Search results for: risk of cancer
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7650

Search results for: risk of cancer

6720 Update on Epithelial Ovarian Cancer (EOC), Types, Origin, Molecular Pathogenesis, and Biomarkers

Authors: Salina Yahya Saddick

Abstract:

Ovarian cancer remains the most lethal gynecological malignancy due to the lack of highly sensitive and specific screening tools for detection of early-stage disease. The OSE provides the progenitor cells for 90% of human ovarian cancers. Recent morphologic, immunohistochemical and molecular genetic studies have led to the development of a new paradigm for the pathogenesis and origin of epithelial ovarian cancer (EOC) based on a ualistic model of carcinogenesis that divides EOC into two broad categories designated Types I and II which are characterized by specific mutations, including KRAS, BRAF, ERBB2, CTNNB1, PTEN PIK3CA, ARID1A, and PPPR1A, which target specific cell signaling pathways. Type 1 tumors rarely harbor TP53. type I tumors are relatively genetically stable and typically display a variety of somatic sequence mutations that include KRAS, BRAF, PTEN, PIK3CA CTNNB1 (the gene encoding beta catenin), ARID1A and PPP2R1A but very rarely TP53 . The cancer stem cell (CSC) hypothesis postulates that the tumorigenic potential of CSCs is confined to a very small subset of tumor cells and is defined by their ability to self-renew and differentiate leading to the formation of a tumor mass. Potential protein biomarker miRNA, are promising biomarkers as they are remarkably stable to allow isolation and analysis from tissues and from blood in which they can be found as free circulating nucleic acids and in mononuclear cells. Recently, genomic anaylsis have identified biomarkers and potential therapeutic targets for ovarian cancer namely, FGF18 which plays an active role in controlling migration, invasion, and tumorigenicity of ovarian cancer cells through NF-κB activation, which increased the production of oncogenic cytokines and chemokines. This review summarizes update information on epithelial ovarian cancers and point out to the most recent ongoing research.

Keywords: epithelial ovarian cancers, somatic sequence mutations, cancer stem cell (CSC), potential protein, biomarker, genomic analysis, FGF18 biomarker

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6719 An Activatable Theranostic for Targeted Cancer Therapy and Imaging

Authors: Sankarprasad Bhuniya, Sukhendu Maiti, Eun-Joong Kim, Hyunseung Lee, Jonathan L. Sessler, Kwan Soo Hong, Jong Seung Kim

Abstract:

A new theranostic strategy is described. It is based on the use of an “all in one” prodrug, namely the biotinylated piperazine-rhodol conjugate 4a. This conjugate, which incorporates the anticancer drug SN-38, undergoes self-immolative cleavage when exposed to biological thiols. This leads to the tumor-targeted release of the active SN-38 payload along with fluorophore 1a. This release is made selective as the result of the biotin functionality. Fluorophore 1a is 32-fold more fluorescent than prodrug 4a. It permits the delivery and release of the SN-38 payload to be monitored easily in vitro and in vivo, as inferred from cell studies and ex vivo analyses of mice xenografts derived HeLa cells, respectively. Prodrug 4a also displays anticancer activity in the HeLa cell murine xenograft tumor model. On the basis of these findings we suggest that the present strategy, which combines within a single agent the key functions of targeting, release, imaging, and treatment, may have a role to play in cancer diagnosis and therapy.

Keywords: theranostic, prodrug, cancer therapy, fluorescence

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6718 Role of Desire in Risk-Perception: A Case Study of Syrian Refugees’ Migration towards Europe

Authors: Lejla Sunagic

Abstract:

The aim of the manuscript is to further the understanding of risky decision-making in the context of forced and irregular migration. The empirical evidence is collected through interviews with Syrian refugees who arrived in Europe via irregular pathways. Analytically, it has been approached through the juxtaposition between risk perception and the notion of desire. As different frameworks have been developed to address differences in risk perception, the common thread was the understanding that individual risk-taking has been addressed in terms of benefits outweighing risks. However, this framework cannot explain a big risk an individual takes because of an underprivileged position and due to a lack of positive alternatives, termed as risk-taking from vulnerability. The accounts of the field members of this study that crossed the sea in rubber boats to arrive in Europe make an empirical fit to such a postulate by reporting that the risk they have taken was not the choice but the only coping strategy. However, the vulnerability argument falls short of explaining why the interviewees, thinking retrospectively, find the risky journey they have taken to be worth it, while they would strongly advise others to restrain from taking such a huge risk. This inconsistency has been addressed by adding the notion of desire to migrate to the elements of risk perception. Desire, as a subjective experience, was what made the risk appear smaller in cost-benefit analysis at the time of decision-making of those who have realized migration. However, when they reflect on others in the context of potential migration via the same pathway, the interviewees addressed the others’ lack of capacity to avoid the same obstacles that they themselves were able to circumvent while omitting to reflect on others’ desire to migrate. Thus, in the risk-benefit analysis performed for others, the risk remains unblurred and tips over the benefits, given the inability to take into account the desire of others. If desire, as the transformative potential of migration, is taken out of the cost-benefit analysis of irregular migration, refugees might not have taken the risky journey. By casting the theoretical argument in the language of configuration, the study is filling in the gap of knowledge on the combination of migration drivers and the way they interact and produce migration outcomes.

