Search results for: cardio-metabolic risk factors

Authors: Alexander Guzman Urbina, Atsushi Aoyama

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The sustainability of traditional technologies employed in energy and chemical infrastructure brings a big challenge for our society. Making decisions related with safety of industrial infrastructure, the values of accidental risk are becoming relevant points for discussion. However, the challenge is the reliability of the models employed to get the risk data. Such models usually involve large number of variables and with large amounts of uncertainty. The most efficient techniques to overcome those problems are built using Artificial Intelligence (AI), and more specifically using hybrid systems such as Neuro-Fuzzy algorithms. Therefore, this paper aims to introduce a hybrid algorithm for risk assessment trained using near-miss accident data. As mentioned above the sustainability of traditional technologies related with energy and chemical infrastructure constitutes one of the major challenges that today’s societies and firms are facing. Besides that, the adaptation of those technologies to the effects of the climate change in sensible environments represents a critical concern for safety and risk management. Regarding this issue argue that social consequences of catastrophic risks are increasing rapidly, due mainly to the concentration of people and energy infrastructure in hazard-prone areas, aggravated by the lack of knowledge about the risks. Additional to the social consequences described above, and considering the industrial sector as critical infrastructure due to its large impact to the economy in case of a failure the relevance of industrial safety has become a critical issue for the current society. Then, regarding the safety concern, pipeline operators and regulators have been performing risk assessments in attempts to evaluate accurately probabilities of failure of the infrastructure, and consequences associated with those failures. However, estimating accidental risks in critical infrastructure involves a substantial effort and costs due to number of variables involved, complexity and lack of information. Therefore, this paper aims to introduce a well trained algorithm for risk assessment using deep learning, which could be capable to deal efficiently with the complexity and uncertainty. The advantage point of the deep learning using near-miss accidents data is that it could be employed in risk assessment as an efficient engineering tool to treat the uncertainty of the risk values in complex environments. The basic idea of using a Near-Miss Deep Learning Approach for Neuro-Fuzzy Risk Assessment in Pipelines is focused in the objective of improve the validity of the risk values learning from near-miss accidents and imitating the human expertise scoring risks and setting tolerance levels. In summary, the method of Deep Learning for Neuro-Fuzzy Risk Assessment involves a regression analysis called group method of data handling (GMDH), which consists in the determination of the optimal configuration of the risk assessment model and its parameters employing polynomial theory.

Keywords: deep learning, risk assessment, neuro fuzzy, pipelines

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Authors: Peifang Hsieh

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New Taipei city faces increasing number of migrant families, in which the needs of children are sometimes neglected due to insufficient support from communities. Moreover, the traditional mindset of disengagement discourages citizens from preemptively identifying families in need in their communities, resulting in delay of prompt intervention from authorities concerned. To safeguard these vulnerable families, New Taipei city develops the 'Integrated Safety-Net Program for High-Risk Families' from 2011 by implementing the following measures: (A) New attitude and action: Instead of passively receiving reported case of high-risk families, the program takes proactive and preemptive approach to detect and respond at early stage, so the cases are prevented from worsening. In addition, cross-departmental integration mechanism is established to meet multiple needs of high-risk families. The children number added to the government care network is greatly increased to over 10,000, which is around 4.4 times the original number before the program. (B) New service points: 2000 city-wide convenience stores are added as service stations so that children in less privileged families can go to any of 24-hour convenience stores across the city to pick up free meals. This greatly increases the approachability to high-risk families. Moreover, the social welfare institutes will be notified with information left in convenience stores by children and follow up with further assistance, greatly enhancing chances of less privileged families being identified. (C) New Key Figures: Mobilize community officers and volunteers to detect and offer on-site assistance. Volunteer organizations within communities are connected to report and offer follow-up services in a more active manner. In total, from 2011 to 2015, 54,789 cases are identified through active care, benefiting 82,124 children. In addition, 87.49% family-cases in the program receiving comprehensive social assistance are no longer at high risk.

Keywords: cross department, high-risk families, public-private partnership, integrated safety net

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Authors: Rui Miguel Costa, Jose Pestana, David Costa, Paula Mangia, Catarina Correia, Mafalda Pinto Coelho

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There is lack of studies examining the relation of different heart rate variability (HRV) parameters with the risk of erectile dysfunction (ED) in younger men. Thus, the present study aimed at examining, in a nonclinical sample of men aged 19-39 years old (mean age = 23.98 years, SD = 4.90), the relations of risk of ED with the standard deviation of the heart rate (SD of HR), high and low frequency power of HRV, and low-to-high frequency HRV ratio. Eighty-three heterosexual Portuguese men completed the 5-item version of the International Index of Erectile Function (IIEF-5) and HRV parameters were calculated from a 5-minute resting period. Risk of ED was determined by IIEF-5 scores of 21 or less. Fifteen men (18.1%) reported symptoms of ED (14 with mild and one with mild to moderate symptoms). Univariate analyses of variance revealed that risk of ED was related to lesser SD of HR and lesser low-frequency power, the two HRV parameters that express a coupling of higher vagal and sympathetic tone. Risk of ED was unrelated to high-frequency power and low-to-high frequency HRV ratio. Further, in a logistic regression, the risk of ED was independently predicted by older age and lower SD of HR, but not by low-frequency power, having a regular sexual partner, and cohabiting. The results provide preliminary evidence that, in younger men, a coupling of higher vagal and sympathetic tone, as indexed by the SD of HR, is important for erections. Greater resting SD of HR might reflect better vascular and interpersonal function via vagal tone coupled with greater motor mobilization to pursue sexual intercourse via sympathetic tone. Many interventions can elevate HRV; future research is warranted on how they can be tailored to treat ED in younger men.

