Search results for: bone fracture risk

Authors: Naghmeh Zamani, Ashkan Pourkand, David Grow

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This paper presents the design and mechanical model of a hybrid impedance/admittance haptic device optimized for applications, like bone drilling, spinal awl probe use, and other surgical techniques were high force is required in the tool-axial direction, and low impedance is needed in all other directions. The performance levels required cannot be satisfied by existing, off-the-shelf haptic devices. This design may allow critical improvements in simulator fidelity for surgery training. The device consists primarily of two low-mass (carbon fiber) plates with a rod passing through them. Collectively, the device provides 6 DOF. The rod slides through a bushing in the top plate and it is connected to the bottom plate with a universal joint, constrained to move in only 2 DOF, allowing axial torque display the user’s hand. The two parallel plates are actuated and located by means of four cables pulled by motors. The forward kinematic equations are derived to ensure that the plates orientation remains constant. The corresponding equations are solved using the Newton-Raphson method. The static force/torque equations are also presented. Finally, we present the predicted distribution of location error, cables velocity, cable tension, force and torque for the device. These results and preliminary hardware fabrication indicate that this design may provide a revolutionary approach for haptic display of many surgical procedures by means of an architecture that allows arbitrary workspace scaling. Scaling of the height and width can be scaled arbitrarily.

Keywords: cable direct driven robot, haptics, parallel plates, bone drilling

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Authors: Md. Refat Jahan Rakiba, M. Belal Hossaina, Rakesh Kumarc, Md. Akram Ullaha, Sultan Al Nahiand, Nazmun Naher Rimaa, Tasrina Rabia Choudhury, Samia Islam Libaf, Jimmy Yub, Mayeen Uddin Khandakerg, Abdelmoneim Suliemanh, Mohamed Mahmoud Sayedi

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Microplastics (MPs) have become an emerging global pollutant due to their wide spread and dispersion and potential threats to marine ecosystems. However, studies on MPs of estuarine and coastal ecosystems of Bangladesh are very limited or not available. In this study, we conducted the first study on the abundance, distribution, characteristics and potential risk assessment of microplastics in the sediment of Karnaphuli River estuary, Bangladesh. Microplastic particles were extracted from sediments of 30 stations along the estuary by density separation, and then enumerated and characterize by using steromicroscope and Fourier Transform Infrared (FT-IR) spectroscopy. In the collected sediment, the number of MPs varied from 22.29 - 59.5 items kg−1 of dry weight (DW) with an average of 1177 particles kg−1 DW. The mean abundance was higher in the downstream and left bank of estuary where the predominant shape, colour, and size of MPs were films (35%), white (19%), and >5000 μm (19%), respectively. The main polymer types were polyethylene terephthalate, polystyrene, polyethylene, cellulose, and nylon. MPs were found to pose risks (low to high) in the sediment of the estuary, with the highest risk occuring at one station near a sewage outlet, according to the results of risk analyses using the pollution risk index (PRI), polymer risk index (H), contamination factors (CFs), and pollution load index (PLI). The single value index, PLI clearly demonastated that all sampling sites were considerably polluted (as PLI >1) with microplastics. H values showed toxic polymers even in lower proportions possess higher polymeric hazard scores and vice versa. This investigation uncovered new insights on the status of MPs in the sediments of Karnaphuli River estuary, laying the groundwork for future research and control of microplastic pollution and management.

Keywords: microplastics, polymers, pollution risk assessment, Karnaphuli esttuary

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Authors: Xiping Guo, Fanglin Ge, Ping Guan

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Refractory high entropy alloys are alternative materials expected to be employed at high temperatures. The comprehensive changes of microstructure and properties of NbTiZrCrAl refractory high entropy alloys are systematically studied by adjusting Al content. Five kinds of button alloy ingots with different contents of Al in NbTiZrCrAlX (X=0, 0.2, 0.5, 0.75, 1.0) were prepared by vacuum non-consumable arc melting technology. The microstructure analysis results show that the five alloys are composed of BCC solid solution phase rich in Nb and Ti and Laves phase rich in Cr, Zr, and Al. The addition of Al changes the structure from hypoeutectic to hypereutectic, increases the proportion of Laves phase, and changes the structure from cubic C15 to hexagonal C14. The hardness and fracture toughness of the five alloys were tested at room temperature, and the compressive mechanical properties were tested at 1000℃. The results showed that the addition of Al increased the proportion of Laves phase and decreased the proportion of the BCC phase, thus increasing the hardness and decreasing the fracture toughness at room temperature. However, at 1000℃, the strength of 0.5Al and 0.75Al alloys whose composition is close to the eutectic point is the best, which indicates that the eutectic structure is of great significance for the improvement of high temperature strength of NbTiZrCrAl refractory high entropy alloys. The five alloys were oxidized for 1 h and 20 h in static air at 1000℃. The results show that only the oxide film of 0Al alloy falls off after oxidizing for 1 h at 1000℃. After 20h, the oxide film of all the alloys fell off, but the oxide film of alloys containing Al was more dense and complete. By producing protective oxide Al₂O₃, inhibiting the preferential oxidation of Zr, promoting the preferential oxidation of Ti, and combination of Cr₂O₃ and Nb₂O₅ to form CrNbO₄, Al significantly improves the high temperature oxidation resistance of NbTiZrCrAl refractory high entropy alloys.

