate of new vulnerabilities discovered and attacks occurring. Frequency and the number of different kinds of vulnerabilities found in an OS can be considered an index of its information security level. In the present study five mostly used OSs, Microsoft Windows (windows 7, windows 8 and windows 10), Apple’s Mac and Linux are assessed for their discovered vulnerabilities and the risk associated with each. Each discovered and reported vulnerability has an exploitability score assigned in CVSS score of the national vulnerability database. In this study the risk from vulnerabilities in each of the five Operating Systems is compared. Risk Indexes used are developed based on the Markov model to evaluate the risk of each vulnerability. Statistical methodology and underlying mathematical approach is described. Initially, parametric procedures are conducted and measured. There were, however, violations of some statistical assumptions observed. Therefore the need for non-parametric approaches was recognized. 6838 vulnerabilities recorded were considered in the analysis. According to the risk associated with all the vulnerabilities considered, it was found that there is a statistically significant difference among average risk levels for some operating systems, indicating that according to our method some operating systems have been more risk vulnerable than others given the assumptions and limitations. Relevant test results revealing a statistically significant difference in the Risk levels of different OSs are presented.

Keywords: cybersecurity, Markov chain, non-parametric analysis, vulnerability, operating system

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Authors: Hedyeh Gamini, Hadi Abdus

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Tsunami, as a natural disaster, is composed of waves that are usually caused by severe movements at the sea floor. Although tsunami and its consequences cannot be prevented in any way, by examining past tsunamis and extracting key points on how to deal with this incident and learning from it, a positive step can be taken to reduce the vulnerability of human settlements and reduce the risk of this phenomenon in architecture and urbanism. The method is reviewing and has examined the documents written and valid internet sites related to managing and reducing the vulnerability of human settlements in face of tsunami. This paper has explored the tsunamis in Indonesia (2004), Sri Lanka (2004) and Japan (2011), and of the study objectives has been understanding how they dealt with tsunami and extracting key points, and the lessons from them in terms of reduction of vulnerability of human settlements in dealing with the tsunami. Finally, strategies to prevent and reduce the vulnerability of communities at risk of tsunamis have been offered in terms of architecture and urban planning. According to what is obtained from the study of the recent tsunamis, the authorities' quality of dealing with them, how to manage the crisis and the manner of their construction, it can be concluded that to reduce the vulnerability of human settlements against tsunami, there are generally four ways that are: 1-Construction of tall buildings with opening on the first floor so that water can flow easily under and the direction of the building should be in a way that water passes easily from the side. 2- The construction of multi-purpose centers, which could be used as vertical evacuation during accidents. 3- Constructing buildings in core forms with diagonal orientation of the coastline, 4- Building physical barriers (natural and synthetic) such as water dams, mounds of earth, sea walls and creating forests

Keywords: tsunami, architecture, reducing vulnerability, human settlements, urbanism

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Authors: Bahareh Montakhabi

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Earthquake is known as one of the deadliest natural disasters, with a high potential for damage to life and property. Some of Iran's cities were completely destroyed after major earthquakes, and the people of the region suffered a lot of mental, financial and psychological damage. Tehran is one of the cities located on the fault line. According to experts, the only city that could be severely damaged by a moderate earthquake in Earthquake Engineering Intensity Scale (EEIS) (70% destruction) is Tehran because Tehran is built precisely on the fault. Seismic risk assessment (SRA) of cities in the scale of urban areas and neighborhoods is the first phase of the earthquake crisis management process, which can provide the information required to make optimal use of available resources and facilities in order to reduce the destructive effects and consequences of an earthquake. This study has investigated strategies to promote safety and reduce the vulnerability of worn-out urban textures in the District 12 of Tehran to the potential risk of earthquake aimed at prioritizing the factors affecting the vulnerability of worn-out urban textures to earthquake crises and how to reduce them, using the analytical-exploratory method, analytical hierarchy process (AHP), Expert choice and SWOT technique. The results of SWAT and AHP analysis of the vulnerability of the worn-out textures of District 12 to internal threats (1.70) and external threats (2.40) indicate weak safety of the textures of District 12 regarding internal and external factors and a high possibility of damage.