Keywords: erectile dysfunction, heart rate variability, standard deviation of the heart rate, younger men

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Authors: Rachel C. F. Sun

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This study aimed to examine the similarities and differences between teachers’ and students’ causal explanations of classroom misbehavior. In-depth semi-structured interviews were conducted with twelve teachers and eighteen Grade 7-9 students. The qualitative data were analyzed, in which the attributed causes of classroom misbehavior were categorized into student, family, school, and peer factors. Findings showed that both interviewed teachers and students shared similarity in attributing to student factors, such as ‘fun and pleasure seeking’ and ‘attention seeking’ as the leading causes of misbehavior. However, the students accounted to school factors, particularly ‘boring lessons’ as the next attributed causes, while the teachers accounted to family factors, such as ‘lack of parent demandingness’. By delineating the factors at student, family, school, and peer levels, these findings help drawing corresponding implications for preventing and mitigating misbehavior in school.

Keywords: causal explanation, misbehavior, student, teacher

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Authors: Hyoup-Sang Yoon

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The quality of video transmitted by mobile ad hoc networks (MANETs) can be influenced by several factors, including protocol layers; parameter settings of each protocol. In this paper, we are concerned with understanding the functional relationship between these influential factors and objective video quality in MANETs. We illustrate a systematic statistical design of experiments (DOE) strategy can be used to analyse MANET parameters and performance. Using a 2k factorial design, we quantify the main and interactive effects of 7 factors on a response metric (i.e., mean opinion score (MOS) calculated by PSNR with Evalvid package) we then develop a first-order linear regression model between the influential factors and the performance metric.

Keywords: evalvid, full factorial design, mobile ad hoc networks, ns-2

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Authors: Zakari Mustapha, Clinton Aigbavboa, Wellington Didi Thwala

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Majority of the incidents and accidents in complex high-risk systems that exist in the construction industry and other sectors have been attributed to unsafe acts of workers. The purpose of this paper was to asses Human Factors Analysis and Classification System (HFACS) in construction accident prevention. The study was conducted through the use of secondary data from journals, books and internet to achieve the objective of the study. The review of literature looked into details of different views from different scholars about HFACS framework in accidents investigations. It further highlighted on various sections or disciplines of accident occurrences in human performance within the construction. The findings from literature review showed that unsafe acts of a worker and unsafe working conditions are the two major causes of accident in the construction industry.Most significant factor in the cause of site accident in the construction industry is unsafe acts of a worker. The findings also show how the application of HFACS framework in the investigation of accident will lead to the identification of common trends. Further findings show that provision for the prevention of accident will be made based on past accident records to identify and prioritize where intervention is needed within the construction industry.

Keywords: accident, construction, HFACS, unsafe acts

Procedia PDF Downloads 323

Authors: Olukayode Bamgbose, Feyisola Agboola, Adewale M. Taiwo, Olanrewaju Olujimi Oluwole Terebo, Azeez Soyingbe, Akeem Bamgbade

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The present study evaluated the contents and health risk assessment of metals determined in milk and milk product samples collected from the Abeokuta market. Forty-five milk and milk product (yoghurt) samples were digested and analysed for selected metals using Atomic Absorption Spectrophotometric method. Health risk assessment was evaluated for hazard quotient (HQ), hazard index (HI), and cancer risk (CR). Data were subjected to descriptive and inferential statistics. The concentrations of Zn, which ranged from 3.24±0.59 to 4.35±0.59 mg/kg, were the highest in the samples. Cr and Cd were measured below the detection limit of the analytical instrument, while the Pb level was higher than the Codex Alimentarius Commission value of 0.02 mg/kg, indicating unsafe for consumption. However, the HQ of Pb and other metals in milk and milk product samples was less than 1.0, thereby establishing no adverse health effects for Pb and other metals. The distribution pattern of metals in milk and milk product samples followed the decreasing order of Zn > Fe > Ni > Co > Cu > Mn > Pb > Cd/Cr. The CR levels of meals were also less than the permissible limit of 1.0 x 10-4, establishing no possible development of cancer. Keywords: adverse effects, cancer, metals, milk, milk product, the permissible limit.

Keywords: adverse effects, cancer, metals, milk, milk product, permissible limit

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Authors: Yawen Xia, Rubi Yang, Jing Zhao

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We examine the environmental, social, and governance (ESG) decision-making of companies during turbulent times like COVID-19. We find that firms’ ESG reputation risk comove with their industry and local peers, suggesting that managers may follow their industry and local counterparts in engaging in irresponsible activities. Moreover, the comovement in reputation risk is attenuated during the COVID-19 pandemic. Further analyses suggest that the reduction in comovement varies by state-level partisanship and death rate during the pandemic. Comovement in reputation risk declines more significantly in the Democratic states with stringent social distancing policies and in states with higher infection severity. Our findings suggest that social distancing provisions during COVID-19 may lead to a reduction in social activities and information sharing among enterprise managers.