Keywords: refugees, risk perception, desire, irregular migration

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6717 Ultra Wideband Breast Cancer Detection by Using SAR for Indication the Tumor Location

Authors: Wittawat Wasusathien, Samran Santalunai, Thanaset Thosdeekoraphat, Chanchai Thongsopa

Abstract:

This paper presents breast cancer detection by observing the specific absorption rate (SAR) intensity for identification tumor location, the tumor is identified in coordinates (x,y,z) system. We examined the frequency between 4-8 GHz to look for the most appropriate frequency. Results are simulated in frequency 4-8 GHz, the model overview include normal breast with 50 mm radian, 5 mm diameter of tumor, and ultra wideband (UWB) bowtie antenna. The models are created and simulated in CST Microwave Studio. For this simulation, we changed antenna to 5 location around the breast, the tumor can be detected when an antenna is close to the tumor location, which the coordinate of maximum SAR is approximated the tumor location. For reliable, we experiment by random tumor location to 3 position in the same size of tumor and simulation the result again by varying the antenna position in 5 position again, and it also detectable the tumor position from the antenna that nearby tumor position by maximum value of SAR, which it can be detected the tumor with precision in all frequency between 4-8 GHz.

Keywords: specific absorption rate (SAR), ultra wideband (UWB), coordinates, cancer detection

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6716 Novel Nickel Complex Compound Reactivates the Apoptotic Network, Cell Cycle Arrest and Cytoskeletal Rearrangement in Human Colon and Breast Cancer Cells

Authors: Nima Samie, Batoul Sadat Haerian, Sekaran Muniandy, M. S. Kanthimathi

Abstract:

Colon and breast cancers are categorized as the most prevalent types of cancer worldwide. Recently, the broad clinical application of metal complex compounds has led to the discovery of potential therapeutic drugs. The aim of this study was to evaluate the cytotoxic action of a selected nickel complex compound (NCC) against human colon and breast cancer cells. In this context, we determined the potency of the compound in the induction of apoptosis, cell cycle arrest, and cytoskeleton rearrangement. HT-29, WiDr, CCD-18Co, MCF-7 and Hs 190.T cell lines were used to determine the IC50 of the compound using the MTT assay. Analysis of apoptosis was carried out using immunofluorescence, acridine orange/ propidium iodide double staining, Annexin-V-FITC assay, evaluation of the translocation of NF-kB, oxygen radical antioxidant capacity, quenching of reactive oxygen species content , measurement of LDH release, caspase-3/-7, -8 and -9 assays and western blotting. The cell cycle arrest was examined using flowcytometry and gene expression was assessed using qPCR array. Results showed that our nickel complex compound displayed a potent suppressive effect on HT-29, WiDr, MCF-7 and Hs 190.T after 24 h of treatment with IC50 value of 2.02±0.54, 2.13±0.65, 3.76±015 and 3.14±0.45 µM respectively. This cytotoxic effect on normal cells was insignificant. Dipping in the mitochondrial membrane potential and increased release of cytochrome c from the mitochondria indicated induction of the intrinsic apoptosis pathway by the nickel complex compound. Activation of this pathway was further evidenced by significant activation of caspase 9 and 3/7.The nickel complex compound (NCC) was also shown activate the extrinsic pathways of apoptosis by activation of caspase-8 which is linked to the suppression of NF-kB translocation to the nucleus. Cell cycle arrest in the G1 phase and up-regulation of glutathione reductase, based on excessive ROS production were also observed. The results of this study suggest that the nickel complex compound is a potent anti-cancer agent inducing both intrinsic and extrinsic pathways as well as cell cycle arrest in colon and breast cancer cells.

Keywords: nickel complex, apoptosis, cytoskeletal rearrangement, colon cancer, breast cancer

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6715 Risk Assessment of Heavy Rainfall and Development of Damage Prediction Function for Gyeonggi-Do Province

Authors: Jongsung Kim, Daegun Han, Myungjin Lee, Soojun Kim, Hung Soo Kim

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Recently, the frequency and magnitude of natural disasters are gradually increasing due to climate change. Especially in Korea, large-scale damage caused by heavy rainfall frequently occurs due to rapid urbanization. Therefore, this study proposed a Heavy rain Damage Risk Index (HDRI) using PSR (Pressure – State - Response) structure for heavy rain risk assessment. We constructed pressure index, state index, and response index for the risk assessment of each local government in Gyeonggi-do province, and the evaluation indices were determined by principal component analysis. The indices were standardized using the Z-score method then HDRIs were obtained for 31 local governments in the province. The HDRI is categorized into three classes, say, the safest class is 1st class. As the results, the local governments of the 1st class were 15, 2nd class 7, and 3rd class 9. From the study, we were able to identify the risk class due to the heavy rainfall for each local government. It will be useful to develop the heavy rainfall prediction function by risk class, and this was performed in this issue. Also, this risk class could be used for the decision making for efficient disaster management. Acknowledgements: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2017R1A2B3005695).

Keywords: natural disaster, heavy rain risk assessment, HDRI, PSR

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6714 Unhealthy Food Consumption Behavior in Suan Sunandha Rajabhat Universities

Authors: Narumon Piaseu

Abstract:

This survey research was aimed to describe and compare consumption behavior of health risk food among students in Suan Sunandha Rajabhat University. Sample included 400 undergraduate students enrolled in the first semester of 2008 academic year. Data were collected by using self reported questionnaire developed by the researcher. Data were then analyzed by descriptive statistics including frequency, percentage, mean, standard deviation, and inferential statistics including independent t-test, and Oneway ANOVA. Results revealed that most of the sample were women (67%), enrolled in social related programs (74%). Approximately half of them (45.5%) stayed in dormitory. The mean of monthly income was 5,164 Baht and daily food expenditure was 114.55 Baht. Majority of them (83%) had ready-to-eat food. A major factor influencing their food selection was their parents (61%). A main reason for their food selection was food that looks good (70.75%). Almost half of them (46.25%) had heavy exercise less than 3 times per week. Regarding knowledge on health risk food, 43.5% of the sample had good knowledge. The followings were moderate (41%) and poor (41%). Most of the sample (60.75%) had consumption behavior at low risk. The following was at moderate risk (37.25%). Only 2% were at high risk. Among the sample, consumption behavior of health risk food were significantly different in years of study (F = 3.168, p = .024), daily food expenditure (F = 8.950, p <.001), and knowledge on health risk food (F = 37.856, p <.001), while no significant difference in consumption behavior of health risk food was found in those with a difference in gender, program of study, living place, and monthly income. Results indicate the importance of providing knowledge regarding health risk food for students and their parents in order to promote appropriate food consumption behavior among the students.