Keywords: risk management, vulnerability, worn-out textures, earthquake

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Authors: Emhemed Shaklawoon, Ibrahim Althomali

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We propose that we identify different defense mechanisms that were used before the introduction of the cloud and compare if their protection mechanisms are still valuable and to what degree. Note that in order to defend against vulnerability, we must know how this vulnerability is abused in an attack. Only then, we will be able to recognize if it is easier or harder to defend against cyber attacks.

Keywords: cloud computing, privacy, cyber attacks, defend the cloud

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Authors: B. Shukir, L. Szivos, D. Kis, P. Barzo

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Glioblastoma is the most malignant brain tumor. In general, the survival rate varies between (14-18) months. Glioblastoma consists a solid and infiltrative part. The standard therapeutic management of glioblastoma is maximum safe resection followed by chemo-radiotherapy. It’s hypothesized that the pretumoral hyperintense region in fluid attenuated inversion recovery (FLAIR) images includes both vasogenic edema and infiltrated tumor cells. In our study, we aimed to define the sensitivity and specificity of hyperintense FLAIR images preoperatively to examine how well it can define the true extent of glioblastoma. (16) glioblastoma patients included in this study. Hyperintense FLAIR region were delineated preoperatively as tumor mask. The infiltrative part of glioblastoma considered the regions where the tumor recurred on the follow up MRI. The recurrence on the CE-T1 images was marked as the recurrence masks. According to (AAL3) and (JHU white matter labels) atlas, the brain divided into cortical and subcortical regions respectively. For calculating specificity and sensitivity, the FLAIR and the recurrence masks overlapped counting how many regions affected by both . The average sensitivity and specificity was 83% and 85% respectively. Individually, the sensitivity and specificity varied between (31-100)%, and (100-58)% respectively. These results suggest that despite FLAIR being as an effective radiologic imaging tool its prognostic value remains controversial and probabilistic tractography remain more reliable available method for identifying the true extent of glioblastoma.

Keywords: brain tumors, glioblastoma, MRI, FLAIR

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Authors: Lamia Bensissaid

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Goals: Endometriosis affects 6 to 10% of women of childbearing age. 17 to 44% of them have ovarian endometriomas. Medical and surgical treatments represent the two therapeutic axes with which PMA can be associated. Laparoscopic intraperitoneal ovarian cystectomy is described as the reference technique in the management of endometriomas by learned societies (CNGOF, ESHRE, NICE). However, it leads to a significant short-term reduction in the AMH level and the number of antral follicles, especially in cases of bilateral cystectomy, large cyst size or cystectomy after recurrence. Often, the disease is at an advanced stage with several surgical patients. Most have adhesions, which increase the risk of surgical complications and suboptimal resection and, therefore recurrence of the cyst. These results led to a change of opinion towards a conservative approach. Sclerotherapy is an old technique which acts by fibrinoid necrosis. It consists of injecting a sclerosing agent into the cyst cavity. Results : Recurrence was less than 15% for a 12-month follow-up; these rates are comparable to those of surgery. It does not seem to have a negative impact on ovarian reserve, but this is not sufficiently evaluated. It has an advantage in IVF pregnancy rates compared to cystectomy, particularly in cases of recurrent endometriomas. It has the advantages: · To be done on an outpatient basis. · To be inexpensive. · To avoid sometimes difficult and iterative surgery: · To allow an increase in pregnancy rates and the preservation of the ovarian reserve compared to iterative surgery. · of great interest in cases of bilateral endometriomas (kissing ovaries) or recurrent endometriomas. Conclusions: Ethanol sclerotherapy could be a good alternative to surgery.

