Search results for: HIV risk factors

Authors: Peter David Reiss

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The concept of the psychosis prodrome has allowed for the identification of adolescent and young adult patients who have a significantly elevated risk of developing schizophrenia spectrum disorders. A number of different interventions have been tested in order to prevent or delay progression of symptoms. To date, there has been no consistent meta-analytical evidence to support efficacy of antipsychotic treatment for patients in the prodromal state, and their use remains therefore inconclusive. Although antipsychotics may manage symptoms transiently, they have not been found to prevent or delay onset of psychotic disorders. Furthermore, pharmacological intervention in high-risk individuals remains controversial, because of the antipsychotic side effect profile in a population in which only about 20 to 35 percent will eventually convert to psychosis over a two-year period, with even after two years conversion rates not exceeding 30 to 40 percent. This general estimate is additionally problematic, in that it ignores the fact that there is significant variation in individual risk among clinical high-risk cases. The current lack of reliable tests for at-risk patients makes it difficult to justify individual treatment decisions. Preventive treatment should ideally be dictated by an individual’s risk while minimizing potentially harmful medication exposure. This requires more accurate predictive assessments by using valid and accessible prognostic markers. The following will compare prediction and risk modification potential of behavioral biomarkers such as disturbances of basic sense of self and emotion awareness, neurocognitive biomarkers such as attention, working and declarative memory, and neurophysiological biomarkers such as glutamatergic abnormalities and NMDA receptor dysfunction. Identification of robust biomarkers could therefore not only provide more reliable means of psychosis prediction, but also help test and develop new clinical interventions targeted at the prodromal state.

Keywords: at-risk mental state, biomarkers, glutamatergic system, NMDA receptor, psychosis prodrome, schizophrenia

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Authors: S. Valarmathi, P. B. Harathi, R. Sridhar, S. Balasubramanian

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Machine learning tools in medical diagnosis is increasing due to the improved effectiveness of classification and recognition systems to help medical experts in diagnosing breast cancer. In this study, ID3 chooses the splitting attribute with the highest gain in information, where gain is defined as the difference between before the split versus after the split. It is applied for age, location, taluk, stage, year, period, martial status, treatment, heredity, sex, and habitat against Very Serious (VS), Very Serious Moderate (VSM), Serious (S) and Not Serious (NS) to calculate the gain of information. The ranked histogram gives the gain of each field for the breast cancer data. The doctors use TNM staging which will decide the risk level of the breast cancer and play an important decision making field in fuzzy logic for perception based measurement. Spatial risk area (taluk) of the breast cancer is calculated. Result clearly states that Coimbatore (North and South) was found to be risk region to the breast cancer than other areas at 20% criteria. Weighted value of taluk was compared with criterion value and integrated with Map Object to visualize the results. ID3 algorithm shows the high breast cancer risk regions in the study area. The study has outlined, discussed and resolved the algorithms, techniques / methods adopted through soft computing methodology like ID3 algorithm for prognostic decision making in the seriousness of the breast cancer.

Keywords: ID3 algorithm, breast cancer, fuzzy logic, MATLAB

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Authors: Marcelo Dias Carvalho, Leticia Ishikawa

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Supply Chain Risk Management refers to a set of strategies used by companies to avoid supply chain disruption caused by damage at production facilities, natural disasters, capacity issues, inventory problems, incorrect forecasts, and delays. Many companies use the techniques of the Toyota Production System, which in a way goes against a better management of supply chain risks. This paper studies key events in some multinationals to analyze the trade-off between the best supply chain risk management techniques and management policies designed to create lean enterprises. The result of a good balance of these actions is the reduction of losses, increased customer trust in the company and better preparedness to face the general risks of a supply chain.

Keywords: just in time, lean manufacturing, supply chain disruptions, supply chain management

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Authors: İbrahi̇m Kara, Seher Arslankaya

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Frequently preferred in the field of engineering in particular, data mining has now begun to be used in the field of health as well since the data in the health sector have reached great dimensions. With data mining, it is aimed to reveal models from the great amounts of raw data in agreement with the purpose and to search for the rules and relationships which will enable one to make predictions about the future from the large amount of data set. It helps the decision-maker to find the relationships among the data which form at the stage of decision-making. In this study, it is aimed to determine the risk of heart attack at the first stage, to control it, and to make its resource planning with the method of data mining. Through the early and correct diagnosis of heart attacks, it is aimed to reveal the factors which affect the diseases, to protect health and choose the right treatment methods, to reduce the costs in health expenditures, and to shorten the durations of patients’ stay at hospitals. In this way, the diagnosis and treatment costs of a heart attack will be scrutinized, which will be useful to determine the risk of the disease at the first stage, to control it, and to make its resource planning.