Keywords: NbTiZrCrAl, refractory high entropy alloy, al content, microstructural evolution, room temperature mechanical properties, high temperature compressive strength, oxidation resistance

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: T. Delval, C. Sauvage, Q. Jullien, R. Viano, T. Diallo, B. Collignan, G. Picinbono

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In the context of the international spread of COVID-19, the Centre Scientifique et Technique du Bâtiment (CSTB) has led a joint research with the French government authorities Hauts-de-Seine department, to analyse the risk in school spaces according to their configuration, ventilation system and spatial segmentation strategy. This paper describes the main results of this joint research. A multidisciplinary team involving experts in indoor air quality/ventilation, pedestrian movements and IT domains was established to develop a COVID risk analysis tool based on Building Information Model. The work started with specific analysis on two pilot schools in order to provide for the local administration specifications to minimize the spread of the virus. Different recommendations were published to optimize/validate the use of ventilation systems and the strategy of student occupancy and student flow segmentation within the building. This COVID expertise has been digitized in order to manage a quick risk analysis on the entire building that could be used by the public administration through an easy user interface implemented in a free BIM Management software. One of the most interesting results is to enable a dynamic comparison of different ventilation system scenarios and space occupation strategy inside the BIM model. This concurrent engineering approach provides users with the optimal solution according to both ventilation and pedestrian flow expertise.

Keywords: BIM, knowledge management, system expert, risk management, indoor ventilation, pedestrian movement, integrated design

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Authors: Roberta Martino, Viviana Ventre

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From a theoretical point of view, the relationship between the risk associated with an investment and the expected value are directly proportional, in the sense that the market allows a greater result to those who are willing to take a greater risk. However, empirical evidence proves that this relationship is distorted in the minds of investors and is perceived exactly the opposite. To deepen and understand the discrepancy between the actual actions of the investor and the theoretical predictions, this paper analyzes the essential parameters used for the valuation of financial assets with greater attention to two elements: probability and the passage of time. Although these may seem at first glance to be two distinct elements, they are closely related. In particular, the error in the theoretical description of the relationship between risk and return lies in the failure to consider the impatience that is generated in the decision-maker when events that have not yet happened occur in the decision-making context. In this context, probability loses its objective meaning and in relation to the psychological aspects of the investor, it can only be understood as the degree of confidence that the investor has in the occurrence or non-occurrence of an event. Moreover, the concept of objective probability does not consider the inter-temporality that characterizes financial activities and does not consider the condition of limited cognitive capacity of the decision maker. Cognitive psychology has made it possible to understand that the mind acts with a compromise between quality and effort when faced with very complex choices. To evaluate an event that has not yet happened, it is necessary to imagine that it happens in your head. This projection into the future requires a cognitive effort and is what differentiates choices under conditions of risk and choices under conditions of uncertainty. In fact, since the receipt of the outcome in choices under risk conditions is imminent, the mechanism of self-projection into the future is not necessary to imagine the consequence of the choice and the decision makers dwell on the objective analysis of possibilities. Financial activities, on the other hand, develop over time and the objective probability is too static to consider the anticipatory emotions that the self-projection mechanism generates in the investor. Assuming that uncertainty is inherent in valuations of events that have not yet occurred, the focus must shift from risk management to uncertainty management. Only in this way the intertemporal dimension of the decision-making environment and the haste generated by the financial market can be cautioned and considered. The work considers an extension of the prospectus theory with the temporal component with the aim of providing a description of the attitude towards risk with respect to the passage of time.

Keywords: impatience, risk aversion, subjective probability, uncertainty

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Authors: Tannaz Alimardani, Amirhossein Moghanian, Morteza Elsa

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Bioactive glasses (BGs) are a group of surface-reactive biomaterials used in clinical applications as implants or filler materials in the human body to repair and replace diseased or damaged bone. Sol-gel technique was employed to prepare a SiO₂-CaO-P₂O₅ glass with a nominal composition of 58S BG with the addition of Sr and Li modifiers which imparts special properties to the BG. The effect of simultaneous addition of Sr and Li on bioactivity and biocompatibility, proliferation, alkaline phosphatase (ALP) activity of osteoblast cell line MC3T3-E1 and antibacterial property against methicillin-resistant Staphylococcus aureus (MRSA) bacteria were examined. BGs were characterized by X-ray diffraction, Fourier transform infrared spectroscopy and scanning electron microscopy before and after soaking the samples in the simulated body fluid (SBF) for different time intervals to characterize the formation of hydroxyapatite (HA) formed on the surface of BGs. Structural characterization indicated that the simultaneous presence of 5% Sr and 5% Li in 58S-BG composition not only did not retard HA formation because of the opposite effect of Sr and Li of the dissolution of BG in the SBF, but also stimulated the differentiation and proliferation of MC3T3-E1s. Moreover, the presence of Sr and Li on the dissolution of the ions resulted in an increase in the mean number of DAPI-labeled nuclei which was in good agreement with the live/dead assay. The result of antibacterial tests revealed that Sr and Li-substituted 58S bioactive glass exhibited a potential antibacterial effect against MRSA bacteria. Because of optimal proliferation and ALP activity of MC3T3-E1cells, proper bioactivity and high antibacterial potential against MRSA, BG-5/5 is suggested as a multifunctional candidate for bone tissue engineering.