Keywords: Endometrioma, Sclerotherapy, infertility, Ethanol

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Authors: Diana Reckien

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Vulnerability assessments are increasingly used to support policy-making in complex environments, like urban areas. Usually, vulnerability studies include the construction of aggregate (sub-) indices and the subsequent mapping of indices across an area of interest. Vulnerability studies show a couple of advantages: they are great communication tools, can inform a wider general debate about environmental issues, and can help allocating and efficiently targeting scarce resources for adaptation policy and planning. However, they also have a number of challenges: Vulnerability assessments are constructed on the basis of a wide range of methodologies and there is no single framework or methodology that has proven to serve best in certain environments, indicators vary highly according to the spatial scale used, different variables and metrics produce different results, and aggregate or composite vulnerability indicators that are mapped easily distort or bias the picture of vulnerability as they hide the underlying causes of vulnerability and level out conflicting reasons of vulnerability in space. So, there is urgent need to further develop the methodology of vulnerability studies towards a common framework, which is one reason of the paper. We introduce a social vulnerability approach, which is compared with other approaches of bio-physical or sectoral vulnerability studies relatively developed in terms of a common methodology for index construction, guidelines for mapping, assessment of sensitivity, and verification of variables. Two approaches are commonly pursued in the literature. The first one is an additive approach, in which all potentially influential variables are weighted according to their importance for the vulnerability aspect, and then added to form a composite vulnerability index per unit area. The second approach includes variable reduction, mostly Principal Component Analysis (PCA) that reduces the number of variables that are interrelated into a smaller number of less correlating components, which are also added to form a composite index. We test these two approaches of constructing indices on the area of New York City as well as two different metrics of variables used as input and compare the outcome for the 5 boroughs of NY. Our analysis yields that the mapping exercise yields particularly different results in the outer regions and parts of the boroughs, such as Outer Queens and Staten Island. However, some of these parts, particularly the coastal areas receive the highest attention in the current adaptation policy. We imply from this that the current adaptation policy and practice in NY might need to be discussed, as these outer urban areas show relatively low social vulnerability as compared with the more central parts, i.e. the high dense areas of Manhattan, Central Brooklyn, Central Queens and the Southern Bronx. The inner urban parts receive lesser adaptation attention, but bear a higher risk of damage in case of hazards in those areas. This is conceivable, e.g., during large heatwaves, which would more affect more the inner and poorer parts of the city as compared with the outer urban areas. In light of the recent planning practice of NY one needs to question and discuss who in NY makes adaptation policy for whom, but the presented analyses points towards an under representation of the needs of the socially vulnerable population, such as the poor, the elderly, and ethnic minorities, in the current adaptation practice in New York City.

Keywords: vulnerability mapping, social vulnerability, additive approach, Principal Component Analysis (PCA), New York City, United States, adaptation, social sensitivity

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Authors: James Hilton Williams

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Recent tsunami events, including the 2011 Tohoku Tsunami, Japan, and the 2015 Illapel Tsunami, Chile, have highlighted the potential for tsunami impacts on the built environment. International research in the tsunami impacts domain has been largely focused toward impacts on buildings and casualty estimations, while only limited attention has been placed on the impacts on infrastructure which is critical for the recovery of impacted communities. New Zealand, with 75% of the population within 10 km of the coast, has a large amount of coastal infrastructure exposed to local, regional and distant tsunami sources. To effectively manage tsunami risk for New Zealand critical infrastructure, including energy, transportation, and communications, the vulnerability of infrastructure networks and components must first be determined. This research develops infrastructure asset vulnerability, functionality and repair- cost functions based on international post-event tsunami impact assessment data from technologically similar countries, including Japan and Chile, and adapts these to New Zealand. These functions are then utilized within a New Zealand based impact framework, allowing for cost benefit analyses, effective tsunami risk management strategies and mitigation options for exposed critical infrastructure to be determined, which can also be applied internationally.

Keywords: impact assessment, infrastructure, tsunami impacts, vulnerability functions

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Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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Authors: Arun Prasad

Abstract:

Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.