Keywords: data mining, decision support systems, heart attack, health sector

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Authors: Nooralhuda Aljlas

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In the ever-growing field of non-governmental organizations, the enhancement of performance management and measurement systems has been increasingly acknowledged by political, economic, social, legal, technological and environmental factors. Within Bahrain Athletics Association, such enhancement results from the key factors leading performance management including collaboration, feedback, human resource management, leadership and participative management. The exploratory, qualitative research conducted reviewed performance management theory. As reviewed, the key factors leading performance management were identified. Drawing on a non-governmental organization case study, the key factors leading Bahrain Athletics Association’s performance management were explored. By exploring the key factors leading Bahrain Athletics Association’s performance management, the research study proposed a theoretical framework of the key factors leading performance management in non-governmental organizations in general. The research study recommended further investigation of the role of the two key factors of command and control and leadership, combining military and civilian approaches to enhancing non-governmental organizations’ performance management.

Keywords: Bahrain athletics association, exploratory, key factor, performance management

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Authors: Yamini Raju, Parminder S. Kang, Adam Moroz, Ross Clement, Alistair Duffy, Ashley Hopwell

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Accurate prediction of fresh produce demand is one the challenges faced by Small Medium Enterprise (SME) wholesalers. Current research in this area focused on limited number of factors specific to a single product or a business type. This paper gives an overview of the current literature on the variability factors used to predict demand and the existing forecasting techniques of short shelf life products. It then extends it by adding new factors and investigating if there is a time lag and possibility of noise in the orders. It also identifies the most important factors using correlation and Principal Component Analysis (PCA).

Keywords: demand forecasting, deteriorating products, food wholesalers, principal component analysis, variability factors

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Authors: Naso Isaiah Thanavisuth, Patompong Satapornpong

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Introduction: Covid-19 has been a global pandemic for some time now, causing severe symptoms to patients that received the virus. However, there has been no report on this gene in the Thai population. Objective: Our aim in this study is to explore and compare the frequency of HLA-C allele that is associated with severe COVID-19 symptoms in Thais and other populations. Method: 200 general Thai population were enrolled in this study. The genotyping of HLA -C alleles were determined by the polymerase chain reaction with sequence-specific oligonucleotide probes (PCR-SSOP) and Luminex®IS 100 system (Luminex Corporation, Austin, Texas, USA). Results: We found that the frequency of alleles HLA-C* 01:02 (16.00%), HLA-C* 08:01(10.50%), HLA-C* 03:04 (10.25%),HLA-C* 07:02 (10.00%), HLA-C* 03:02 (9.25%), HLA-C* 07:01 (6.75%), HLA-C* 04:01 (5.00%), HLA-C* 06:02 (4.00%), HLA-C* 04:03 (4.00%), and HLA-C* 07:04 (3.75%) were more common in the Thai population. HLA-C* 01:02 (16.00%) allele was the highest frequency in the North, Center, and North East groups in Thailand, but there was the South region that was not significantly different when compared with the other groups of the region. Additionally, HLA-C∗14:02 allele was similarly distributed in Thais (3.00%), African Americans (1.98%), Caucasians (2.08%), Hispanics (1.71%), North American Natives (1.34%) and Asians (5.01%) by p-value = 0.6506, 0.6506, 0.6506, 0.6135 and 0.7182, respectively. Conclusion: Genetic variation database is important to identify HLA can be a risk factor for severe COVID-19 in many populations. In this study, we will support the research of the HLA markers for screening severe COVID-19 in many populations.

Keywords: HLA-C * 14:02, COVID-19, allele frequency, Thailand

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Authors: Made Kurnia Widiastuti Giri, Nyoman Kanca, Arie Swastini, Bambang Purwanto

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Aim: Waria transgenders are a phenomenon whose existence is undeniable. The sexual behaviours of waria transgenders belong to the groups of high-risk STDs infections, especially HIV/AIDS. The present study was aimed at finding out the general idea of the existence of waria transgenders in Singaraja, their sexual transactions, their sexual behaviours, and at exploring the factors affecting their sexual behaviours along with their participation in regular reproduction health control. Methods: The subjects of the present research were male-to-female transgenders living in the town of Singaraja. The research applied a qualitative approach. Data collection in this research was conducted through in-depth interview and observation. Results: The results of the study exposed 1) the existence of waria transgender community in Singaraja observed from their active participation in social events such as taking the roles of counsellors in the campaign of prevention and control of HIV/AIDS with the Local Commission of AIDS Control and other foundations; 2) the sexual services provided by waria transgenders which were performed in squeeze method, oral and anal sex which could be categorized as HIV/AIDS high-risk sexual behaviours, while the consistency in doing safe sex among the trangenders in Singaraja showed that most of the waria transgenders (80%) were aware of the urgency of using condoms during sexual intercourse; and 3) the low participation of the waria transgenders in Singaraja in regular reproduction health check up at the local Centre of Public Health Service was caused by their negative perception about being examined by female doctors. Conclucions: Waria in singaraja categorized as HIV/AIDS high-risk sexual behaviours but they do have consistency in doing safe sex by using condoms. They have a negative psychological perception about being examined by female doctors.