Keywords: alkaline, alkaline earth, bioglass, co-doping, ion release

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Authors: Olga A. Momot, Boris I. Synzynys, Alla A. Oudalova

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Obninsk is situated in the Kaluga region 100 km southwest of Moscow on the left bank of the Protva River. Several enterprises utilizing nuclear energy are operating in the town. A special attention in the region where radiation-hazardous facilities are located has traditionally been paid to radioactive gas and aerosol releases into the atmosphere; liquid waste discharges into the Protva river and groundwater pollution. Municipal intakes involve 34 wells arranged 15 km apart in a sequence north-south along the foot of the left slope of the Protva river valley. Northern and southern water intakes are upstream and downstream of the town, respectively. They belong to river valley intakes with mixed feeding, i.e. precipitation infiltration is responsible for a smaller part of groundwater, and a greater amount is being formed by overflowing from Protva. Water intakes are maintained by the Protva river runoff, the volume of which depends on the precipitation fallen out and watershed area. Groundwater contamination with tritium was first detected in a sanitary-protective zone of the Institute of Physics and Power Engineering (SRC-IPPE) by Roshydromet researchers when realizing the “Program of radiological monitoring in the territory of nuclear industry enterprises”. A comprehensive survey of the SRC-IPPE’s industrial site and adjacent territories has revealed that research nuclear reactors and accelerators where tritium targets are applied as well as radioactive waste storages could be considered as potential sources of technogenic tritium. All the above sources are located within the sanitary controlled area of intakes. Tritium activity in water of springs and wells near the SRC-IPPE is about 17.4 – 3200 Bq/l. The observed values of tritium activity are below the intervention levels (7600 Bq/l for inorganic compounds and 3300 Bq/l for organically bound tritium). The risk has being assessed to estimate possible effect of considered tritium concentrations on human health. Data on tritium concentrations in pipe-line drinking water were used for calculations. The activity of 3H amounted to 10.6 Bq/l and corresponded to the risk of such water consumption of ~ 3·10-7 year-1. The risk value given in magnitude is close to the individual annual death risk for population living near a NPP – 1.6·10-8 year-1 and at the same time corresponds to the level of tolerable risk (10-6) and falls within “risk optimization”, i.e. in the sphere for planning the economically sound measures on exposure risk reduction. To estimate the chemical risk, physical and chemical analysis was made of waters from all springs and wells near the SRC-IPPE. Chemical risk from groundwater contamination was estimated according to the EPA US guidance. The risk of carcinogenic diseases at a drinking water consumption amounts to 5·10-5. According to the classification accepted the health risk in case of spring water consumption is inadmissible. The compared assessments of risk associated with tritium exposure, on the one hand, and the dangerous chemical (e.g. heavy metals) contamination of Obninsk drinking water, on the other hand, have confirmed that just these chemical pollutants are responsible for health risk.

Keywords: radiation-hazardous facilities, water intakes, tritium, heavy metal, health risk

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Authors: Yolanda Indah Permatasari, Sudarsono Hardjosoekarto

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Public private partnership (PPP) scheme was considered as an alternative source of funding for infrastructure provision. However, the performance of PPP scheme and interest of private sector to participate in the provision of infrastructure was still practically low. This phenomenon motivates the research to reconstruct the form of collaborative governance at the policy level from the perspective of transaction cost of the PPP scheme. Soft-system methodology (SSM)-based action research was used as this research methodology. The result of this study concludes that the emergence of transaction cost sources at the policy level is caused by the absence of a law that governs infrastructure investment, especially the implementation of PPP scheme. This absence is causing the imbalance in risk allocation and risk mitigation between the public and private sector. Thus, this research recommended the formulation of infrastructure investment law that aims to minimize asymmetry information, to anticipate the principal-principal problems, and to provide legal basis that ensures risk certainty and guarantee fair risk allocation between public and private sector.

Keywords: public governance, public private partnership, soft system methodology, transaction cost

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Authors: Otto Kakhidze, Hoda Alkhzaimi, Adam Ramey, Nasir Memon

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This paper provides an alternative, cyber security based a conceptual framework for the ethics of automated warfare. The large body of work produced on fully or partially autonomous warfare systems tends to overlook malicious security factors as in the possibility of technical attacks on these systems when it comes to the moral and legal decision-making. The argument provides a risk-oriented justification to why technical malicious risks cannot be dismissed in legal, ethical and policy considerations when warfare models are being implemented and deployed. The assumptions of the paper are supported by providing a broader model that contains the perspective of technological vulnerabilities through the lenses of the Game Theory, Just War Theory as well as standard and non-standard defense ethics. The paper argues that a conventional risk-benefit analysis without considering ethical factors is insufficient for making legal and policy decisions on automated warfare. This approach will provide the substructure for security and defense experts as well as legal scholars, ethicists and decision theorists to work towards common justificatory grounds that will accommodate the technical security concerns that have been overlooked in the current legal and policy models.