Keywords: laparoscopy, hernia, mesh, surgery

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Authors: Azzouzi Fadoua

Abstract:

This study focuses on the diagnosis of the dynamics of natural resources in a semi-arid mountainous weakened by natural vulnerability and anthropogenic action. This is evident in the forms of hydraulic erosion and degradation of agricultural land. The rate of this damaged land is 53%, with a strong presence of concentrated erosion; this shows that balanced and semi-balanced environments are less apparent to the Watershed, representing 47%. The results revealed the crucial role of the slopes and the density of the hydraulic networks to facilitate the transport of fine elements, at the level of the slopes with low vegetation intensity, to the lake of the dam. Something that endangers the siltation of the latter. After the study of natural and anthropogenic elements, it turned out that natural vulnerability is an integral part of the current dynamic, especially when it coincides with the overexploitation of natural resources, in this case, the exploitation of steep slopes for the cultivation of cereals and overgrazing. This causes the soil to pile up and increase the rate of runoff.

Keywords: watershed, erosion, natural vulnerability, anthropogenic

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Authors: Yi-Chun Kuo, Jo-Chieh Lin

Abstract:

The objective of a supply chain strategy is to reduce waste and increase efficiency to attain cost benefits, and to guarantee supply chain flexibility when facing the ever-changing market environment in order to meet customer requirements. Strategy implementation aims to fulfill common goals and attain benefits by integrating upstream and downstream enterprises, sharing information, conducting common planning, and taking part in decision making, so as to enhance the overall performance of the supply chain. With the rise of outsourcing and globalization, the increasing dependence on suppliers and customers and the rapid development of information technology, the complexity and uncertainty of the supply chain have intensified, and supply chain vulnerability has surged, resulting in adverse effects on supply chain performance. Thus, this study aims to use supply chain vulnerability as a moderating variable and apply structural equation modeling (SEM) to determine the relationships among supply chain strategy, supply chain integration, and supply chain performance, as well as the moderating effect of supply chain vulnerability on supply chain performance. The data investigation of this study was questionnaires which were collected from the management level of enterprises in Taiwan and China, 149 questionnaires were received. The result of confirmatory factor analysis shows that the path coefficients of supply chain strategy on supply chain integration and supply chain performance are positive (0.497, t= 4.914; 0.748, t= 5.919), having a significantly positive effect. Supply chain integration is also significantly positively correlated to supply chain performance (0.192, t = 2.273). The moderating effects of supply chain vulnerability on supply chain strategy and supply chain integration to supply chain performance are significant (7.407; 4.687). In Taiwan, 97.73% of enterprises are small- and medium-sized enterprises (SMEs) focusing on receiving original equipment manufacturer (OEM) and original design manufacturer (ODM) orders. In order to meet the needs of customers and to respond to market changes, these enterprises especially focus on supply chain flexibility and their integration with the upstream and downstream enterprises. According to the observation of this research, the effect of supply chain vulnerability on supply chain performance is significant, and so enterprises need to attach great importance to the management of supply chain risk and conduct risk analysis on their suppliers in order to formulate response strategies when facing emergency situations. At the same time, risk management is incorporated into the supply chain so as to reduce the effect of supply chain vulnerability on the overall supply chain performance.

Keywords: supply chain integration, supply chain performance, supply chain vulnerability, structural equation modeling

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Authors: Eleni Stefania Kalapoda

Abstract:

Recurring heat waves due to the global climate change emergency pose continuous risks to human health and urban resources. Local and state decision-makers incorporate Heat Vulnerability Indices (HVIs) to quantify and map the relative impact on human health in emergencies. These maps enable government officials to identify the highest-risk districts and to concentrate emergency planning efforts and available resources accordingly (e.g., to reevaluate the location and the number of heat-relief centers). Even though the framework of conducting an HVI is unique per municipality, its accuracy in assessing the heat risk is limited. To resolve this issue, varied housing-related metrics should be included. This paper quantifies and classifies NYC’s single detached housing typology within high-vulnerable NYC districts using detailed energy simulations and post-processing calculations. The results show that the variation in indoor heat risk depends significantly on the dwelling’s design/operation characteristics, concluding that low-ventilated dwellings are the most vulnerable ones. Also, it confirmed that when building-level determinants of exposure are excluded from the assessment, HVI fails to capture important components of heat vulnerability. Lastly, the overall vulnerability ratio of the housing units was calculated between 0.11 to 1.6 indoor heat degrees in terms of ventilation and shading capacity, insulation degree, and other building attributes.