Keywords: ESG, Covid, peer pressure, local comovement, orporate governance

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Authors: E. Carraro, Sa. Bonetta, Si. Bonetta, E. Ceretti, G. C. V. Viola, C. Pignata, S. Levorato, T. Salvatori, S. Vannini, V. Romanazzi, A. Carducci, G. Donzelli, T. Schilirò, A. De Donno, T. Grassi, S. Bonizzoni, A. Bonetti, G. Gilli, U. Gelatti

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In 2013, air pollution and particulate matter were classified as carcinogenic to human by the IARC. At present, PM is Europe's most problematic pollutant in terms of harm to health, as reported by European Environmental Agency (EEA) in the EEA Technical Report on Air quality in Europe, 2015. A percentage between 17-30 of the EU urban population lives in areas where the EU air quality 24-hour limit value for PM10 is exceeded. Many studies have found a consistent association between exposure to PM and the incidence and mortality for some chronic diseases (i.e. lung cancer, cardiovascular diseases). Among the mechanisms responsible for these adverse effects, genotoxic damage is of particular concern. Children are a high-risk group in terms of the health effects of air pollution and early exposure during childhood can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE (Monitoring Air Pollution Effects on Children for supporting public health policy) is a project founded by EU Life+ Programme (LIFE12 ENV/IT/000614) which intends to evaluate the associations between air pollution and early biological effects in children and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. This work is focused on the micronuclei frequency in child buccal cells in association with airborne PM levels taking into account the influence of other factors associated with the lifestyle of children. The micronucleus test was performed in exfoliated buccal cells of 6–8 years old children from 5 Italian towns with different air pollution levels. Data on air quality during the study period were obtained from the Regional Agency for Environmental Protection. A questionnaire administered to children’s parents was used to obtain details on family socio-economic status, children health condition, exposures to other indoor and outdoor pollutants (i.e. passive smoke) and life-style, with particular reference to eating habits. During the first sampling campaign (winter 2014-15) 1315 children were recruited and sampled for Micronuclei test in buccal cells. In the sampling period the levels of the main pollutants and PM10 were, as expected, higher in the North of Italy (PM10 mean values 62 μg/m3 in Torino and 40 μg/m3 in Brescia) than in the other towns (Pisa, Perugia, Lecce). A higher Micronucleus frequency in buccal cells of children was found in Brescia (0.6/1000 cells) than in the other towns (range 0.3-0.5/1000 cells). The statistical analysis underlines a relation of the micronuclei frequency with PM concentrations, traffic level near child residence, and level of education of parents. The results suggest that, in addition to air pollution exposure, some other factors, related to lifestyle or further exposures, may influence micronucleus frequency and cellular response to air pollutants.

Keywords: air pollution, buccal cells, children, micronucleus cytome assay

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Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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Authors: Sisay Shine, Frew Tadesse, Zemenu Shiferaw, Lema Mideksa

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Background: Stunting is one of the most important public health problems in Ethiopia with an estimated 44.4% of children less than five years of age are stunted. Thus, this study aimed to assess prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia. Objective of the study: To assess prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia, 2016. Methods: Community based cross sectional study design was done among 770 children in pastoral community of Korahay Zone. Systematic sampling techniques were used to select households and took child mother pair from each selected households. Data was collected using pre-tested and structured questionnaire. Odds ratio with 95% confidence interval was used to assess level of significance. Result: Prevalence of stunting among 6-59 months age children was 31.9%. Sex (AOR: 1.47, 95%CI 1.02, 2.11), age (AOR: 2.10, 95%CI 1.16, 3.80), maternal education (AOR: 3.42, 95%CI 1.58, 7.41), maternal occupation (AOR: 3.10, 95%CI 1.85, 5.19), monthly income (AOR: 1.47, 95%CI 1.03, 2.09), PNC visits (AOR: 1.59, 95%CI 1.07, 2.37), source of water (AOR: 3.41, 95%CI 1.96, 5.93), toilet availability (AOR: 1.71, 95%CI 1.13, 2.58), first milk feeding (AOR: 3.37, 95%CI 2.27, 5.02) and bottle feeding (AOR: 2.07, 95%CI 1.34, 3.18) were significant predictors of stunting. Conclusion and recommendations: Prevalence of stunting among 6-59 months children was high 31.9%. Lack maternal education, not feeding first milk, unsafe water supply, absence toilet availability and bottle feeding can increase the risk of stunting. So, educating mothers on child feeding practice, sanitation and important of first milk can reduce stunting.

Keywords: dietary, environmental, healthcare, socio-demographic, stunting

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Authors: Babak Darvish Rouhani, Mohd Nazri Mahrin, Fatemeh Nikpay, Pourya Nikfard, Maryam Khanian Najafabadi

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Enterprise Architecture (EA) is a strategy that is employed by enterprises in order to align their business and Information Technology (IT). EA is managed, developed, and maintained through Enterprise Architecture Implementation Methodology (EAIM). The effectiveness of EA implementation is the degree in which EA helps to achieve the collective goals of the organization. This paper analyzes the results of a survey that aims to explore the factors that affect the effectiveness of EAIM and specifically the relationship between factors and effectiveness of the output and functionality of EA project. The exploratory factor analysis highlights a specific set of five factors: alignment, adaptiveness, support, binding, and innovation. The regression analysis shows that there is a statistically significant and positive relationship between each of the five factors and the effectiveness of EAIM. Consistent with theory and practice, the most prominent factor for developing an effective EAIM is innovation. The findings contribute to the measuring the effectiveness of EA implementation project by providing an indication of the measurement implementation approaches which is used by the Enterprise Architects, and developing an effective EAIM.