Keywords: automated warfare, ethics of automation, inherent hijacking, security vulnerabilities, risk, uncertainty

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Authors: Mina Henneb, Rafik Belabbas, Safia Zenia

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The objective of this study was to determine the prevalence and to identify the risk factors of Eimeria spp. and Giardia spp. infection in rabbits from the local population of four localities in northern Algeria. Dung samples were collected from 16 farms, totalling 111 rabbits, and were analysed by the flotation method. Additional, data regarding the farms and management practices were obtained by means of a questionnaire used in the surveys and interviews. The results revealed that the prevalence of Eimerias pp. contamination was 68.75% (11/16) for farms and 58.56% (65/111) for rabbits, respectively. The prevalence of Giardia spp. was respectively 56.25% (9/16) for farms and 11.7% (13/111) for rabbits. The analyses showed that the prevalence of Eimeria spp. was significantly higher in the farms that did not comply with hygiene and non-conventional feeding and watering. However, the prevalence of Giardia spp. was significant in rabbits kept in poor conditions of rearing. In conclusion, this study showed that the prevalence of these two parasites in rabbits from the local population is relevant and may have important implications for the rabbit industry and public health, especially in rural areas.

Keywords: Algeria, digestive parasites, prevalence, rabbits, risk factors

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Authors: Ananya Ananya, Karthik Rao

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Accurate segmentation of knee cartilage in 3-D magnetic resonance (MR) images for quantitative assessment of volume is crucial for studying and diagnosing osteoarthritis (OA) of the knee, one of the major causes of disability in elderly people. Radiologists generally perform this task in slice-by-slice manner taking 15-20 minutes per 3D image, and lead to high inter and intra observer variability. Hence automatic methods for knee cartilage segmentation are desirable and are an active field of research. This paper presents design and experimental evaluation of 2D convolutional neural networks based fully automated methods for knee cartilage segmentation in 3D MRI. The architectures are validated based on 40 test images and 60 training images from SKI10 dataset. The proposed methods segment 2D slices one by one, which are then combined to give segmentation for whole 3D images. Proposed methods are modified versions of U-net and dilated convolutions, consisting of a single step that segments the given image to 5 labels: background, femoral cartilage, tibia cartilage, femoral bone and tibia bone; cartilages being the primary components of interest. U-net consists of a contracting path and an expanding path, to capture context and localization respectively. Dilated convolutions lead to an exponential expansion of receptive field with only a linear increase in a number of parameters. A combination of modified U-net and dilated convolutions has also been explored. These architectures segment one 3D image in 8 – 10 seconds giving average volumetric Dice Score Coefficients (DSC) of 0.950 - 0.962 for femoral cartilage and 0.951 - 0.966 for tibia cartilage, reference being the manual segmentation.

Keywords: convolutional neural networks, dilated convolutions, 3 dimensional, fully automated, knee cartilage, MRI, segmentation, U-net

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Authors: Pema Choejey, David Murray, Chun Che Fung

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Bhutan is becoming increasingly dependent on Information and Communications Technologies (ICTs), especially the Internet for performing the daily activities of governments, businesses, and individuals. Consequently, information systems and networks are becoming more exposed and vulnerable to cybersecurity threats. This paper highlights the findings of the survey study carried out to understand the perceptions of cybersecurity implementation among government organizations in Bhutan. About 280 ICT personnel were surveyed about the effectiveness of cybersecurity implementation in their organizations. A questionnaire based on a 5 point Likert scale was used to assess the perceptions of respondents. The questions were asked on cybersecurity practices such as cybersecurity policies, awareness and training, and risk management. The survey results show that less than 50% of respondents believe that the cybersecurity implementation is effective: cybersecurity policy (40%), risk management (23%), training and awareness (28%), system development life cycle (34%); incident management (26%), and communications and operational management (40%). The findings suggest that many of the cybersecurity practices are inadequately implemented and therefore, there exist a gap in achieving a required cybersecurity posture. This study recommends government organizations to establish a comprehensive cybersecurity program with emphasis on cybersecurity policy, risk management, and awareness and training. In addition, the research study has practical implications to both government and private organizations for implementing and managing cybersecurity.

Keywords: awareness and training, cybersecurity policy, risk management, security risks

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Authors: Sachin K. Samuchiwal, Barbara Balestrieri, Amanda Paskavitz, Hannah Raff, Joshua A. Boyce

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IL-33, a recently discovered member of the IL-1 cytokine family, binds to the TLR/IL1R super family receptor ST2 and induces type 2 immune responses. IL-33 is constitutively expressed in structural cells at barrier sites such as skin, lung, and intestine, and also inducibly expressed by hematopoietic cells including macrophages. Stimulation of macrophages by Lipopolysaccharide (LPS) can induce de novo IL-33 expression, and also causes the production of prostaglandin-E2 (PGE2) via cyclooxygenase (COX)-2 and microsomal PGE2 synthase-1 (mPGES-1). Because PGE2 can regulate macrophage functions through both autocrine and paracrine mechanisms, the potential interplay of endogenous PGE2 on IL-33 production was explored. Bone-marrow derived murine macrophages (bmMF) that lack either mPGES-1 or EP2 receptor expression were stimulated with LPS in the absence or presence of exogenous PGE2 along with pharmacological agonists and antagonists. The study results demonstrate that endogenous PGE2 markedly enhances LPS-induced IL-33 production by bmMFs via EP2 receptors. Moreover, exogenous PGE2 can amplify LPS-induced IL-33 expression dominantly by EP2 and partly by EP4 receptors by a pathway involving cAMP and exchange protein activated by cAMP (EPAC), but not protein kinase A (PKA). Though both IL-33 production and PGE2 generation in response to LPS require activation of both p38 MAPK and NF-κB, PGE2 did not influence this activation. In conclusion, it is demonstrated that endogenous PGE2 signaling through EP2 and EP4 receptors is a prerequisite for LPS-induced IL-33 production in bmMFs and the underlying cAMP mediated pathway involves EPAC. Since IL-33 is a critical pro-inflammatory cytokine in various pathological disorders, this PGE2-EP2/EP4-cAMP mediated pathway can be exploited to intervene in IL-33 driven pathologies.