Keywords: waria transgenders, sexual behaviours, reproduction health, hiv/aids

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Authors: Sarah A. Harris, Fleur L. McIntyre, Paola T. Chivers, Benjamin G. Piggott, Fiona H. Farringdon

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Australian Rules Football (ARF) is an invasion based, contact field sport with over one million participants. The contact nature of the game increases exposure to all injuries, including head trauma. Evidence suggests that both concussion and sub-concussive traumas such as head knocks may damage the brain, in particular the prefrontal cortex. The prefrontal cortex may not reach full maturity until a person is in their early twenties with males taking longer to mature than females. Repeated trauma to the pre-frontal cortex during maturation may lead to negative social, cognitive and emotional effects. It is also during this period that males exhibit high levels of risk taking behaviours. Risk propensity and the incidence of injury is an unexplored area of research. Little research has considered if the level of player’s (especially younger players) risk propensity in everyday life places them at an increased risk of injury. Hence the current study, investigated if a relationship exists between risk propensity and self-reported injuries including diagnosed concussion and head knocks, among male ARF players aged 18 to 31 years. Method: The study was conducted over 22 weeks with one West Australian Football League (WAFL) club during the 2015 competition. Pre-season risk propensity was measured using the 7-item self-report Risk Propensity Scale. Possible scores ranged from 9 to 63, with higher scores indicating higher risk propensity. Players reported their self-perceived injuries (concussion, head knocks, upper body and lower body injuries) fortnightly using the WAFL Injury Report Survey (WIRS). A unique ID code was used to ensure player anonymity, which also enabled linkage of survey responses and injury data tracking over the season. A General Linear Model (GLM) was used to analyse whether there was a relationship between risk propensity score and total number of injuries for each injury type. Results: Seventy one players (N=71) with an age range of 18.40 to 30.48 years and a mean age of 21.92 years (±2.96 years) participated in the study. Player’s mean risk propensity score was 32.73, SD ±8.38. Four hundred and ninety five (495) injuries were reported. The most frequently reported injury was head knocks representing 39.19% of total reported injuries. The GLM identified a significant relationship between risk propensity and head knocks (F=4.17, p=.046). No other injury types were significantly related to risk propensity. Discussion: A positive relationship between risk propensity and head trauma in contact sports (specifically WAFL) was discovered. Assessing player’s risk propensity therefore, may identify those more at risk of head injuries. Potentially leading to greater monitoring and education of these players throughout the season, regarding self-identification of head knocks and symptoms that may indicate trauma to the brain. This is important because many players involved in WAFL are in their late teens or early 20’s hence, may be at greater risk of negative outcomes if they experience repeated head trauma. Continued education and research into the risks associated with head injuries has the potential to improve player well-being.

Keywords: football, head injuries, injury identification, risk

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Authors: Kennedy Zinn, Chris Anderson

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Chronic Covid syndrome (CCS) is a condition in which individuals who test positive for Covid-19 experience persistent symptoms after recovering from the virus. CCS affects every organ system, including the central nervous system. Neurological “long-haul” symptoms last from a few weeks to several months and include brain fog, chronic fatigue, dyspnea, mood dysregulation, and headaches. Data suggest that 10-30% of individuals testing positive for Covid-19 develop CCS. Current literature indicates a decreased quality of life in persistent symptoms. CCS is a pervasive and pernicious COVID-19 sequelae. More research is needed to understand risk factors, impact, and possible interventions. Research frequently cites cytokine storming as noteworthy etiology in CCS. Cytokine storming is a malfunctional immune response and facilitates multidimensional interconnected physiological responses. The most prominent responses include abnormal blood flow, hypoxia/hypoxemia, inflammation, and endothelial damage. Neurological impairments and pathogenesis in CCS parallel that of traumatic brain injury (TBI). Both exhibit impairments in memory, cognition, mood, sustained attention, and chronic fatigue. Evidence suggests abnormal blood flow, inflammation, and hypoxemia as shared causal factors. Cytokine storming is also typical in mTBI. The shared characteristics in symptoms and etiology suggest potential parallel routes of investigation that allow for better understanding of CCS. Research on the effect of altitude in mTBI varies. Literature finds decreased rates of concussions at higher altitudes. Other studies suggest that at a higher altitude, pre-existing mTBI symptoms are exacerbated. This may mean that in CCS, the geographical location where individuals live and the location where individuals experienced acute Covid-19 symptoms may influence the severity and risk of developing CCS. It also suggests that clinics which treat mTBI patients could also provide benefits for those with CCS. This study aims to examine the relationships between altitude and CCS as a risk factor and investigate the longevity and severity of symptoms in different altitudes. Existing patient data from a concussion clinic using fMRI scans and self-reported symptoms will be used for approximately 30 individuals with CCS symptoms. The association between acclimated altitude and CCS severity will be analyzed. Patients will be classified into low, medium, and high altitude groups and compared for differences on fMRI severity scores and self-reported measures. It is anticipated that individuals living in lower altitudes are at higher risk of developing more severe neuropsychological symptoms in CCS. It is also anticipated that a treatment approach for mTBI will also be beneficial to those with CCS.