Keywords: food consumption, risky behavior, Suan Sunandha Rajabhat University, health risk

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6713 Exploring the Effect of Accounting Information on Systematic Risk: An Empirical Evidence of Tehran Stock Exchange

Authors: Mojtaba Rezaei, Elham Heydari

Abstract:

This paper highlights the empirical results of analyzing the correlation between accounting information and systematic risk. This association is analyzed among financial ratios and systematic risk by considering the financial statement of 39 companies listed on the Tehran Stock Exchange (TSE) for five years (2014-2018). Financial ratios have been categorized into four groups and to describe the special features, as representative of accounting information we selected: Return on Asset (ROA), Debt Ratio (Total Debt to Total Asset), Current Ratio (current assets to current debt), Asset Turnover (Net sales to Total assets), and Total Assets. The hypotheses were tested through simple and multiple linear regression and T-student test. The findings illustrate that there is no significant relationship between accounting information and market risk. This indicates that in the selected sample, historical accounting information does not fully reflect the price of stocks.

Keywords: accounting information, market risk, systematic risk, stock return, efficient market hypothesis, EMH, Tehran stock exchange, TSE

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6712 Identification of a Panel of Epigenetic Biomarkers for Early Detection of Hepatocellular Carcinoma in Blood of Individuals with Liver Cirrhosis

Authors: Katarzyna Lubecka, Kirsty Flower, Megan Beetch, Lucinda Kurzava, Hannah Buvala, Samer Gawrieh, Suthat Liangpunsakul, Tracy Gonzalez, George McCabe, Naga Chalasani, James M. Flanagan, Barbara Stefanska

Abstract:

Hepatocellular carcinoma (HCC), the most prevalent type of primary liver cancer, is the second leading cause of cancer death worldwide. Late onset of clinical symptoms in HCC results in late diagnosis and poor disease outcome. Approximately 85% of individuals with HCC have underlying liver cirrhosis. However, not all cirrhotic patients develop cancer. Reliable early detection biomarkers that can distinguish cirrhotic patients who will develop cancer from those who will not are urgently needed and could increase the cure rate from 5% to 80%. We used Illumina-450K microarray to test whether blood DNA, an easily accessible source of DNA, bear site-specific changes in DNA methylation in response to HCC before diagnosis with conventional tools (pre-diagnostic). Top 11 differentially methylated sites were selected for validation by pyrosequencing. The diagnostic potential of the 11 pyrosequenced probes was tested in blood samples from a prospective cohort of cirrhotic patients. We identified 971 differentially methylated CpG sites in pre-diagnostic HCC cases as compared with healthy controls (P < 0.05, paired Wilcoxon test, ICC ≥ 0.5). Nearly 76% of differentially methylated CpG sites showed lower levels of methylation in cases vs. controls (P = 2.973E-11, Wilcoxon test). Classification of the CpG sites according to their location relative to CpG islands and transcription start site revealed that those hypomethylated loci are located in regulatory regions important for gene transcription such as CpG island shores, promoters, and 5’UTR at higher frequency than hypermethylated sites. Among 735 CpG sites hypomethylated in cases vs. controls, 482 sites were assigned to gene coding regions whereas 236 hypermethylated sites corresponded to 160 genes. Bioinformatics analysis using GO, KEGG and DAVID knowledgebase indicate that differentially methylated CpG sites are located in genes associated with functions that are essential for gene transcription, cell adhesion, cell migration, and regulation of signal transduction pathways. Taking into account the magnitude of the difference, statistical significance, location, and consistency across the majority of matched pairs case-control, we selected 11 CpG loci corresponding to 10 genes for further validation by pyrosequencing. We established that methylation of CpG sites within 5 out of those 10 genes distinguish cirrhotic patients who subsequently developed HCC from those who stayed cancer free (cirrhotic controls), demonstrating potential as biomarkers of early detection in populations at risk. The best predictive value was detected for CpGs located within BARD1 (AUC=0.70, asymptotic significance ˂0.01). Using an additive logistic regression model, we further showed that 9 CpG loci within those 5 genes, that were covered in pyrosequenced probes, constitute a panel with high diagnostic accuracy (AUC=0.887; 95% CI:0.80-0.98). The panel was able to distinguish pre-diagnostic cases from cirrhotic controls free of cancer with 88% sensitivity at 70% specificity. Using blood as a minimally invasive material and pyrosequencing as a straightforward quantitative method, the established biomarker panel has high potential to be developed into a routine clinical test after validation in larger cohorts. This study was supported by Showalter Trust, American Cancer Society (IRG#14-190-56), and Purdue Center for Cancer Research (P30 CA023168) granted to BS.