Keywords: enterprise architecture, enterprise architecture implementation methodology, implementation methodology, factors, EA, effectiveness

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Authors: Osayomwanbor E. Oghama, John O. Olomukoro

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The school environment, apart from home, is probably the most important indoor environment for children. Children spend as much as 80-90% of their indoor time either at school or at home; an average of 35 - 40 hours per week in schools, hence are at the risk of indoor air pollutants such as volatile organic compounds (VOCs). Concentrations of VOCs vary widely but are generally higher indoors than outdoors. This research was, therefore, carried out to evaluate the levels of VOCs in secondary school classrooms in Benin City, Edo State. Samples were obtained from a total of 18 classrooms in 6 secondary schools. Samples were collected 3 times from each school and from 3 different classrooms in each school using Draeger ORSA 5 tubes. Samplers were left to stay for a school-week (5 days). The VOCs detected and analyzed were benzene, ethlybenzene, isopropylbenzene, naphthalene, n-butylbenzene, n-propylbenzene, toluene, m-xylene, p-xylene, o-xylene, styrene, chlorobenzene, chloroform, 1,2-dichloropropane, 2,2-dichloropropane, tetrachloroethane, tetrahydrofuran, isopropyl acetate, α-pinene, and camphene. The results showed that chloroform, o-xylene, and styrene were the most abundant while α-pinene and camphene were the least abundant. The health risk assessment was done in terms of carcinogenic (CRI) and non-carcinogenic risks (THR). The CRI values of the schools ranged from 1.03 × 10-5 to 1.36 × 10-5 μg/m³ (a mean of 1.16 × 10-5 μg/m³) with School 6 and School 3 having the highest and lowest values respectively. The THR values of the study schools ranged from 0.071-0.086 μg/m³ (a mean of 0.078 μg/m³) with School 3 and School 2 having the highest and lowest values respectively. The results show that all the schools pose a potential carcinogenic risks having CRI values greater than the recommended limit of 1 × 10-6 µg/m³ and no non-carcinogenic risk having THR values less than the USEPA hazard quotient of 1 µg/m³. It is recommended that school authorities should ensure adequate ventilation in their schools, supplementing natural ventilation with mechanical sources, where necessary. In addition, indoor air quality should be taken into consideration in the design and construction of classrooms.

Keywords: carcinogenic risk indicator, health risk, indoor air, non-carcinogenic risk indicator, secondary schools, volatile organic compounds

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Authors: Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas, Fatemeh Rezaei

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Surgical procedures aim at preserving human life and improving quality of their life. However, there are many potential risk sources that can cause serious harm to patients. For centuries, managers believed that technical competence of a surgeon is the only key to a successful surgery. But over the past decade, risks are considered in terms of process-based safety procedures, teamwork and inter departmental communication. Aims: This study aims to determine how the process- biased surgical risk management should be done in terms of project management tool named ABS (Activity Breakdown Structure). Settings and Design: This study was conducted in two stages. First, literature review and meeting with professors was done to determine principles and framework of surgical risk management. Next, responsible teams for surgical patient journey were involved in following meeting to develop the process- biased surgical risk management. Methods and Material: This study is a qualitative research in which focus groups with the inductive approach is used. Sampling was performed to achieve representativeness through intensity sampling biased on experience and seniority. Analysis Method used: context analysis of interviews and consensus themes extracted from FDG meetings discussion was the analysis tool. Results: we developed the patient journey process in 5 main phases, 24 activities and 108 tasks. Then, responsible teams, transposition and allocated places for performing determined. Some activities and tasks themes were repeated in each phases like patient identification and records review because of their importance. Conclusions: Risk management of surgical departments is significant as this facility is the hospital’s largest cost and revenue center. Good communication between surgical team and other clinical teams outside surgery department through process- biased perspective could improve safety of patient under this procedure.

Keywords: risk management, activity breakdown structure (ABS), surgical department, medical sciences

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Authors: Ljiljana Stojković, Manja Zec, Maja Zivkovic, Maja Bundalo, Marija Glibetić, Dragan Alavantić, Aleksandra Stankovic

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Cardiovascular disease (CVD) is associated with alterations in DNA methylation, the latter modulated by dietary polyphenols. The present pilot study (part of the original clinical study registered as NCT02800967 at www.clinicaltrials.gov) aimed to investigate the impact of 4-week daily consumption of polyphenol-rich Aronia melanocarpa juice on Long Interspersed Nucleotide Element-1 (LINE-1) methylation in peripheral blood leukocytes, in subjects (n=34, age of 41.1±6.6 years) at moderate CVD risk, including an increased body mass index, central obesity, high normal blood pressure and/or dyslipidemia. The goal was also to examine whether factors known to affect DNA methylation, such as folate intake levels, MTHFR C677T gene variant, as well as the anthropometric and metabolic parameters, modulated the LINE-1 methylation levels upon consumption of polyphenol-rich Aronia juice. The experimental analysis of LINE-1 methylation was done by the MethyLight method. MTHFR C677T genotypes were determined by the polymerase chain reaction-restriction fragment length polymorphism method. Folate intake was assessed by processing the data from the food frequency questionnaire and repeated 24-hour dietary recalls. Serum lipid profile was determined by using Roche Diagnostics kits. The statistical analyses were performed using the Statistica software package. In women, after vs. before the treatment period, a significant decrease in LINE-1 methylation levels was observed (97.54±1.50% vs. 98.39±0.86%, respectively; P=0.01). The change (after vs. before treatment) in LINE-1 methylation correlated directly with MTHFR 677T allele presence, average daily folate intake and the change in serum low-density lipoprotein cholesterol, while inversely with the change in serum triacylglycerols (R=0.72, R2=0.52, adjusted R2=0.36, P=0.03). The current results imply potential cardioprotective effects of habitual polyphenol-rich Aronia juice consumption achieved through the modifications of DNA methylation pattern in subjects at CVD risk, which should be further confirmed. Hence, the precision nutrition-driven modulations of DNA methylation may become targets for new approaches in the prevention and treatment of CVD.