Keywords: bone marrow macrophages, EPAC, IL-33, PGE2

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Authors: Chantal Hendriks, Harry Gibson, Anna Trett, Penny Hancock, Catherine Moyes

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The use of modern inputs for crop protection, such as insecticides, is strongly underestimated in Sub-Saharan Africa. Several studies measured toxic concentrations of insecticides in fruits, vegetables and fish that were cultivated in Sub-Saharan Africa. The use of agricultural insecticides has impact on human and environmental health, but it also has the potential to impact on insecticide resistance in malaria transmitting mosquitos. To analyse associations between historic use of agricultural insecticides and the distribution of insecticide resistance through space and time, the use and environmental fate of agricultural insecticides needs to be mapped through the same time period. However, data on the use and environmental fate of agricultural insecticides in Africa are limited and therefore risk maps on the spatiotemporal occurrence of agricultural insecticides are created using environmental data. Environmental data on crop density and crop type were used to select the areas that most likely receive insecticides. These areas were verified by a literature review and expert knowledge. Pesticide fate models were compared to select most dominant processes that are involved in the environmental fate of insecticides and that can be mapped at a continental scale. The selected processes include: surface runoff, erosion, infiltration, volatilization and the storing and filtering capacity of soils. The processes indicate the risk for insecticide accumulation in soil, water, sediment and air. A compilation of all available data for traces of insecticides in the environment was used to validate the maps. The risk maps can result in space and time specific measures that reduce the risk of insecticide exposure to non-target organisms.

Keywords: crop protection, pesticide fate, tropics, insecticide resistance

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Authors: Oksana Domkina

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According to the modern economic theory, human capital became one of the main production factors and the most promising direction of investment, as such investment provides opportunity of obtaining high and long-term economic and social effects. Informational technology (IT) sector is the representative of this new economy which is most dependent on human capital as the main competitive factor. So the question for this sector is not whether investment in development of personal should be made, but what are the most effective ways of executing it and who has to pay for the education: Worker, company or government. In this paper we examine the IT sector, describe the labor market of IT workers and its development, and analyze the risks that IT companies may face if they invest in the development of their workers and what factors influence it. The main problem and difficulty of quantitative estimation of risk of investment in human capital of a company and its forecasting is human factor. Human behavior is often unpredictable and complex, so it requires specific approaches and methods of assessment. To build a comprehensive method of estimation of the risk of investment in human capital of a company considering human factor, we decided to use the method of analytic hierarchy process (AHP), that initially was created and developed. We separated three main group of factors: Risks related to the worker, related to the company, and external factors. To receive data for our research, we conducted a survey among the HR departments of Ukrainian IT companies used them as experts for the AHP method. Received results showed that IT companies mostly invest in the development of their workers, although several hire only already qualified personnel. According to the results, the most significant risks are the risk of ineffective training and the risk of non-investment that are both related to the firm. The analysis of risk factors related to the employee showed that, the factors of personal reasons, motivation, and work performance have almost the same weights of importance. Regarding internal factors of the company, there is a high role of the factor of compensation and benefits, factors of interesting projects, team, and career opportunities. As for the external environment, one of the most dangerous factor of risk is competitor activities, meanwhile the political and economical situation factor also has a relatively high weight, which is easy to explain by the influence of severe crisis in Ukraine during 2014-2015. The presented method allows to take into consideration all main factors that affect the risk of investment in human capital of a company. This gives a base for further research in this field and allows for a creation of a practical framework for making decisions regarding the personnel development strategy and specific employees' development plans for the HR departments.

Keywords: risks, personnel development, investment in development, factors of risk, risk of investment in development, IT, analytic hierarchy process, AHP

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Authors: Naser Kazemi Eilaki, Carolyn Ahmer, Ilona Heldal, Bjarne Christian Hagen

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Older people and people with disabilities are recognized as at-risk groups when it comes to egress and travel from hazard zone to safe places. One's disability can negatively influence her or his escape time, and this becomes even more important when people from this target group live alone. This research deals with the fire safety of mentioned people's buildings by means of probabilistic methods. For this purpose, fire safety is addressed by modeling the egress of our target group from a hazardous zone to a safe zone. A common type of detached house with a prevalent plan has been chosen for safety analysis, and a limit state function has been developed according to the time-line evacuation model, which is based on a two-zone and smoke development model. An analytical computer model (B-Risk) is used to consider smoke development. Since most of the involved parameters in the fire development model pose uncertainty, an appropriate probability distribution function has been considered for each one of the variables with indeterministic nature. To achieve safety and reliability for the at-risk groups, the fire safety index method has been chosen to define the probability of failure (causalities) and safety index (beta index). An improved harmony search meta-heuristic optimization algorithm has been used to define the beta index. Sensitivity analysis has been done to define the most important and effective parameters for the fire safety of the at-risk group. Results showed an area of openings and intervals to egress exits are more important in buildings, and the safety of people would improve with increasing dimensions of occupant space (building). Fire growth is more critical compared to other parameters in the home without a detector and fire distinguishing system, but in a home equipped with these facilities, it is less important. Type of disabilities has a great effect on the safety level of people who live in the same home layout, and people with visual impairment encounter more risk of capturing compared to visual and movement disabilities.