Keywords: biomarker, DNA methylation, early detection, hepatocellular carcinoma

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6711 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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6710 Railway Accidents: Using the Global Railway Accident Database and Evaluation for Risk Analysis

Authors: Mathias Linden, André Schneider, Harald F. O. von Korflesch

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The risk of train accidents is an ongoing concern for railway organizations, governments, insurance companies and other depended sectors. Safety technologies are installed to reduce and to prevent potential damages of train accidents. Since the budgetary for the safety of railway organizations is limited, it is necessary not only to achieve a high availability and high safety standard but also to be cost effective. Therefore, an economic assessment of safety technologies is fundamental to create an accurate risk analysis. In order to conduct an economical assessment of a railway safety technology and a quantification of the costs of the accident causes, the Global Railway Accident Database & Evaluation (GRADE) has been developed. The aim of this paper is to describe the structure of this accident database and to show how it can be used for risk analyses. A number of risk analysis methods, such as the probabilistic safety assessment method (PSA), was used to demonstrate this accident database’s different possibilities of risk analysis. In conclusion, it can be noted that these analyses would not be as accurate without GRADE. The information gathered in the accident database was not available in this way before. Our findings are relevant for railway operators, safety technology suppliers, assurances, governments and other concerned railway organizations.

Keywords: accident causes, accident costs, accident database, global railway accident database & evaluation, GRADE, probabilistic safety assessment, PSA, railway accidents, risk analysis

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6709 Full Mini Nutritional Assessment Questionnaire and the Risk of Malnutrition and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos E. Lampropoulos, Maria Konsta, Tamta Sirbilatze, Ifigenia Apostolou, Vicky Dradaki, Konstantina Panouria, Irini Dri, Christina Kordali, Vaggelis Lambas, Georgios Mavras

Abstract:

Objectives: Full Mini Nutritional Assessment (MNA) questionnaire is one of the most useful tools in diagnosis of malnutrition in hospitalized patients, which is related to increased morbidity and mortality. The purpose of our study was to assess the nutritional status of elderly, hospitalized patients and examine the hypothesis that MNA may predict mortality and extension of hospitalization. Methods: One hundred fifty patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. The following data were taken into account in analysis: anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission. The latter was compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and extended hospitalization respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 20% per each unit increase of full MNA score (OR=0.8, 95% CI 0.74-0.89, p < 0.0001). Patients who admitted due to cancer were 23 times more likely to die, compared to those with infection (OR=23, 95% CI 3.8-141.6, p=0.001). Similarly, patients who admitted due to stroke were 7 times more likely to die (OR=7, 95% CI 1.4-34.5, p=0.02), while these with all other causes of admission were less likely (OR=0.2, 95% CI 0.06-0.8, p=0.03), compared to patients with infection. According to multivariate linear regression analysis, each increase of unit of full MNA, decreased the admission duration on average 0.3 days (b:-0.3, 95% CI -0.45 - -0.15, p < 0.0001). Patients admitted due to cancer had on average 6.8 days higher extension of hospitalization, compared to those admitted for infection (b:6.8, 95% CI 3.2-10.3, p < 0.0001). Conclusion: Mortality and extension of hospitalization is significantly increased in elderly, malnourished patients. Full MNA score is a useful diagnostic tool of malnutrition.

Keywords: duration of admission, malnutrition, mini nutritional assessment score, prognostic factors for mortality

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6708 Nanomaterials Based Biosensing Chip for Non-Invasive Detection of Oral Cancer

Authors: Suveen Kumar

Abstract:

Oral cancer (OC) is the sixth most death causing cancer in world which includes tumour of lips, floor of the mouth, tongue, palate, cheeks, sinuses, throat, etc. Conventionally, the techniques used for OC detection are toluidine blue staining, biopsy, liquid-based cytology, visual attachments, etc., however these are limited by their highly invasive nature, low sensitivity, time consumption, sophisticated instrument handling, sample processing and high cost. Therefore, we developed biosensing chips for non-invasive detection of OC via CYFRA-21-1 biomarker. CYFRA-21-1 (molecular weight: 40 kDa) is secreted in saliva of OC patients which is a non-invasive biological fluid with a cut-off value of 3.8 ng mL-1, above which the subjects will be suffering from oral cancer. Therefore, in first work, 3-aminopropyl triethoxy silane (APTES) functionalized zirconia (ZrO2) nanoparticles (APTES/nZrO2) were used to successfully detect CYFRA-21-1 in a linear detection range (LDR) of 2-16 ng mL-1 with sensitivity of 2.2 µA mL ng-1. Successively, APTES/nZrO2-RGO was employed to prevent agglomeration of ZrO2 by providing high surface area reduced graphene oxide (RGO) support and much wider LDR (2-22 ng mL-1) was obtained with remarkable limit of detection (LOD) as 0.12 ng mL-1. Further, APTES/nY2O3/ITO platform was used for oral cancer bioseneor development. The developed biosensor (BSA/anti-CYFRA-21-1/APTES/nY2O3/ITO) have wider LDR (0.01-50 ng mL-1) with remarkable limit of detection (LOD) as 0.01 ng mL-1. To improve the sensitivity of the biosensing platform, nanocomposite of yattria stabilized nanostructured zirconia-reduced graphene oxide (nYZR) based biosensor has been developed. The developed biosensing chip having ability to detect CYFRA-21-1 biomolecules in the range of 0.01-50 ng mL-1, LOD of 7.2 pg mL-1 with sensitivity of 200 µA mL ng-1. Further, the applicability of the fabricated biosensing chips were also checked through real sample (saliva) analysis of OC patients and the obtained results showed good correlation with the standard protein detection enzyme linked immunosorbent assay (ELISA) technique.