Keywords: Aronia melanocarpa, cardiovascular risk, LINE-1, methylation, peripheral blood leukocytes, polyphenol

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Authors: Ezgi Nevruz, Kasirga Yildirak, Ashis SenGupta

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Comparing or ranking risks is the main motivating factor behind the human trait of making choices. Cumulative prospect theory (CPT) is a preference theory approach that evaluates perception and bias in decision making under risk and uncertainty. We aim to investigate the aggregate claims of different risk classes in terms of their comparability and amenability to ordering when the impact of risk perception is considered. For this aim, we prioritize the aggregate claims taken as actuarial risks by using various stochastic ordering relations. In order to prioritize actuarial risks, we use stochastic relations such as stochastic dominance and stop-loss dominance that are proposed in the frame of partial order theory. We take into account the dependency of the individual claims exposed to similar environmental risks. At first, we modify the zero-utility premium principle in order to obtain a solution for the stop-loss premium under CPT. Then, we propose a stochastic stop-loss dominance of the aggregate claims and find a relation between the stop-loss dominance and the first-order stochastic dominance under the dependence assumption by using properties of the familiar as well as some emerging multivariate claim distributions.

Keywords: cumulative prospect theory, partial order theory, risk perception, stochastic dominance, stop-loss dominance

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Authors: Sarah Müller-Sägebrecht

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Today’s volatile environment challenges executives to make the right strategic decisions to gain sustainable success. Entrepreneurship scholars postulate mainly positive effects of environmental changes on entrepreneurship behavior, such as developing new business opportunities, promoting ingenuity, and the satisfaction of resource voids. A strategic solution approach to overcome threatening environmental changes and catch new business opportunities is business model innovation (BMI). Although this research stream has gained further importance in the last decade, BMI research is still insufficient. Especially BMI barriers, such as inefficient strategic decision-making processes, need to be identified. Strategic decisions strongly impact organizational future and are, therefore, usually made in groups. Although groups draw on a more extensive information base than single individuals, group-interaction effects can influence the decision-making process - in a favorable but also unfavorable way. Decisions are characterized by uncertainty and risk, whereby their intensity is perceived individually differently. The individual risk-willingness influences which option humans choose. The special nature of strategic decisions, such as in BMI processes, is that these decisions are not made individually but in groups due to their high organizational scope. These groups consist of different personalities whose individual risk-willingness can vary considerably. It is known from group decision theory that these individuals influence each other, observable in different group-interaction effects. The following research questions arise: i) How does group interaction shape BMI decision-making from managers’ perspective? ii) What are the potential interrelations among managers’ risk-willingness, group biases, and BMI decision-making? After conducting 26 in-depth interviews with executives from the manufacturing industry, applied Gioia methodology reveals the following results: i) Risk-averse decision-makers have an increased need to be guided by facts. The more information available to them, the lower they perceive uncertainty and the more willing they are to pursue a specific decision option. However, the results also show that social interaction does not change the individual risk-willingness in the decision-making process. ii) Generally, it could be observed that during BMI decisions, group interaction is primarily beneficial to increase the group’s information base for making good decisions, less than for social interaction. Further, decision-makers mainly focus on information available to all decision-makers in the team but less on personal knowledge. This work contributes to strategic decision-making literature twofold. First, it gives insights into how group-interaction effects influence an organization’s strategic BMI decision-making. Second, it enriches risk-management research by highlighting how individual risk-willingness impacts organizational strategic decision-making. To date, it was known in BMI research that risk aversion would be an internal BMI barrier. However, with this study, it becomes clear that it is not risk aversion that inhibits BMI. Instead, the lack of information prevents risk-averse decision-makers from choosing a riskier option. Simultaneously, results show that risk-averse decision-makers are not easily carried away by the higher risk-willingness of their team members. Instead, they use social interaction to gather missing information. Therefore, executives need to provide sufficient information to all decision-makers to catch promising business opportunities.

Keywords: business model innovation, cognitive biases, group-interaction effects, strategic decision-making, risk-willingness

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Authors: Larry O. Awo, George N. Duru

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There is growing public and mental health concerns over the availability of gambling platforms and shops in Nigeria and the high level of youth involvement in gambling. Early theorizing maintained that gambling involvement driven by the quest for resource gains. However, evidences show that the economic model of gambling tend to explain the involvement of the gambling business owners (sport lottery operators: SLOs) as most gamblers lose more than they win. This loss, according to the law of effect, ought to discourage decisions to gamble. However, the quest to recover loses has often initiated and prolonged gambling sessions. Therefore, the need to investigate mental contemplations (such as counterfactual reasoning (upward versus downward) of what “would, should, or could” have been, and feeling of the illusion of control; IOC) over gambling outcome as risk or protective factors in gambling decisions became pertinent. The present study sought to understand the differential contributions and conditional effects of upward versus downward counterfactual reasoning as pathways through which the association between IOC and gambling decision of Nigerian youths (N = 120, mean age = 18.05, SD = 3.81) could be explained. The study adopted a randomized group design, and data were obtained by means of stimulus material (the Gambling Episode; GE) and self-report measures of IOC and Gambling Decision. One-way analysis of variance (ANOVA) result showed that participants in the upward counterfactual reasoning group (M = 22.08) differed from their colleagues in the downward counterfactual reasoning group (M = 17.33) on the decision to gamble, and this difference was significant [F(1,112) = 23, P < .01]. HAYES PROCESS macro moderation analysis results showed that 1) IOC and upward counterfactual reasoning were positively associated with the decision to gamble (B = 14.21, t = 6.10, p < .01 and B = 7.22, t = 2.07, p < .01), 3) upward counterfactual reasoning did not moderate the association between IOC and gambling decision (p > .05), and 4) downward counterfactual reasoning negatively moderated the association between IOC and gambling decision (B = 07, t = 2.18, p < .05) such that the association was strong at a low level of downward counterfactual, but wane at high levels of downward counterfactual reasoning. The implication of these findings are that IOC and upward counterfactual reasoning were risk factors and promote gambling behavior, while downward counterfactual reasoning protects individuals from gambling activities. Thus, it is concluded that downward counterfactual reasoning strategies should be included in gambling therapy and treatment packages as it could diminish feelings of both IOC and negative feelings of missed positive outcomes and the urge to gamble.