Keywords: fire safety, at-risk groups, zone model, egress time, uncertainty

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Authors: E. Cenderelli, E. Bruno, G. Iacoviello, A. Lazzini

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The financial sector is exposed to the risk of cyber-attacks like any other industrial sector. Furthermore, the topic of CybeRisk (cyber risk) has become particularly relevant given that Information Technology (IT) attacks have increased drastically in recent years, and cannot be stopped by single organizations requiring a response at international and national level. IT risk is never a matter purely for the IT manager, although he clearly plays a key role. A bank's risk management function requires a thorough understanding of the evolving risks as well as the tools and practical techniques available to address them. Upon the request of European and national legislation regarding CybeRisk in the financial system, banks are therefore called upon to strengthen the operational model for CybeRisk management. This will require an important change with a more intense collaboration with the structures that deal with information security for the development of an ad hoc system for the evaluation and control of this type of risk. The aim of the work is to propose a framework for the management and control of CybeRisk that will bridge the gap in the literature regarding the understanding and consideration of CybeRisk as an integral part of business management. The IT function has a strong relevance in the management of CybeRisk, which is perceived mainly as operational risk, but with a positive tendency on the part of risk management to the identification of CybeRisk assessment methods that are increasingly complete, quantitative and able to better describe the possible impacts on the business. The paper provides answers to the research questions: Is it possible to define a CybeRisk governance structure able to support the comparison between risk and security? How can the relationships between IT assets be integrated into a cyberisk assessment framework to guarantee a system of protection and risks control? From a methodological point of view, this research uses a case study approach. The choice of “Monte dei Paschi di Siena” was determined by the specific features of one of Italy’s biggest lenders. It is chosen to use an intensive research strategy: an in-depth study of reality. The case study methodology is an empirical approach to explore a complex and current phenomenon that develops over time. The use of cases has also the advantage of allowing the deepening of aspects concerning the "how" and "why" of contemporary events, on which the scholar has little control. The research bases on quantitative data and qualitative information obtained through semi-structured interviews of an open-ended nature and questionnaires to directors, members of the audit committee, risk, IT and compliance managers, and those responsible for internal audit function and anti-money laundering. The added value of the paper can be seen in the development of a framework based on a mapping of IT assets from which it is possible to identify their relationships for purposes of a more effective management and control of cyber risk.

Keywords: bank, CybeRisk, information technology, risk management

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Authors: Fedor Semenov

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One of the most widespread facial bones’ malformations – the congenital palatoschisis – significant impact on drainage and ventilation of the middle ear through the incorrect work of soft palate muscles, which results in recurrent middle ear inflammation and subsequently leads to the hearing dysfunction. The purpose of this research is to evaluate the auditory tube function and hearing condition before the operative treatment (uranoplasty) and after 3 and 12 months. 42 patients aged from 6 months to 17 years who had soft and hard palate cleft and B and C type tympanogram were included in that study. The examination includes otoscopy, pure tone audiometry (for patients older than 8 years – 11 patients), tympanometry. According to the otoscopy results all the patients were divided into two groups: those who had a retracted eardrum and those who had a normal one. The results of pure tone audiometry showed that there were six patients with an air-bone gap of more than 10 dB and the five with normal audiograms. According to the results of this research, uranoplasty demonstrated strongly positive effects on the auditory tube function: normalization of eardrum view upon otoscopy was observed in 64% of children with a retracted eardrum three month after surgery and 85 % twelve months. The quantity of patients with A-type of tympanogram improved in 25 children out of 41 in 3 month and in 35 out of 41 in twelve months after operation. While before the operative treatment, six patients older than 8 years had had an air-bone gap of more than 10 dB; only two of them still had it in 12 months, and the others’ audiograms were normal. To sum it up, the uranoplasty showed a significant contribution in the restoration of auditory tube functioning. Some patients had signs of auditory dysfunction even after the operative treatment. That group of children needs further treatment by an otorhinolaryngologist.

Keywords: auditory tube dysfunction, palatoschisis, uranoplasy, otitis

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Authors: Amel Oueslati, Olfa Benouda

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New Value at Risk (VaR) estimation is proposed and investigated. The well-known two stages Garch-EVT approach uses conditional volatility to generate one step ahead forecasts of VaR. With daily data for twelve stocks that decompose the Dow Jones Industrial Average (DJIA) index, this paper incorporates the volume in the first stage volatility estimation. Afterwards, the forecasting ability of this conditional volatility concerning the VaR estimation is compared to that of a basic volatility model without considering any trading component. The results are significant and bring out the importance of the trading volume in the VaR measure.

Keywords: Garch-EVT, value at risk, volume, volatility

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Authors: Mohammed Aljoma, Eblal Zakzok

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Safety is a science that seeks to protect and avoid humans from risks in any field and prevent losses in properties and lives as much as possible. On the other hand, occupational safety goals aim to protect workers from risks which can occur during work execution. The main purpose of occupational safety is to ultimately protect people, properties and the environment by reducing accidents and injuries that may cause losses and damages. To achieve this goal, we must remove the direct and indirect reasons which cause accidents and injuries; some of the reasons of accidents are the unsafe cases and inept behavior or both of them. This research focuses on the manner of providing instant protection from the very first beginning to people, properties and the environment by: -Inserting safety demands in the planning and designing works by identifying risk levels in every task of the project, -Using a new risk managing system or modifying or changing a previously-used one.