Keywords: heat vulnerability index, energy efficiency, urban heat, resiliency to heat, climate adaptation, climate mitigation, building energy

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Authors: Rifaldy, Misbahudin, Khalid Rizky, Ricky Aryanto, M. Alfiyan Bagus, Fahri Septianto, Firman Najib Wibisana, Excobar Arman

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Indonesia is a country that has a high level of disaster because it is on the ring of fire, and there are several regions with three major plates meeting in the world. So that disaster analysis must always be done to see the potential disasters that might always occur, especially in this research are landslides and liquefaction. This research was conducted to analyze areas that are vulnerable to landslides and liquefaction hazards and their relationship with the assessment of the issue of moving the new capital of the Republic of Indonesia to the island of Kalimantan with a total area of 612,267.22 km². The method in this analysis uses the Analytical Hierarchy Process and consistency ratio testing as a complex and unstructured problem-solving process into several parameters by providing values. The parameters used in this analysis are the slope, land cover, lithology distribution, wetness index, earthquake data, peak ground acceleration. Weighted overlay was carried out from all these parameters using the percentage value obtained from the Analytical Hierarchy Process and confirmed its accuracy with a consistency ratio so that a percentage of the area obtained with different vulnerability classification values was obtained. Based on the analysis results obtained vulnerability classification from very high to low vulnerability. There are (0.15%) 918.40083 km² of highly vulnerable, medium (20.75%) 127,045,44815 km², low (56.54%) 346,175.886188 km², very low (22.56%) 138,127.484832 km². This research is expected to be able to map landslides and liquefaction disasters on the island of Kalimantan and provide consideration of the suitability of regional development of the new capital of the Republic of Indonesia. Also, this research is expected to provide input or can be applied to all regions that are analyzing the vulnerability of landslides and liquefaction or the suitability of the development of certain regions.

Keywords: analytic hierarchy process, Borneo Island, landslide and liquefaction, vulnerability analysis

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Authors: Nasiru Medugu Idris

Abstract:

This research is aimed at assessing the vulnerability of climate change to rural communities (farmers, herdsmen and fishermen) in Nigeria with the view to study the underlying causes and degree of vulnerability to climate change and examine the conflict between farmers and herdsmen as a result of climate change. This research employed the use of quantitative and qualitative means of data gathering techniques as well as physical observations. Six states (Kebbi, Adamawa, Nasarawa, Osun, Ebonyi, and Akwa Ibom) have been selected on the ground that they are key food production areas in the country and are therefore essential to continual food security in the country. So also, they also double as fishing communities in order to aid the comprehensive study of all the effects on climate on farmers and fishermen alike. Community focus group discussions were carried out in the various states for an interactive session and also to have firsthand information on their level of awareness on climate change. Climate data from the Nigerian Meteorological Agency over the past decade were collected for the purpose of analyzing trends in climate. The study observed that the level of vulnerability of rural dwellers most especially farmers, herdsmen and fishermen to climate change is very high due to their socioeconomic, ethnic and historical perspective of their trend. The study, therefore, recommends that urgent step needs to be put in place to help control natural hazards and man-made disasters and serious measures are also needed in order to minimize severe societal, economic and political crises; some of which may either escalate to violent conflicts or could be avoided by efforts of conflict resolution and prevention by the initiation of a process of de-escalation. So this study has recommended the best-fit adaptive and mitigation measures to climate change vulnerability in rural communities of Nigeria.

Keywords: adaptation, farmers, fishermen, herdsmen

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