Keywords: counterfactual reasoning, gambling cognition, gambling decision, nigeria, youths

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Authors: Hanan Azzam1, Nashwa Abousamra1, Amany Mansour1, Yaser Abd El-dayem2, , Solafa Elsharawy1

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Background: Inherited thrombophilias are a heterogenous group of conditions which have been implicated in a variety of pregnancy complications. More recently, deficiency of protein Z (PZ) has been liked to pregnancy complications, including preterm delivery. Aim: We designed this study to evaluate the association of inherited thrombophilias including [Protein C (PC), Protein S (PS), Anti thrombin III (ATIII) deficiency and activated protein C (APC) resistance] and protein Z deficiency with a variety of pregnancy complications. Patients and Methods: 60 women with different pregnancy complications, including 20 patients with preeclampsia, 20 patients with intrauterine growth resistance (IUGR), and 20 patients with intrauterine fetal death (IUFD), in addition to 30 healthy pregnant women were recruited for the present study. PC and free PS antigen, ATIII activity, modified functional APC-resistance, and PZ levels were determined. Results: There was no significant association between inherited thrombophilias and complicated pregnancies as regards PC deficiency (p=1.0), AT III and PS deficiency (p=0.312), and APC-resistance (P=0.083). PZ was significantly associated with complicated pregnancies (p=0.012). Patients with protein Z levels below 1.5 µg/ml were considered deficient. Accordingly, we demonstrated protein Z deficiency in 30% of complicated pregnancies (RR 6.0, 95% CI 1.29-27.90;p=0.022), 20% of preeclampsia (RR 3.5, 95% CI 0.57 – 21.28; P = 0.174), 40% of IUGR (RR 9.3 95% CI 1.72-50.61; P = 0.010) and 30% of IUFD (RR 6, 95% CI 1.07 – 33.64; P = 0.042). Conclusions: These findings indicate the absence of association of inherited thrombophilias, including PC, PS, AT III deficiency, and APC resistance with pregnancy complications. However, PZ deficiency is associated with increased risk of pregnancy complications, especially intrauterine growth restriction and intrauterine fetal death.

Keywords: protein C, protein S, thrombophelia, pregnancy, protein Z

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Authors: Siqi Qiu, Yijian Zheng, Xin Guo Ming

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In many reliability and risk analysis, failures of components are supposed to be independent. However, in reality, the ignorance of failure dependencies among components may render the results of reliability and risk analysis incorrect. There are two principal ways to incorporate failure dependencies in system reliability and risk analysis: implicit and explicit methods. In the implicit method, failure dependencies can be modeled by joint probabilities, correlation values or conditional probabilities. In the explicit method, certain types of dependencies can be modeled in a fault tree as mutually independent basic events for specific component failures. In this paper, explicit and implicit methods based on BDD will be proposed to evaluate the reliability of systems considering failure dependencies. The obtained results prove the equivalence of the proposed implicit and explicit methods. It is found that the consideration of failure dependencies decreases the reliability of systems. This observation is intuitive, because more components fail due to failure dependencies. The consideration of failure dependencies helps designers to reduce the dependencies between components during the design phase to make the system more reliable.

Keywords: reliability assessment, risk assessment, failure dependencies, binary decision diagram

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

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

Keywords: hypertension, nephropathy, hemodialysis, diabetes

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Authors: Samuel Carpintero

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Public-private partnerships (PPP) arrangements have emerged all around the world as a response to infrastructure deficits and the need to refurbish existing infrastructure. The motivations of governments for embarking on PPPs for the delivery of public infrastructure are manifold, and include on-time and on-budget delivery as well as access to private project management expertise. The PPP formula has been used by some State governments in United States and Canada, where the participation of private companies in financing and managing infrastructure projects has increased significantly in the last decade, particularly in the transport sector. On the one hand, this paper examines the various ways used in these two countries in the implementation of PPP arrangements, with a particular focus on risk transfer. The examination of risk transfer in this paper is carried out with reference to the following key PPP risk categories: construction risk, revenue risk, operating risk and availability risk. The main difference between both countries is that in Canada the demand risk remains usually within the public sector whereas in the United States this risk is usually transferred to the private concessionaire. The aim is to explore which lessons can be learnt from both models than might be useful for other countries. On the other hand, the paper also analyzes why the Spanish companies have been so successful in winning PPP contracts in North America during the past decade. Contrary to the Latin American PPP market, the Spanish companies do not have any cultural advantage in the case of the United States and Canada. Arguably, some relevant reasons for the success of the Spanish groups are their extensive experience in PPP projects (that dates back to the late 1960s in some cases), their high technical level (that allows them to be aggressive in their bids), and their good position and track-record in the financial markets. The article’s empirical base consists of data provided by official sources of both countries as well as information collected through face-to-face interviews with public and private representatives of the stakeholders participating in some of the PPP schemes. Interviewees include private project managers of the concessionaires, representatives of banks involved as financiers in the projects, and experts in the PPP industry with close knowledge of the North American market. Unstructured in-depth interviews have been adopted as a means of investigation for this study because of its powers to achieve honest and robust responses and to ensure realism in the collection of an overall impression of stakeholders’ perspectives.