Keywords: planning, scheduling, risk management, project duration, site safety

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Authors: Alma Shehu, Majlinda Vasjari, Sonila Duka, Loreta Vallja, Nevila Broli

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Humans consume drinking water from several sources, including tap water, bottled water, natural springs, filtered tap water, etc. The quality of drinking water is crucial for human survival given the fact that the consumption of contaminated drinking water is related to many diseases and deaths all over the world. This study represents the investigation of the quality and health risks of different types of drinking waters being consumed by the population in Albania, arising from heavy metals content. Investigated water included industrialized water, tap water, and spring water. In total, 20 samples were analyzed for the content of Pb, Cd, Cr, Ni, Cu, Fe, Zn, Al, and Mn. Determination of each metal concentration in selected samples was conducted by atomic absorption spectroscopy method with electrothermal atomization, GFAAS. Water quality was evaluated by comparing the obtained metals concentrations with the recommended maximum limits, according to the European Directive (98/83/EC) and Guidelines for Drinking Water Quality (WHO, 2017). Metal Index (MI) was used to assess the overall water quality due to heavy metals content. Health risk assessment was conducted based on the recommendations of the USEPA (1996), human health risk assessment, via ingestion. Results of this investigation showed that Al, Ni, Fe, and Cu were the metals found in higher concentrations while Cd exhibited the lowest concentration. Among the analyzed metals, Al (one sample) and Ni (in five samples) exceeded the maximum allowed limit. Based on the pollution metal index, it was concluded that the overall quality of Glina bottled water can be considered as toxic to humans, while the quality of bottled water (Trebeshina) was classified as moderately toxic. Values of health risk quotient (HQ) varied between 1x10⁻⁶-1.3x10⁻¹, following the order Ni > Cd > Pb > Cu > Al > Fe > Zn > Mn. All the values were lower than 1, which suggests that the analyzed samples exhibit no health risk for humans.

Keywords: drinking water, health risk assessment, heavy metals, pollution index

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Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

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Authors: Vladyslav Povoroznyuk, Tetiana Orlуk, Nataliia Dzerovych

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Introduction: Back pain is an extremely common health care problem worldwide. Many studies show a link between an obesity and risk of lower back pain. The aim is to study correlation and peculiarities of vertebral pain in women of different age depending on their anthropometric indicators. Materials: 1886 women aged 25-89 years were examined. The patients were divided into groups according to age (25-44, 45-59, 60-74, 75-89 years old) and body mass index (BMI: to 18.4 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-30 kg/m2 (overweight) and more than 30.1 kg/m2 (obese). Methods: The presence and intensity of pain was evaluated in the thoracic and lumbar spine using a visual analogue scale (VAS). BMI is calculated by the standard formula based on body weight and height measurements. Statistical analysis was performed using parametric and nonparametric methods. Significant changes were considered as p <0.05. Results: The intensity of pain in the thoracic spine was significantly higher in the underweight women in the age groups of 25-44 years (p = 0.04) and 60-74 years (p=0.005). The intensity of pain in the lumbar spine was significantly higher in the women of 45-59 years (p = 0.001) and 60-74 years (p = 0.0003) with obesity. In the women of 45-74 years BMI was significantly positively correlated with the level of pain in the lumbar spine. Obesity significantly increases the relative risk of pain in the lumbar region (RR=0.07 (95% CI: 1.03-1.12; p=0.002)), while underweight significantly increases the risk of pain in the thoracic region (RR=1.21 (95% CI: 1.00-1.46; p=0.05)). Conclusion: In women, vertebral pain syndrome may be related to the anthropometric characteristics (e.g., BMI). Underweight may indirectly influence the development of pain in the thoracic spine and increase the risk of pain in this part by 1.21 times. Obesity influences the development of pain in the lumbar spine increasing the risk by 1.07 times.

Keywords: body mass index, age, pain in thoracic and lumbar spine, women

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Authors: Eftekhari M. H., Mozaffari-Khosravi H., Shidfar F.

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Background: Many Iranian adolescent girls are iron deficient, but it is unclear whether the iron deficiency is associated with other nutritional risk indicators. Objective: we aimed to investigate the association between iron deficiency and weight status (measured as BMI) among a reprehensive sample of teenage girls. Methods: A cross-sectional study was performed in a region of southern I.R.Iran. One hundred eighty-seven iron-deficient participants (aged between 11 to 14) were selected by systematic random sampling among all students in grades 1 to 3 from high schools for girls. We assayed hemoglobin, hematocrit, serum ferritin, iron and total iron binding capacity and measured weight and height. Body mass index was calculated according to age and gender-specific BMI growth charts for children 2 to 20 years of age. Results: 13% were at risk for being overweight and 8.3% were overweight. The severity of iron deficiency increased as BMI increased from normal to at risk for overweight and overweight. Iron deficiency anemia was most prevalent among overweight adolescents than at risk for overweight and normal weight adolescents (28%, 18%, and 13%, respectively). Conclusions: The results of this study showed an inverse association of BMI with serum ferritin. Overweight adolescents demonstrated an increased prevalence of anemia. Because of the potentially harmful effects of iron deficiency, obese adolescents should be routinely screened and treated as necessary.