Keywords: non-invasive, oral cancer, nanomaterials, biosensor, biochip

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6707 Schedule Risk Management for Complex Projects: The Royal Research Ship: Sir David Attenborough Case Study

Authors: Chatelier Charlene, Oyegoke Adekunle, Ajayi Saheed, Jeffries Andrew

Abstract:

This study seeks to understand Schedule Risk Assessments as a priori for better performance whilst exploring the strategies employed to deliver complex projects like the New Polar research ship. This high-profile vessel was offered to Natural Environment Research Council and British Antarctic Survey (BAS) by Cammell Laird Shipbuilders. The Research Ship was designed to support science in extreme environments, with the expectancy to provide a wide range of specialist scientific facilities, instruments, and laboratories to conduct research over multiple disciplines. Aim: The focus is to understand the allocation and management of schedule risk on such a Major Project. Hypothesising that "effective management of schedule risk management" could be the most critical factor in determining whether the intended benefits mentioned are delivered within time and cost constraints. Objective 1: Firstly, the study seeks to understand the allocation and management of schedule risk in Major Projects. Objective 2: Secondly, it explores "effective management of schedule risk management" as the most critical factor determining the delivery of intended benefits. Methodology: This study takes a retrospective review of schedule risk management and how it influences project performance using a case study approach for the RRS (Royal Research Ship) Sir David Attenborough. Research Contribution: The outcomes of this study will contribute to a better understanding of project performance whilst building on its under-researched relationship to schedule risk management for complex projects. The outcomes of this paper will guide further research on project performance and enable the understanding of how risk-based estimates over time impact the overall risk management of the project.

Keywords: complexity, major projects, performance management, schedule risk management, uncertainty

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6706 Quality of the Ruin Probabilities Approximation Using the Regenerative Processes Approach regarding to Large Claims

Authors: Safia Hocine, Djamil Aïssani

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Risk models, recently studied in the literature, are becoming increasingly complex. It is rare to find explicit analytical relations to calculate the ruin probability. Indeed, the stability issue occurs naturally in ruin theory, when parameters in risk cannot be estimated than with uncertainty. However, in most cases, there are no explicit formulas for the ruin probability. Hence, the interest to obtain explicit stability bounds for these probabilities in different risk models. In this paper, we interest to the stability bounds of the univariate classical risk model established using the regenerative processes approach. By adopting an algorithmic approach, we implement this approximation and determine numerically the bounds of ruin probability in the case of large claims (heavy-tailed distribution).

Keywords: heavy-tailed distribution, large claims, regenerative process, risk model, ruin probability, stability

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6705 Urban Flood Risk Mapping–a Review

Authors: Sherly M. A., Subhankar Karmakar, Terence Chan, Christian Rau

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Floods are one of the most frequent natural disasters, causing widespread devastation, economic damage and threat to human lives. Hydrologic impacts of climate change and intensification of urbanization are two root causes of increased flood occurrences, and recent research trends are oriented towards understanding these aspects. Due to rapid urbanization, population of cities across the world has increased exponentially leading to improperly planned developments. Climate change due to natural and anthropogenic activities on our environment has resulted in spatiotemporal changes in rainfall patterns. The combined effect of both aggravates the vulnerability of urban populations to floods. In this context, an efficient and effective flood risk management with its core component as flood risk mapping is essential in prevention and mitigation of flood disasters. Urban flood risk mapping involves zoning of an urban region based on its flood risk, which depicts the spatiotemporal pattern of frequency and severity of hazards, exposure to hazards, and degree of vulnerability of the population in terms of socio-economic, environmental and infrastructural aspects. Although vulnerability is a key component of risk, its assessment and mapping is often less advanced than hazard mapping and quantification. A synergic effort from technical experts and social scientists is vital for the effectiveness of flood risk management programs. Despite an increasing volume of quality research conducted on urban flood risk, a comprehensive multidisciplinary approach towards flood risk mapping still remains neglected due to which many of the input parameters and definitions of flood risk concepts are imprecise. Thus, the objectives of this review are to introduce and precisely define the relevant input parameters, concepts and terms in urban flood risk mapping, along with its methodology, current status and limitations. The review also aims at providing thought-provoking insights to potential future researchers and flood management professionals.

Keywords: flood risk, flood hazard, flood vulnerability, flood modeling, urban flooding, urban flood risk mapping

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6704 Potential Ecological Risk Index of the Northern Egyptian Lagoons, South of Mediterranean Sea, Egypt

Authors: Mohamed El-Bady

Abstract:

The Northern Egyptian Lagoons are (from east to west) Bardawil Lagoon, Manzala Lagoon, Burullus Lagoon, Edku Lagoons and Mariute Lagoon. These lagoons have been received the bulk of drainage water from the lands of Delta and from the other coastal areas. Where, the heavy metals can occur in Lagoons environments through a variety of sources, including industries, wastewaters and domestic effluents. The potential ecological risk index (RI) calculation of the bottom sediments of the northern lagoons depends on contamination factor (CF), potential ecological risk factor and proposed toxic response factor (Tr). Each lagoon with special indices according to its conditions.

Keywords: Northern Lagoons, Nile Delta, ecological risk index, contamination factor

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6703 GATA3-AS1 lncRNA as a Predictive Biomarker for Neoadjuvant Chemotherapy Response in Locally Advanced Luminal B Breast Cancer: An RNA ISH Study

Authors: Tania Vasquez Mata, Luis A. Herrera, Cristian Arriaga Canon

Abstract:

Background: Locally advanced breast cancer of the luminal B phenotype, poses challenges due to its variable response to neoadjuvant chemotherapy. A predictive biomarker is needed to identify patients who will not respond to treatment, allowing for alternative therapies. This study aims to validate the use of the lncRNA GATA3-AS1, as a predictive biomarker using RNA in situ hybridization. Research aim: The aim of this study is to determine if GATA3-AS1 can serve as a biomarker for resistance to neoadjuvant chemotherapy in patients with locally advanced luminal B breast cancer. Methodology: The study utilizes RNA in situ hybridization with predesigned probes for GATA3-AS1 on Formalin-Fixed Paraffin-Embedded tissue sections. The samples underwent pretreatment and protease treatment to enable probe penetration. Chromogenic detection and signal evaluation were performed using specific criteria. Findings: Patients who did not respond to neoadjuvant chemotherapy showed a 3+ score for GATA3-AS1, while those who had a complete response had a 1+ score. Theoretical importance: This study demonstrates the potential clinical utility of GATA3-AS1 as a biomarker for resistance to neoadjuvant chemotherapy. Identifying non-responders early on can help avoid unnecessary treatment and explore alternative therapy options. Data collection and analysis procedures: Tissue samples from patients with locally advanced luminal B breast cancer were collected and processed using RNA in situ hybridization. Signal evaluation was conducted under a microscope, and scoring was based on specific criteria. Questions addressed: Can GATA3-AS1 serve as a predictive biomarker for neoadjuvant chemotherapy response in locally advanced luminal B breast cancer? Conclusion: The lncRNA GATA3-AS1 can be used as a biomarker for resistance to neoadjuvant chemotherapy in patients with locally advanced luminal B breast cancer. Its identification through RNA in situ hybridization of tissue obtained from the initial biopsy can aid in treatment decision-making.

Keywords: biomarkers, breast neoplasms, genetics, neoadjuvant therapy, tumor

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6702 Modelling Operational Risk Using Extreme Value Theory and Skew t-Copulas via Bayesian Inference

Authors: Betty Johanna Garzon Rozo, Jonathan Crook, Fernando Moreira

Abstract:

Operational risk losses are heavy tailed and are likely to be asymmetric and extremely dependent among business lines/event types. We propose a new methodology to assess, in a multivariate way, the asymmetry and extreme dependence between severity distributions, and to calculate the capital for Operational Risk. This methodology simultaneously uses (i) several parametric distributions and an alternative mix distribution (the Lognormal for the body of losses and the Generalized Pareto Distribution for the tail) via extreme value theory using SAS®, (ii) the multivariate skew t-copula applied for the first time for operational losses and (iii) Bayesian theory to estimate new n-dimensional skew t-copula models via Markov chain Monte Carlo (MCMC) simulation. This paper analyses a newly operational loss data set, SAS Global Operational Risk Data [SAS OpRisk], to model operational risk at international financial institutions. All the severity models are constructed in SAS® 9.2. We implement the procedure PROC SEVERITY and PROC NLMIXED. This paper focuses in describing this implementation.

Keywords: operational risk, loss distribution approach, extreme value theory, copulas

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6701 Patient Scheduling Improvement in a Cancer Treatment Clinic Using Optimization Techniques

Authors: Maryam Haghi, Ivan Contreras, Nadia Bhuiyan

Abstract:

Chemotherapy is one of the most popular and effective cancer treatments offered to patients in outpatient oncology centers. In such clinics, patients first consult with an oncologist and the oncologist may prescribe a chemotherapy treatment plan for the patient based on the blood test results and the examination of the health status. Then, when the plan is determined, a set of chemotherapy and consultation appointments should be scheduled for the patient. In this work, a comprehensive mathematical formulation for planning and scheduling different types of chemotherapy patients over a planning horizon considering blood test, consultation, pharmacy and treatment stages has been proposed. To be more realistic and to provide an applicable model, this study is focused on a case study related to a major outpatient cancer treatment clinic in Montreal, Canada. Comparing the results of the proposed model with the current practice of the clinic under study shows significant improvements regarding different performance measures. These major improvements in the patients’ schedules reveal that using optimization techniques in planning and scheduling of patients in such highly demanded cancer treatment clinics is an essential step to provide a good coordination between different involved stages which ultimately increases the efficiency of the entire system and promotes the staff and patients' satisfaction.

Keywords: chemotherapy patients scheduling, integer programming, integrated scheduling, staff balancing

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6700 Risk Management in Islamic Banks: A Case Study of the Faisal Islamic Bank of Egypt

Authors: Mohamed Saad Ahmed Hussien

Abstract:

This paper discusses the risk management in Islamic banks and aims to determine the difference in the practices and methods of risk management in those banks compared to the conventional banks, and to make a case study of the biggest Islamic bank in Egypt (Faisal Islamic Bank of Egypt) to identify the most important financial risks faced and how to manage those risks. It was found that Islamic banks face two types of risks. The first type is similar to the risks in conventional banks; the second type is the additional risks which facing the Islamic banks only as a result of some Islamic modes of financing. With regard to the risk management, Islamic banks such as conventional banks applied the regulatory rules issued by the Central Banks and the Basel Committee; Islamic banks also applied the instructions and procedures issued by the Islamic Financial Services Board (IFSB). Also, Islamic banks are similar to the conventional banks in the practices and methods which they use to manage the risks. And there are some factors that may affect the risk management in Islamic banks, such as the size of the bank and the efficiency of the administration and the staff of the bank.

Keywords: conventional banks, Faisal Islamic Bank of Egypt, Islamic banks, risk management

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6699 The Use of Coronary Calcium Scanning for Cholesterol Assessment and Management

Authors: Eva Kirzner

Abstract:

Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.

Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium

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6698 Planning a Supply Chain with Risk and Environmental Objectives

Authors: Ghanima Al-Sharrah, Haitham M. Lababidi, Yusuf I. Ali

Abstract:

The main objective of the current work is to introduce sustainability factors in optimizing the supply chain model for process industries. The supply chain models are normally based on purely economic considerations related to costs and profits. To account for sustainability, two additional factors have been introduced; environment and risk. A supply chain for an entire petroleum organization has been considered for implementing and testing the proposed optimization models. The environmental and risk factors were introduced as indicators reflecting the anticipated impact of the optimal production scenarios on sustainability. The aggregation method used in extending the single objective function to multi-objective function is proven to be quite effective in balancing the contribution of each objective term. The results indicate that introducing sustainability factor would slightly reduce the economic benefit while improving the environmental and risk reduction performances of the process industries.