Keywords: altitude, chronic covid syndrome, concussion, covid brain, EPIC treatment, fMRI, traumatic brain injury

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Authors: Lana Singleton

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Achieving a sufficient global solution to climate change seems elusive through disappointing climate agreements and lack of cooperation. However, is this reluctance of coordination deep rooted on a more individual, societal level within countries due to a fundamental lack of social and institutional trust? The risks of climate change are illustrious and widely accepted, yet responses on an individual level are also largely inadequate. This research looks to further investigate types of trust, risk perception of climate change, and their interaction to build a greater understanding of whether a social trap (Rothstein, 2005) – where an absence of trust can overwhelm an individuals’ risk perception and result in minimal action despite knowing the dangers of no action – exists and where it is more prevalent. Presence of the social trap will be analysed for willingness to act in favour of climate change mitigation as well as attitude (acceptance) of different types of renewable energy forms. Using probit models with cross-sectional survey data on four developed European countries (UK, France, Germany, and Norway), we find evidence of the social trap in the aggregated data model, which highlights the importance of social trust regarding willingness to act in favour of climate mitigation as there is a high probability of action regardless of risk perception of climate change when social trust is high. In contrast, the same is not true for renewables, as interactions were mainly insignificant, although there were interesting findings involving institutional trust, gender, and country specific results for particular renewables.

Keywords: climate risk, renewables, risk perception, social trap, trust, willingness to act

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Authors: Tamadu Perry Egedegu

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Rapid growth in the use of electronic data has affected both the employee and work place. Our experience shows that jobs that have multiple risk factors have a greater likelihood of causing Work Related Musculoskeletal Disorder (WRMSDs), depending on the duration, frequency and/or magnitude of exposure to each. The study investigated musculoskeletal disorder among office workers. Thus, it is important that ergonomic risk factors be considered in light of their combined effect in causing or contributing to WRMSDs. Fast technological growth in the use of electronic system; have affected both workers and the work environment. Awkward posture and long hours in front of these visual display terminals can result in work-related musculoskeletal disorders (WRMSD). The study shall contribute to the awareness creation on the causes and consequences of WRMSDs due to lack of ergonomics training. The study was conducted using an observational cross-sectional design. A sample of 109 respondents was drawn from the target population through purposive sampling method. The sources of data were both primary and secondary. Primary data were collected through questionnaires and secondary data were sourced from journals, textbooks, and internet materials. Questionnaires were the main instrument for data collection and were designed in a YES or NO format according to the study objectives. Content validity approval was used to ensure that the variables were adequately covered. The reliability of the instrument was done through test-retest method, yielding a reliability index at 0.84. The data collected from the field were analyzed with a descriptive statistics of chart, percentage and mean. The study found that the most affected body regions were the upper back, followed by the lower back, neck, wrist, shoulder and eyes, while the least affected body parts were the knee calf and the ankle. Furthermore, the prevalence of work-related 'musculoskeletal' malfunctioning was linked with long working hours (6 - 8 hrs.) per day, lack of back support on their seats, glare on the monitor, inadequate regular break, repetitive motion of the upper limbs, and wrist when using the computer. Finally, based on these findings some recommendations were made to reduce the prevalent of WRMSDs among office workers.

Keywords: work related musculoskeletal disorder, Nigeria, office computer users, ergonomic risk factor

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Authors: Jianhua Zhang, Weiping Chen, Guanjie Chen, Jason Flannick, Emma Fikse, Glenda Smerin, Yanqin Yang, Yulong Li, John A. Hanover, William F. Simonds

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Ethnic disparities in many diseases are well recognized and reflect the consequences of genetic, behavior, and environmental factors. However, direct scientific evidence connecting the ethnic genetic variations and the disease disparities has been elusive, which may have led to the ethnic inequalities in large scale genetic studies. Through the genome-wide analysis of data representing 185,934 subjects, including 14,955 from our own studies of the African America Diabetes Mellitus, we discovered sets of genetic variants either unique to or conserved in all ethnicities. We further developed a quantitative gene function-based high-risk variant index (hrVI) of 20,428 genes to establish profiles that strongly correlate with the subjects' self-identified ethnicities. With respect to the ability to detect human essential and pathogenic genes, the hrVI analysis method is both comparable with and complementary to the well-known genetic analysis methods, pLI and VIRlof. Application of the ethnicity-specific hrVI analysis to the type 2 diabetes mellitus (T2DM) national repository, containing 20,791 cases and 24,440 controls, identified 114 candidate T2DM-associated genes, 8.8-fold greater than that of ethnicity-blind analysis. All the genes identified are defined as either pathogenic or likely-pathogenic in ClinVar database, with 33.3% diabetes-associated and 54.4% obesity-associated genes. These results demonstrate the utility of hrVI analysis and provide the first genetic evidence by clustering patterns of how genetic variations among ethnicities may impede the discovery of diabetes and foreseeably other disease-associated genes.