Keywords: adolescent, over weight, iron deficiency, Iran

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Authors: Syed Atif Ali, Farzan Yahya

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This research paper covers the issue of risk management impact on the company performance. Degree of financial leverage (DFL), degree of operating leverage (DOL) and the working capital ratio (WCR) are taken as independent variables which are the representative of risk and the earning price per share (EPS), return on assets (ROA), return on equity (ROE), Sales and Net profits which are the representative of performance. Last 10 years (2004-2013) of Cement sector of Pakistan data is chosen as sample for analyze their relations by multiple regression technique. Through analyses, it is found that WCR impact adequately on the company performance because if company has enough liquidity than it perform its operations smoothly and enhance its performance very well. DFL should be control moderately because enough DFL leads performance of company downward. On the other hand, the DOL should be less because it causes the less profitability for a company from its operations.

Keywords: degree of financial leverage (DFL), degree of operating leverage (DOL), working capital ratio (WCR), earning per share (EPS), return on equity (ROE), return on assets (ROA)

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Authors: N. R. P Withana, E. Auch

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The purpose of this study was to investigate perceptions of climate change risk to forest ecosystems and forest-based communities as well as perceived effectiveness of adaptation strategies for climate change as well as challenges for adaptation. Data was gathered using a pre-tested semi-structured questionnaire. Simple random selection technique was applied. For the majority of issues, the responses were obtained on multi-point Likert scales, and the scores provided were, in turn, used to estimate the means and other useful estimates. A composite knowledge index developed using correct responses to a set of self-rated statements were used to evaluate the issues. The mean of the knowledge index was 0.64. Also all respondents recorded values of the knowledge index above 0.25. Increase forest fire was perceived by respondents as the greatest risk to forest eco-system. Decrease access to water supplies was perceived as the greatest risk to livelihoods of forest based communities. The most effective adaptation strategy relevant to climate change risks to forest eco-systems and forest based communities livelihoods in Kathmandu valley in Nepal as perceived by the respondents was reforestation and afforestation. As well, lack of public awareness was perceived as the major limitation for climate change adaptation. However, perceived risks as well as effective adaptation strategies showed an inconsistent association with knowledge indicators and social-cultural variables. The results provide useful information to any party who involve with climate change issues in Nepal, since such attempts would be more effective once the people’s perceptions on these aspects are taken into account.

Keywords: climate change, risk perceptions, forest ecosystems, forest-based communities

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Authors: B. Kenny

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The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

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Authors: Divya SY. Ang, Mark B. Tan, Nicholas EM. Yeo, Siti RB. Sudirman, Khong Yik Chew

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Introduction: The importance of the amalgamation of technological and engineering advances with surgical principles of reconstruction cannot be overemphasized. With earlier detection of cancer, consequences of high-speed living and neglect, like traumatic injuries and infection, resulting in increasingly younger patients with bone defects. This may result in malformations and suboptimal function that is more noticeable and palpable in the younger, active demographic. Our team proposes a technique that encapsulates a mesh of multidisciplinary effort, tissue engineering and reconstructive principles. Methods/Materials: Our patient was a young competitive footballer in his early 30s who was diagnosed with submandibular adenoid cystic carcinoma with bony involvement. He was thus counselled for a right hemi mandibulectomy, the floor of mouth resection, right selective neck dissection, tracheostomy, and free fibular flap reconstruction of his mandible and required post-operative radiotherapy. Being young and in his prime sportsman years, he was unable to accept the morbidities associated with using his fibula to reconstruct his mandible despite it being the gold standard reconstructive option. The fibula is an ideal vascularized bone flap because it’s reliable and easily shaped with relatively minimal impact on functional outcomes. The fibula contributes to 30% of weightbearing and is the attachment for the lateral compartment muscles; it is stronger in footballers concerning lateral bending. When harvesting the fibula, the distal 6-8cm and up to 10% of the total length is preserved to maintain the ankle’s stability, thus, minimizing the impact on daily activities. There are studies that have noted gait variability post-operatively. Therefore, returning to a premorbid competitive level may be doubtful. To improve his functional outcomes, the decision was made to try and restore the fibula's form and function. Using the concept of Fused Deposition Modelling (FDM), our team comprising of Plastics, Otolaryngology, Orthopedics and Radiology, worked with Osteopore to design a 3D bioresorbable implant to regenerate the fibula defect (14.5cm). Bone marrow was harvested via reaming the contralateral hip prior to the wide resection. 30mls of his blood was obtained for extracting platelet rich plasma. These were packed into the Osteopore 3D-printed bone scaffold. This was then secured into the fibula defect with titanium plates and screws. The flexor hallucis longus and soleus were anchored along the construct and intraosseous membrane, done in a single setting. Results: He was reviewed closely as an outpatient over 10 months post operatively. He reported no discernable loss or difference in ankle function. He is satisfied and back in training and our team has video and photographs that substantiate his progress. Conclusion: FDM allows regeneration of long bone defects. However, we aimed to also restore his eversion and inversion that is imperative for footballers and hence reattached his previously dissected muscles along the length of the Osteopore implant. We believe that the reattachment of the muscle stabilizes not only the construct but allows optimum muscle tensioning when moving his ankle. This is a simple but effective technique in restoring complete function and form in a young patient whose minute muscle control is imperative to life.

Keywords: fused deposition modelling, functional reconstruction, lower limb bony defects, regenerative surgery, 3D printing, tissue engineering

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Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia

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Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.

Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders

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