Keywords: environmental indicators, optimization, risk, supply chain

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6697 Socioeconomic Burden of a Diagnosis of Cervical Cancer in Women in Rural Uganda: Findings from a Phenomenological Study

Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

Abstract:

Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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6696 Role of Molecular Changes and Immunohistochemical in Early Detection of Liver Cancer

Authors: Fatimah A. Alhomaid

Abstract:

The present study was planned to investigate the role of molecular changes and immunohistochemical in early detection of liver cancer in Saudi patients. our results were carried out on 54 patients liver cancer. We obtained our data from laboratory in King Khalid University Hospital. The specimens were taken (54) patients with liver cancer 34 male and 14 female and 2 control. The average age of varied from 37-85 years. The tumor was diagnosed as grade I in tow patients (male and female) and grade 2 in 45 patients (28 male and 17 female) while the grade 3 in 4 patients (all males). The specimens were processed for haematoxylin and eosin staining, immunohistochemical technique and flow cytometry analysis. Our study noted that most patients had adenocarcinoma which characterized by presence of signet-ring cells were very clear in advanced patients with adenocarcinoma. Our sections in adenocarcinoma in grade 2 and stage 3 had an increase in signet ring cells,an increase in the acini of glands and an increase in number of lymphocytes which spread to the muscular layer. With advancing the disease, there were haemorrhage in blood and increase in lymphocytes and increase in the number of nuclei in the tubular glands. Our study was carried on 48 patients, immunohistochemical diagnosis (CK20, PCNA, P53) and the analysis of DNA content by flow cytometry technique. Our study indicated that the presence of correlation between the immunohistochemical analysis for P53 and the grades. The reaction of P53 appeared as strong in nucleus in grades &stage 3 and appeared in other sections as dark brown pigment. Our study indicated that the absence of correlation between the immunohistochemical analysis for PCAN and the grades. In our sections there were strong reaction in the more 80% of nuclei in grade 1& stage 2. Our study indicated that the presence of correlation between the immunohistochemical analysis for CK20 and the grades. Our results indicated the presence of positive reaction in cytoplasm varied from weak to moderate in grade 3 & stage 4. Concerning the Flow cytometry technique our results indicated that the presence of correlation between the DNA and different stages of liver cancer.

Keywords: cancer, CK20, DNA, cytometry analysis, liver, immunohistochemical, molecular changes, PCNA, p53

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6695 Antigen-Presenting Cell Characteristics of Human γδ T Lymphocytes in Chronic Myeloid Leukemia

Authors: Piamsiri Sawaisorn, Tienrat Tangchaikeeree, Waraporn Chan-On, Chaniya Leepiyasakulchai, Rachanee Udomsangpetch, Suradej Hongeng, Kulachart Jangpatarapongsa

Abstract:

Human Vγ9Vδ2 T lymphocytes are regarded as promising effector cells for cancer immunotherapy since they have the ability to eliminate several tumor cells through non-peptide antigen recognition and non-major histocompatibility complex (MHC) restriction. An issue of recent interest is the capability to activate γδ T cells by use of a group of drugs, such as pamidronate, that cause accumulation of phosphoantigen which is recognized by γδ T cell receptors. Moreover, their antigen presenting cell-like phenotype and function have been confirmed in many clinical trials. In this study, Vγ9Vδ2 T cells derived from normal peripheral blood mononuclear cells were activated with pamidronate and the expanded Vγ9Vδ2 T cells can recognize and kill chronic myeloid leukemia (CML) cells treated with pamidronate through their cytotoxic activity. To support the strong role played by Vγ9Vδ2 T cells against cancer, we provide the evidence that Vγ9Vδ2 T cells activated with CML cell lysate antigen can efficiently express antigen presenting cell (APC) phenotype and function. In conclusion, pamidronate can be used in intentional activation of human Vγ9Vδ2 T cells and can increase the susceptibility of CML cells to cytotoxicity of Vγ9Vδ2 T cells. The activated Vγ9Vδ2 T cells by cancer cells lysate can show their APC characteristics, and so greatly increase the interest in exploring their therapeutic potential in hematologic malignancy.

Keywords: γδ T lymphocytes, antigen-presenting cells, chronic myeloid leukemia, cancer, immunotherapy

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6694 Simplifying Health Risk Assessment (HRA) and Its Operationalisation for Turnaround Activities

Authors: Thirumila Muthukamaru

Abstract:

The objective of a Health Risk Assessment (HRA) is to achieve a quality evaluation of risk assessments in a timely manner where adequate controls can be in place to protect workers health, especially during turnarounds where the exposure to health hazards is expected to rise during the performance of the many activities that take place, exposing workers to health risk. HRA development requires a competent team comprising experienced subject matter experts in the field, such as Industrial hygienists, Occupational Health Doctors, Turnaround Coordinators, Operation / Maintenance personnel, etc. The conventional way of conducting HRA is not only tedious and time-consuming but also less appreciated when it is not interpreted correctly, which may contribute to inadequate operationalization of it. Simplification can be the essence of timely intervention in managing health risks. This paper is intended as a sharing of the approach taken to simplify the methodology of developing the HRA report and operationalizing it. The approach includes developing a Generic HRA for turnaround activities to be used as a reference document and the empowerment of identified personnel through upskilling sessions to take up the role of facilitating HRA sessions. This empowerment is one of the key approaches towards the successful translation of the HRA into specific turnaround Job Hazard Analysis (JHA) that embed it in the Permit to Work (PTW) process. The approach used here increases awareness and compliance on HRA for turnaround activities through better interpretation and operationalization of the HRA report, adding value to the risk assessment for turnaround activities.