Keywords: diabetes-associated genes, ethnic health disparities, high-risk variant index, hrVI, T2DM

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Authors: Kaoutar Chbihi, Aziza Menouni, Imane Berni, Tarik Abchouch, Samir El Jaafari

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The unpredictability and ambiguity of a pandemic, combined with the economic impact, sedentary lifestyle, and increased living cost, have the potential to seriously raise the risk of mental health issues among the population. Therefore, this study had the aim to assess the magnitude of mental health outcomes and risk factors among the general population in Morocco in times of the Covid-19 pandemic. This study consisted of a cross-sectional design and was survey-based and region-stratified by collecting demographic data and mental health measurements from 523 participants. The degree of depression, anxiety, and insomnia symptoms were assessed by using the 9-item Patient Health Questionnaire and the 7-items Generalized Anxiety Disorder. The survey was completed by 523 individuals. Results showed that 67.9% were women, and 58.6% were aged 18-30 years. 49% of participants reported depression issues, while 39.8% experienced anxiety. Being a married woman with children was associated with severe symptoms of depression and anxiety. Finally, our findings reported a significant mental health burden among the general population of Morocco, which needs to be tackled by specific co-created interventions and adapted strategies in order to prevent impacts on public health.

Keywords: anxiety, COVID-19, depression, mental health, Morocco, pandemic

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Authors: Rosida A. Razak, Mohamad Shanudin Zakaria

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The fundamental issues in ICT Governance (ICTG) implementation for Malaysian Public Sector (MPS) is how ICT be applied to support improvements in productivity, management effectiveness and the quality of services offered to its citizens. Our main concern is to develop and adopt a common definition and framework to illustrate how ICTG can be used to better align ICT with government’s operations and strategic focus. In particular, we want to identify and categorize factors that drive a successful ICTG process. This paper presents the results of an exploratory study to identify, validate and refine such Critical Success Factors (CSFs) and confirmed seven CSFs and nineteen sub-factors as influential factors that fit MPS after further validated and refined. The Delphi method applied in validation and refining process before being endorsed as appropriate for MPS. The identified CSFs reflect the focus areas that need to be considered strategically to strengthen ICT Governance implementation and ensure business success.

Keywords: IT governance, critical success factors, productivity, CSFs

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Authors: Leela Lakshmi Sai Srinivas Parasa, Pushpavalli Naidu, Bhaskar Kambhampati

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Background: Obstructive Sleep Apnea (OSA) is a common but underdiagnosed sleep disorder characterized by repeated upper airway collapse during sleep. It frequently coexists with Type 2 Diabetes Mellitus (T2DM), a chronic metabolic condition with significant global and national health implications. The interplay between these conditions increases the risk of severe complications such as stroke, hypertension, and cardiovascular diseases. Understanding the prevalence of high-risk OSA in T2DM patients is essential for improving clinical outcomes and guiding public health interventions. Objective: This study aimed to assess the prevalence of high-risk OSA among T2DM patients using the Berlin questionnaire and to identify demographic and clinical predictors of risk. Methodology: This cross-sectional study of 100 patients with Type2 diabetes was undertaken at a tertiary care hospital in India for a period of 2 months. OSA was evaluated using the Berlin questionnaire. Diabetes mellitus was diagnosed according to WHO criteria as fasting blood sugar level > 7 mmol/L or random blood sugar >126 mg/dl on 2 separate occasions. Particulars of patients were recorded following which detailed history and physical examination were done. Data was analyzed using spss version 21. Results: The prevalence of high-risk OSA was 72% among the study population. The mean age was 54.9 +- 12.47 years. Age groups were divided into 3 groups (less than 50, 50-65, and greater than 65) The highest prevalence was observed in the 50-65 age group, accounting for 59.7% of high-risk cases. Gender distribution revealed a higher proportion of high-risk females (88.46%) compared to males (66.21%). Normal-weight individuals (BMI 18.5–24.9 kg/m²) represented 74.02% of high-risk OSA cases, while overweight individuals (BMI 25–29.9 kg/m²) accounted for 65.21%. Additionally, 90.9% of hypertensive patients were identified as high-risk for OSA. Conclusion: The study highlights a high prevalence of OSA risk among T2DM patients, especially those with hypertension and those in the middle-aged group. These findings emphasize the importance of routine OSA screening and tailored interventions for diabetic patients to reduce associated health risks. Proactive management can help mitigate the compounded effects of these two conditions, improving overall patient outcomes and reducing the burden on healthcare systems.

Keywords: obstructive sleep apnea, type 2 diabetes mellitus, berlin questionnaire, prevalence, hypertension

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Authors: Rajendra Kanojia

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Femoral components with inbuilt rotation require thicker flexion resection of the lateral femoral condyle and could potential risk to damage the popliteus tendon especially in the smaller Asian knees. We prospectively evaluated 10 patients with bilateral varus osteoarthritis knee to size the cuts and their location in relation to the popliteus tendon. Two different types of implant were used on either side, one side requires resection in 3° external rotation (group A) and other side femoral component with inbuilt external roation (group B). We had popliteus tendon injury in 3 knees all from group B. Risk of damaging the popliteus tendon was found higher in group B.