Keywords: PPP, concession, infrastructure, construction

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Authors: Lavanya Dharmendran, Shenuka Singh, Sona Baburathanam

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

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

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Authors: Marju Ben Sayed, Shigeko Haruyama

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Among all kinds of natural disaster, the flood is a common feature in rapidly urbanizing Dhaka city. In this research, assessment of flood risk of Dhaka metropolitan area has been investigated by using an integrated approach of GIS, remote sensing and socio-economic data. The purpose of the study is to measure the flooding risk concerning with the flood protection embankment in big flooding events (1988, 1998 and 2004) and urbanization of Dhaka metropolitan zone. In this research, we considered the Dhaka city into two parts; East Dhaka (outside the flood protection embankment) and West Dhaka (inside the flood protection embankment). Using statistical data, we explored the socio-economic status of the study area population by comparing the density of population, land price and income level. We have drawn the cross section profile of the flood protection embankment into three different points for realizing the flooding risk in the study area, especially in the big flooding year (1988, 1998 and 2004). According to the physical condition of the study area, the land use/land cover map has been classified into five classes. Comparing with each land cover unit, historical weather station data and the socio-economic data, the flooding risk has been evaluated. Moreover, we compared between DEM data and each land cover units to find out the relationship with flood. It is expected that, this study could contribute to effective flood forecasting, relief and emergency management for a future flood event in Dhaka city.

Keywords: land use, land cover change, socio-economic, Dhaka city, GIS, flood

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Authors: Liyu Adhi Kasari Sulung

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Poverty has been a major problem in Indonesia. Islamic micro finance (IMF) named Baitul Maal Wat Tamwil (Bmt) plays a prominent role to eradicate this. Indonesia as the biggest muslim country has many successful applied products such as worldwide adopt group-based lending approach, flexible financing for farmers, and gold pawning. The Problems related to these models are operation risk management and internal control system (ICS). A proper ICS will help an organization in preventing the occurrence of bad financing through detecting error and irregularities in its operation. This study aims to seek a proper risk management scheme of credit system in Bmt and internal control system’s rank for every stage. Risk management variables are obtained at the first In-Depth Interview (IDI) and Focus Group Discussion (FGD) with Shariah supervisory boards, boards of directors, and operational managers. Survey was conducted covering nationwide data; West Java, South Sulawesi, and West Nusa Tenggara. Moreover, Content analysis is employed to build the relationship among these variables. Research Findings shows that risk management Characteristics in Indonesia involves ex ante, credit process, and ex post strategies to deal with risk in credit system. Ex-ante control consists of Shariah compliance, survey, group leader reference, and islamic forming orientation. Then, credit process involves saving, collateral, joint liability, loan repayment, and credit installment controlling. Finally, ex-post control includes shariah evaluation, credit evaluation, grace period and low installment provisions. In addition, internal control order sort three stages by its priority; Credit process as first rank, then ex-post control as second, and ex ante control as the last rank.

Keywords: internal control system, islamic micro finance, poverty, risk management

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Authors: Marina Nosik, Irina Rymanova, Sergei Sevostyanihin, Natalya Sergeeva, Alexander Sobkin

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This paper presents results of the survey regarding the awareness about HIV/AIDS among HIV-infected individuals. A questionnaire covering various aspects of HIV-infection was conducted among 110 HIV-infected individuals who attended the G.A. Zaharyan Moscow Tuberculosis Clinic, Department for the treatment of TB patients with HIV. The questionnaire included questions about modes of HIV transmission and preventive measures against HIV/AIDS, as well as questions about age, gender, education, and employment status. The survey revealed that the respondents in the whole had a good knowledge regarding modes of HIV transmission and preventive measures against HIV/AIDS: about 83,6% male respondents and 85,7% female respondents gave accurate answers regarding the HIV-infection. However, the overwhelming majority of the study participants, that is, 88,5% men and 98% women, was quite ignorant about the risk of acquiring HIV through saliva and toothbrush of HIV-infected individual. Though that risk is rather insignificant, it is still biologically possible. And this gap in knowledge needs to be filled. As the study showed another point of concern was the fact, that despite the knowledge of HIV transmission risk through unprotected sex about 40% percent of HIV-positive men and 25% of HIV-positive women did not insist on using condoms with their sexual partners. These findings indicate that there are still some aspects about HIV-infection which needed to be clarified and explained through more detailed and specific educational programmes.

Keywords: AIDS, HIV transmission risks, HIV misconceptions, risk behavior

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Authors: Sajjad Baghernezhad

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Meta-heuristic and hybrid algorithms have high adeer in modeling medical problems. In this study, a neural network was used to predict covid-19 among high-risk and low-risk patients. This study was conducted to collect the applied method and its target population consisting of 550 high-risk and low-risk patients from the Kerman University of medical sciences medical center to predict the coronavirus. In this study, the memetic algorithm, which is a combination of a genetic algorithm and a local search algorithm, has been used to update the weights of the neural network and develop the accuracy of the neural network. The initial study showed that the accuracy of the neural network was 88%. After updating the weights, the memetic algorithm increased by 93%. For the proposed model, sensitivity, specificity, positive predictivity value, value/accuracy to 97.4, 92.3, 95.8, 96.2, and 0.918, respectively; for the genetic algorithm model, 87.05, 9.20 7, 89.45, 97.30 and 0.967 and for logistic regression model were 87.40, 95.20, 93.79, 0.87 and 0.916. Based on the findings of this study, neural network models have a lower error rate in the diagnosis of patients based on individual variables and vital signs compared to the regression model. The findings of this study can help planners and health care providers in signing programs and early diagnosis of COVID-19 or Corona.