Keywords: industrial hygiene, health risk assessment, HRA, risk assessment

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6693 Cytotoxic Activity against MCF-7 Breast Cancer Cells and Antioxidant Property of Aqueous Tempe Extracts from Extended Fermentation

Authors: Zatil Athaillah, Anastasia Devi, Dian Muzdalifah, Wirasuwasti Nugrahani, Linar Udin

Abstract:

During tempe fermentation, some chemical changes occurred and they contributed to sensory, appearance, and health benefits of soybeans. Many studies on health properties of tempe have specialized on their isoflavones. In this study, other components of tempe, particularly water soluble chemicals, was investigated for their biofunctionality. The study was focused on the ability to suppress MCF-7 breast cancer cell growth and antioxidant activity, as expressed by DPPH radical scavenging activity, total phenols and total flavonoids, of the water extracts. Fermentation time of tempe was extended up to 120 hr to increase the possibility to find the functional components. Extraction yield and soluble nitrogen content were also quantified as accompanying data. Our findings suggested that yield of water extraction of tempe increased as fermentation was extended up to 120 hr, except for a slight decrease at 72 hr. Water extracts of tempe showed inhibition of MCF-7 breast cancer cell growth, as shown by lower IC50 values when compared to control (unfermented soybeans). Among the varied fermentation timescales, 60-hr period showed the highest activity (IC50 of 8.7 ± 4.95 µg/ml). The anticancer activity of extracts obtained from different fermentation time was positively correlated with total soluble nitrogens, but less relevant with antioxidant data. During 48-72 hr fermentation, at which cancer suppression activity was significant, the antioxidant properties from the three assays were not higher than control. These findings indicated that water extracts of tempe from extended fermentation could inhibit breast cancer cell growth but further study to determine the mechanism and compounds that play important role in the activity should be conducted.

Keywords: tempe, anticancer, antioxidant, phenolic compounds

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6692 Influence Analysis of Profit Sharing Agreement and Financing Risk to Profitability in Islamic Bank of Indonesia

Authors: Irena Paramita Pramono

Abstract:

Islamic bank is a financial industry with huge potential to grow in Indonesia. Profit-sharing agreement in the operations of Islamic banks distinguishes Islamic banks with conventional banks. Profit-sharing agreement allows sharing of benefits and risks between shahibul maal and mudharib in islamic bank. This study aimed to observe the patterns of influence between the risk-sharing agreement, financing risk and Profitability in Islamic banks. This research used several Islamic banks as sample and path analysis method. The empirical results of this research shows that the profit-sharing agreement in deposits structure has no direct significant effect to ROA, but it has indirect effect to ROA through profit-sharing financing. On the other hand, profit-sharing financing has direct and indirect influence to ROA through financing risk. This research shows that profit-sharing financing has a positive significant effect to the financing risk and also to the ROA. The research recommends Islamic banks to continue using and developing profit-sharing agreement in its operational activities, hence to create value.

Keywords: Islamic bank, profit-loss sharing agreement, financing risk, profitability

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6691 Associations of Vitamin D Receptor Polymorphisms with Coronary Artery Diseases

Authors: Elham Sharif, Nasser Rizk, Sirin Abu Aqel, Ofelia Masoud

Abstract:

Background: Previous studies have investigated the association of rs1544410, rs7975232 and rs731236 polymorphisms in vitamin D receptor gene and its impact on diseases such as cancer, diabetes and hypertension in different ethnic backgrounds. Aim: The aim of this study is to investigate the association between VDR polymorphisms using three SNP’s (rs1544410, rs7975232 and rs731236) and the severity of the significant lesion in coronary arteries among angiographically diagnosed CAD. Methods: A prospective-retrospective study was conducted on 192 CAD patients enrolled from the cardiology department-Heart Hospital HMC, grouped in 96 subjects with significant stenosis and 96 with non-significant stenosis with a mean age between 30 and 75 years old. Genotyping was performed for the following SNPs rs1544410, rs7975232 and rs731236 using TaqMan assay by the Real Time PCR, ABI 7500 in Health Sciences Labs at Qatar University Biomedical Research Center. Results: The results showed that both groups have matched age and gender distribution but patients with the significant stenosis have significantly higher; BMI (p=0.047); smoking status (p=0.039); FBS (p= 0.031); CK-MB (p=0.025) and Troponin (p=0.002) than the patients with non–significant lesion. Among the traditional risk factors, smoking increases the odds of the severe stenotic lesion in CAD patients by 1.984, with 95% CI between 1.024 – 7.063, with p= 0.042.HWE showed deviations of the rs1544410 and rs731236 among the study subjects. The most frequent genotype in distribution of rs7975232 is the AA among the significant stenosis patients, while the heterozygous AC was the frequent genotype in distribution among the non-significant stenosis group. The carriers of CC genotype in rs7975232 increased the risk of having significant coronary arteries stenotic lesion by 1.83 with 95% CI (1.020 – 3.280), p=0.043. No association was found between the rs7975232 with vitamin D and VDBP. Conclusion: There is a significant association between rs7975232 and the severity of CAD lesion. The carrier of CC genotype in rs7975232 increased the risk of having significant coronary arteries atherosclerotic lesion especially in patients with smoking history independent of vitamin D.

Keywords: vitamin D, vitamin D receptor, polymorphism, coronary harat disease

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