Keywords: popliteaus tendon injury, TKA, orthopaedic surgery, biomechanics and clinical applications

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Authors: Sarah A. Alotaibi, Mohammed A. Almutairi, Abdullah A. Alsayari, Adibah M. Almutairi, Somaiah K. Almubayedh

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Concerns over the presence of acrylamide in food date back to 2002, when Swedish scientists stated that, in carbohydrate-rich foods, amounts of acrylamide were formed when cooked at high temperatures. Similar findings were reported by other researchers which, consequently, caused major international efforts to investigate dietary exposure and the subsequent health complications in order to properly manage this issue. Due to this issue, in this work, we aim to determine the acrylamide level in different foods (coffee, potato chips, biscuits, and baby food) commonly consumed by the Saudi population. In a total of forty-three samples, acrylamide was detected in twenty-three samples at levels of 12.3 to 2850 µg/kg. In reference to the food groups, the highest concentration of acrylamide was found in coffee samples (<12.3-2850 μg/kg), followed by potato chips (655-1310 μg/kg), then biscuits (23.5-449 μg/kg), whereas the lowest acrylamide level was observed in baby food (<14.75 – 126 μg/kg). Most coffee, biscuits and potato chips products contain high amount of acrylamide content and also the most commonly consumed product. Saudi adults had a mean exposure of acrylamide for coffee, potato, biscuit, and cereal (0.07439, 0.04794, 0.01125, 0.003371 µg/kg-b.w/day), respectively. On the other hand, exposure to acrylamide in Saudi infants and children to the same types of food was (0.1701, 0.1096, 0.02572, 0.00771 µg/kg-b.w/day), respectively. Most groups have a percentile that exceeds the tolerable daily intake (TDI) cancer value (2.6 µg/kg-b.w/day). Overall, the MOE results show that the Saudi population is at high risk of acrylamide-related disease in all food types, and there is a chance of cancer risk in all age groups (all values ˂10,000). Furthermore, it was found that in non-cancer risks, the acrylamide in all tested foods was within the safe limit (˃125), except for potato chips, in which there is a risk for diseases in the population. With potato and coffee as raw materials, additional studies were conducted to assess different factors, including temperature, cocking time, and additives affecting the acrylamide formation in fried potato and roasted coffee, by systematically varying processing temperatures and time values, a mitigation of acrylamide content was achieved when lowering the temperature and decreasing the cooking time. Furthermore, it was shown that the combination of the addition of chitosan and NaCl had a large impact on the formation.

Keywords: risk assessment, dietary exposure, MOA, acrylamide, hazard

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Authors: Christopher G. Harris, Guy D. Eslick

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Purpose: Lobular carcinoma in situ (LCIS) is a known risk factor for breast cancer of unclear significance when detected in association with invasive carcinoma. This meta-analysis aims to determine the impact of LCIS on local recurrence risk for individuals with breast cancer treated with breast conservation therapy to help guide appropriate treatment strategies. Methods: We identified relevant studies from five electronic databases. Studies were deemed suitable for inclusion where they compared patients with invasive breast cancer and concurrent LCIS to those with breast cancer alone, all patients underwent breast conservation therapy (lumpectomy with adjuvant radiation therapy), and local recurrence was evaluated. Recurrence data were pooled by use of a random effects model. Results: From 1488 citations screened by our search, 8 studies were deemed suitable for inclusion. These studies comprised of 908 cases and 10638 controls. Median follow-up time was 90 months. There was a significantly increased overall risk of local breast cancer recurrence for individuals with LCIS in association with breast cancer following breast conservation therapy [pOR 1.87; 95% CI 1.14-3.04; p = 0.012]. The risk of local recurrence was non-significantly increased at 5 [pOR 1.09; 95% CI 0.48-2.48; p = 0.828] and 10 years [pOR 1.90; 95% CI 0.89-4.06; p = 0.096]. Conclusions: Individuals with LCIS in association with invasive breast cancer have an increased risk of local recurrence following breast conservation therapy. This supports consideration of aggressive local control of LCIS by way of completion mastectomy or re-excision for certain high-risk patients.

Keywords: breast cancer, breast conservation therapy, lobular carcinoma in situ, lobular neoplasia, local recurrence, meta-analysis

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Authors: Beatrice Adeoye

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Background: One of the health challenges developing countries face is air pollution from indoor and outdoor activities. Smoke as a result of cooking, burning wastes and power generators litter the air space on a continual basis due to poverty and governance challenges. The short and long term implications of these actions are enormous and studies have attributed smoke as one of the leading preventable risk factors contributing to global burden of respiratory infections. Design/Methods: The issue at hand therefore includes an exploration of the existing policy frameworks regarding smoke, adherence to international conventions and practices, and more importantly the activities of the government in addressing these issues. Aside this, an understanding of the implications of smoke on peoples’ health and well-being also become crucial. Consequently, this article seeks to interrogate the effect of smoke on the health and well-being of Nigerians and the activities of the policy makers in addressing these challenges. Results (Main Argument): This study reviewed both primary and secondary data on poverty, smoke emission and attendant health risks coupled with existing policies on smoke and air pollution in the country. For instance, over 69% of Nigerians are poor, ranking third in the world; 2.9 billion people live in homes using wood, coal or dung as their primary cooking fuel; equally, 50.6% of Nigerians has no access to regular electricity supply. Further, sustainable policy regarding smoke emission is lacking in the country. This work further submitted that continued low standard of living as a result of governance challenges coupled with a lack of sustainable policy have aggravated the health risks related to smoke in the country. Conclusions: The implication on the health of the children, mothers and vulnerable groups for the future of the country is enormous and may continue if not addressed. Urgent attention therefore needs to be focused on this area considering what this portends for the nation now and in the future.