Keywords: COVID-19, decision support technique, neural network, genetic algorithm, memetic algorithm

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Authors: Mahla Azimi

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Introduction: Post-bladder catheter infection is a common and significant healthcare-associated infection that affects individuals with indwelling urinary catheters. These infections can lead to various complications, including urinary tract infections (UTIs), bacteremia, sepsis, and increased morbidity and mortality rates. This article aims to provide a comprehensive review of post-bladder catheter infections, including their causes, risk factors, clinical presentation, diagnosis, treatment options, and preventive measures. Causes and Risk Factors: Post-bladder catheter infections primarily occur due to the colonization of microorganisms on the surface of the urinary catheter. The most common pathogens involved are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species. Several risk factors contribute to the development of these infections, such as prolonged catheterization duration, improper insertion technique, poor hygiene practices during catheter care, compromised immune system function in patients with underlying conditions or immunosuppressive therapy. Clinical Presentation: Patients with post-bladder catheter infections may present with symptoms such as fever, chills, malaise, suprapubic pain or tenderness, and cloudy or foul-smelling urine. In severe cases or when left untreated for an extended period of time, patients may develop more severe symptoms like hematuria or signs of systemic infection. Diagnosis: The diagnosis of post-bladder catheter infection involves a combination of clinical evaluation and laboratory investigations. Urinalysis is crucial in identifying pyuria (presence of white blood cells) and bacteriuria (presence of bacteria). A urine culture is performed to identify the causative organism(s) and determine its antibiotic susceptibility profile. Treatment Options: Prompt initiation of appropriate antibiotic therapy is essential in managing post-bladder catheter infections. Empirical treatment should cover common pathogens until culture results are available. The choice of antibiotics should be guided by local antibiogram data to ensure optimal therapy. In some cases, catheter removal may be necessary, especially if the infection is recurrent or associated with severe complications. Preventive Measures: Prevention plays a vital role in reducing the incidence of post-bladder catheter infections. Strategies include proper hand hygiene, aseptic technique during catheter insertion and care, regular catheter maintenance, and timely removal of unnecessary catheters. Healthcare professionals should also promote patient education regarding self-care practices and signs of infection. Conclusion: Post-bladder catheter infections are a significant healthcare concern that can lead to severe complications and increased healthcare costs. Early recognition, appropriate diagnosis, and prompt treatment are crucial in managing these infections effectively. Implementing preventive measures can significantly reduce the incidence of post-bladder catheter infections and improve patient outcomes. Further research is needed to explore novel strategies for prevention and management in this field.

Keywords: post-bladder catheter infection, urinary tract infection, bacteriuria, indwelling urinary catheters, prevention

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Authors: Davaakhuu Vandannyam, Amarsaikhan Dashtseren, Oyungoo Badamdorj

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Background: Shift work and extended working hours are increasing in many industries and organization's in the world. Over a 24 hour period, the circadian clock regulates sleep/wake patterns, body temperature, hormone levels, digestion and many other functions. Depending on the time of day or night, the human body is programmed for periods of wakefulness and sleep, high and low body temperature, high and low digestive activity and so on. Shift work is highly prevalent in industrialized societies (>20%) but, when it includes night work, it has pronounced negative effects on sleep, subjective and physiological sleepiness, performance, accident risk, as well as on health outcomes such as cardiovascular disease and certain forms of cancer. Method: In this cross-sectional field study, 634 shift work and day work nurses from a plant were involved, with participation rate of 100% (634 nurses). The general health questionnaire (GHQ-28) and RLS, ESS, ISI, FSS were used to evaluate the level of insomnia, sleepiness, fatigue and restless legs syndrome, respectively. Results: As a result of research on some indicators of health risks caused from work shift, it was proven that prevalence of restless legs syndrome was at 5.5% and 25.9% are in risk of becoming sick, 42.3% are in fatigue, 3.5% in high stage of insomnia and 27.4% are sleepy on duty. Insomnia of nurses mainly affected from long-hour shift, dissatisfaction, workload, lose of focus and use of coffee. There is sleepiness lies in the workplace due to number of shifts, unsatisfactory performance and emergency calls between shifts. It has been determined that risk of sickness influenced by number of shifts in a month and long hour shift, dissatisfaction and use of coffee and divisions are causing restless legs syndrome. Conclusions: Among the nurses, it was found that the prevalence of insomnia is 31.6%, sleepiness 27.4%, fatigue 42.3%, restless legs syndrome 35% and stress 25.9%. These factors of shift work affecting health tend to go up as working hours increase and more common among shift work nurses.

Keywords: shiftwork, insomnia, sleepiness, restless

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Authors: Pinar Ercan, Bulut Mert

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The baking industry is prone to occupational health challenges like other industries. Workers in bakeries face many hazards in their work environment; hazards have the potential for causing injury, illness or work accidents. Most of these hazards are preventable and arise from the neglect of occupational safety measures. Some bakeries in Izmır Turkey was evaluated according to occupational health and safety. First of all, the production process was evaluated. The survey was administered to a total of 50 employees. The survey consisted of two sections. The first one comprised only demographic questions and items related to job characteristics. The remaining section was assessing the satisfaction and confidence about occupational health and safety in terms of employees consist of a 10-item questionnaire by using HSE (2010) survey with some modifications. Also, hazards, risks and control measures in the bakeries were determined. Risk assessment has been done by the use of '5x5 Risk Assessment Table' for this purpose.

Keywords: bakeries, occupational health and safety, hazards, risks, risk assessment

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