Keywords: air pollution, indoor, outdoor, respiratory infections

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Authors: Hirbaye Mokona, Abebaw Gebeyehu, Aemro Zerihun

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Introduction: Attention deficit hyperactivity disorder is serious public health problem affecting millions of children throughout the world. Method: A cross-sectional study conducted from May to June 2015 among children age 6 to 17 years living in rural area of Girja district. Multi-stage cluster sampling technique was used to select 1302 study participants. Disruptive Behavior Disorder rating scale was used to collect the data. Data were coded, entered and cleaned by Epi-Data version 3.1 and analyzed by SPSS version 20. Logistic regression analysis was used and Variables that have P-values less than 0.05 on multivariable logistic regression was considered as statistically significant. Results: Prevalence of Attention deficit hyperactivity disorder (ADHD) among children age 6 to 17 years was 7.3%. Being male [AOR=1.81, 95%CI: (1.13, 2.91)]; living with single parent [AOR=5.0, 95%CI: (2.35, 10.65)]; child birth order/rank [AOR=2.35, 95%CI: (1.30, 4.25)]; low family socio-economic status [AOR= 2.43, 95%CI: (1.29, 4.59)]; maternal alcohol/khat use during pregnancy [AOR=3.14, 95%CI: (1.37, 7.37)] and complication at delivery [AOR=3.56, 95%CI: (1.19, 10.64)] were more likely to develop Attention deficit hyperactivity disorder. Conclusion: In this study, the prevalence of Attention deficit hyperactivity disorder was similar with worldwide prevalence. Prevention and early management of its modifiable risk factors should be carryout alongside increasing community awareness.

Keywords: attention deficit hyperactivity disorder, ADHD, associated factors, children, prevalence

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Authors: Shi-Yu Xu

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The top three risk factors that have contributed to building collapses during past earthquake events in Taiwan are: "irregular floor plans or elevations," "insufficient columns in single-bay buildings," and the "weak-story problem." Fortunately, these unsound structural characteristics can be directly identified from the floor plans. However, due to the vast number of old buildings, conducting manual inspections to identify these compromised structural features in all existing structures would be time-consuming and prone to human errors. This study aims to develop an algorithm that utilizes artificial intelligence techniques to automatically pinpoint the structural components within a building's floor plans. The obtained spatial information will be utilized to construct a digital structural model of the building. This information, particularly regarding the distribution of columns in the floor plan, can then be used to conduct preliminary seismic assessments of the building. The study employs various image processing and pattern recognition techniques to enhance detection efficiency and accuracy. The study enables a large-scale evaluation of structural vulnerability for numerous old buildings, providing ample time to arrange for structural retrofitting in those buildings that are at risk of significant damage or collapse during earthquakes.

Keywords: structural vulnerability detection, object recognition, seismic capacity assessment, old buildings, artificial intelligence

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Authors: Joseph Paul Chunga

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The investment universe is awash with a myriad of financial choices that investors have to opt for, which principally culminates into a duality between aggressive or conservative approaches. Howbeit, it is pertinent to emphasize that the investment vehicles with an aggressive approach tend to take on more risk than the latter group in an effort to generate higher future returns for their respective investors. This study examines the conditionality effect that such partiality in financing has on the High-Tech and Public Utility companies listed on the Shenzhen Stock Exchange (SSE). Specifically, it examines the significance of the relationship between capitalization ratios of Total Debt Ratio (TDR), Degree of Financial Leverage (DFL) and profitability ratios of Earnings per Share (EPS) and Returns on Equity (ROE) on the Financial Risk of the two industries. We employ a modified version of the Panel Regression Model used by Rahman (2017) to estimate the relationship. The study finds that there is a significant positive relationship between the capitalization ratios on the financial risk of Public Utility companies more than High-Tech companies and a substantial negative relationship between the profitability ratios and the financial risk of the former than the latter companies. This then spells an important insight for prospective investors with regards to the volatility of earnings of such companies.

Keywords: financial leverage, debt financing, conservative firms, aggressive firms

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Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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Authors: Seyed Ali Mohammadiborna, Mehdi Ravanshadnia

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Project delays usually detrimentally affect perceptions of project success and can in some instances, result in increased costs and other time-related damages to project stakeholders. One of the realities in the national infrastructure projects is that since the primary stakeholders are state-affiliated, the delay factors of the projects have not been seriously taken into account despite the importance of on-time completion of projects. Project postponement has different economic and social consequences and leads to the technical and economic infeasibility of the infrastructure projects in the form of reduced productivity and exploitation capacity. The present study aimed at investigating delay factors of Iranian national infrastructure projects according to regulatory reports of the Plan and Budget Organization (BPO) of Iran. The present study scrutinized the influence of each of the factors that caused delays in national Iranian infrastructure projects according to the supervision reports of the planning and budget organization in 8 years. For this purpose, the study analyzed the information regarding the impact of 12 key delay factors causing delays in average 4867 projects per year in all provinces. The said factors were classified into the three groups of executive, credit, and financial and environmental-procurement factors.

Keywords: delays, infrastructure, projects, regulatory

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Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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Authors: Katarzyna Niewiadomska

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Many technology startups fail to achieve a worthwhile return on investment for their funders, founders, and employees. Failures in product development, to-market strategy, sales, and delivery are commonly recognized. Founder failures are not as obvious and harder to identify. This paper explores six critical failure points that entrepreneurs and innovators are susceptible to and aims to link their emotional intelligence and behavioral profile to the points at which they experienced self-perceived failure. A model of six failure points from the perspective of the technology entrepreneur ranging from pre-startup to maturity is provided. By analyzing emotional and behavioral profile data from entrepreneurs and recording in-person accounts, certain key emotional and behavioral clusters contributing to each failure point are determined, and several underlying factors are defined and discussed. Recommendations that support entrepreneurs and innovators stalling at each failure point are given. This work can enable stakeholders to evaluate founder emotional and behavioral profiles and to take risk-mitigating action, either through coaching or through more robust team creation, to avoid founder-related company failure. The paper will be of interest to investors funding startups, executives leading them and mentors supporting them.

Keywords: behavior, emotional intelligence, entrepreneur, failure

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Authors: Nadera Al Hourani

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The study aimed at testing the effect of the organizational factors on reinforcing the knowledge sharing competence in the Jordanian commercial banks. The study population consisted of all the commercial banks working in Jordan according to the statistics of the Jordanian Banks Association by the end of 2010 (n=12). The researchers took a sample of the branch managers (n=240), and constructed a questionnaire to achieve the objective of the study. 235 questionnaires were returned and 16 were discarded due to incompleteness of their data, thus accepting 219 questionnaires. The results of the study indicated statistically significant effect of the organizational factors with their elements: (organizational structure, organizational culture, and human resources policy) in knowledge sharing. The study recommended that the Jordanian commercial banks have to continue attention to the organizational factors through supporting the less important variables and lowest means within the independent variable (organizational factors). The organizational structure came lowest, which urges the management of the commercial banks to adopt a flexible organizational structure capable to reinforce the knowledge sharing competence.

Keywords: banks, Jordan, knowledge, organizational factors, sharing

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Authors: Karl-Erich Lindenschmidt, Apurba Das, Joel Trudell, Keanne Russell

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In this presentation, we explore options for mitigating ice-jam flooding along the Athabasca River in western Canada. Not only flood hazard, expressed in this case as the probability of flood depths and extents being exceeded, but also flood risk, in which annual expected damages are calculated. Flood risk is calculated, which allows a cost-benefit analysis to be made so that decisions on the best mitigation options are not based solely on flood hazard but also on the costs related to flood damages and the benefits of mitigation. The river ice model is used to simulate extreme ice-jam flood events with which scenarios are run to determine flood exposure and damages in flood-prone areas along the river. We will concentrate on three mitigation options – the placement of a dike, artificial breakage of the ice cover along the river, the installation of an ice-control structure, and the construction of a reservoir. However, any mitigation option is not totally failsafe. For example, dikes can still be overtopped and breached, and ice jams may still occur in areas of the river where ice covers have been artificially broken up. Hence, for all options, it is recommended that zoning of building developments away from greater flood hazard areas be upheld. Flood mitigation can have a negative effect of giving inhabitants a false sense of security that flooding may not happen again, leading to zoning policies being relaxed. (Text adapted from Lindenschmidt [2022] "Ice Destabilization Study - Phase 2", submitted to the Regional Municipality of Wood Buffalo, Alberta, Canada)

Keywords: ice jam, flood hazard, flood risk river ice modelling, flood risk

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Authors: Behrooz Balaei, Suzanne Wilkinson, Regan Potangaroa, Larry Abel, Philip McFarlane

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Water supply system failure has serious direct and indirect effects on people wellbeing. Post-disaster water system serviceability depends on a variety of factors from technical characteristics to social, economic, and organizational attributes of communities. This paper tests the organizational factors affecting water supply resilience to outline how these factors contributed to previous disasters. To do so, a framework is briefly introduced in this study to provide a clear guide to identify the significant relevant organizational factors. Then the factors affecting water serviceability following a disaster are outlines. Next, these factors are measured in the case of Tropical Cyclone Pam, which hit Vanuatu in March 2015. Reviewing the existing literature has also been carried out to obtain a comprehensive understanding of the background A site visit and a series of interviews have also been undertaken following the cyclone to collect site-specific data and information. In the end, the organizational factors were ranked to enable decision makers to identify significance of each factor compared to the others.

Keywords: water supply, resilience, organizational capacity, Vanuatu, Tropical Cyclone Pam

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