Search results for: perceived risk

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

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Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

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Authors: Launcelot McGrath

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The Coronavirus disease 2019 (COVID-19) has spread rapidly around the world, resulting in high mortality rates and very large numbers of people requiring medical treatment in ICU. Management of patient hospitalisation is a critical aspect to control this disease and reduce chaos in the healthcare systems. Remote monitoring provides a solution to protect vulnerable and elderly high-risk patients. Continuous remote monitoring of oxygen saturation, respiratory rate, heart rate, and temperature, etc., provides medical systems with up-to-the-minute information about their patients' statuses. Remote monitoring also limits the spread of infection by reducing hospital overcrowding. This paper examines the potential of remote monitoring for Covid-19 to assist in the rapid identification of patients at risk, facilitate the detection of patient deterioration, and enable early interventions.

Keywords: remote monitoring, patient care, oxygen saturation, Covid-19, hospital management

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Authors: Pierre Mintom, William Djeukeu Asongni, Michelle Moni, William Dakam, Christine Fernande Nyangono Biyegue.

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Background: In order to prevent congestive heart failure, control of hypertension and hypercholesterolemia is necessary because those risk factors frequently occur in combination. Objective: The aim of the study is to determine the prevalence and risk factors of hypertension, hypercholesterolemia and double burden HTA-Hypercholesterolemia in patients with congestive heart failure. Methodology: A database of 98 patients suffering from congestive heart failure was used. The latter were recruited from August 15, 2017, to March 5, 2018, in the Cardiology department of Deido District Hospital of Douala. This database provides information on sociodemographic parameters, biochemical examinations, characteristics of heart failure and food consumption. ESC/ESH and NCEP-ATPIII definitions were used to define Hypercholesterolemia (total cholesterol ≥200mg/dl), Hypertension (SBP≥140mmHg and/or DBP≥90mmHg). Double burden hypertension-hypercholesterolemia was defined as follows: total cholesterol (CT)≥200mg/dl, SBP≥140mmHg and DBP≥90mmHg. Results: The prevalence of hypertension (HTA), hypercholesterolemia (hyperchol) and double burden HTA-Hyperchol were 61.2%, 66.3% and 45.9%, respectively. No sociodemographic factor was associated with hypertension, hypercholesterolemia and double burden, but Male gender was significantly associated (p<0.05) with hypercholesterolemia. HypoHDLemia significantly increased hypercholesterolemia and the double burden by 19.664 times (p=0.001) and 14.968 times (p=0.021), respectively. Regarding dietary habits, the consumption of rice, peanuts and derivatives and cottonseed oil respectively significantly (p<0.05) exposed to the occurrence of hypertension. The consumption of tomatoes, green bananas, corn and derivatives, peanuts and derivatives and cottonseed oil significantly exposed (p<0.05) to the occurrence of hypercholesterolemia. The consumption of palm oil and cottonseed oil exposed the occurrence of the double burden of hypertension-hypercholesterolemia. Consumption of eggs protects against hypercholesterolemia, and consumption of peanuts and tomatoes protects against the double burden. Conclusion: hypercholesterolemia associated with hypertension appears as a complicating factor of congestive heart failure. Key risk factors are mainly diet-based, suggesting the importance of nutritional education for patients. New management protocols emphasizing diet should be considered.

Keywords: risk factors, hypertension, hypercholesterolemia, congestive heart failure

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Authors: Hala M. El-hanbuli, Mohammed F. Darweesh

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The incidence rates of any tumor vary hugely with geographical location. Basal Cell Carcinoma (BCC) is one of the most common skin cancer that has many histopathologic subtypes. Objective: The aim was to study the histopathological features of BCC cases that were received in the Pathology Department, Kasr El-Aini hospital, Cairo University, Egypt during the period from Jan 2004 to Dec 2013 and to evaluate the clinical characters through the patient data available in the request sheets. Methods: Slides and data of BCC cases were collected from the archives of the pathology department, Kasr El-Aini hospital. Revision of all available slides and histological classification of BCC according to WHO (2006) was done. Results: A total number of 310 cases of BCC representing about 65% from the total number of malignant skin tumors examined during the 10-years duration in the department. The age ranged from 8 to 84 years, the mean age was (55.7 ± 15.5). Most of the patients (85%) were above the age of 40 years. There was a slight male predominance (55%). Ulcerated BCC was the most common gross picture (60%), followed by nodular lesion (30%) and finally the ulcerated nodule (10%). Most of the lesions situated in the high-risk sites (77%) where the nose was the most common site (35%) followed by the periocular area (22%), then periauricular (15%) and finally perioral (5%). No lesion was reported outside the head. The tumor size was less than 2 centimeters in 65% of cases, and from 2-5 centimeters in the lesions' greatest dimension in the rest of cases. Histopathological reclassification revealed that the nodular BCC was the most common (68%) followed by the pigmented nodular (18.75%). The histologic high-risk groups represented (7.5%) about half of them (3.75%) being basosquamous carcinoma. The total incidence for multiple BCC and 2nd primary was 12%. Recurrent BCC represented 8%. All of the recurrent lesions of BCC belonged to the histologic high-risk group. Conclusion: Basal Cell Carcinoma is the most common skin cancer in the 10-year survey. Histopathological diagnosis and classification of BCC cases are essential for the determination of the tumor type and its biological behavior.

Keywords: basal cell carcinoma, high risk, histopathological features, statistical analysis

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Authors: Pulak Swain, A. K. Ojha

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Portfolio optimization is based on dealing with the problems of efficient asset allocation. Risk and Expected return are two conflicting criteria in such problems, where the investor prefers the return to be high and the risk to be low. Using multi-objective approach we can solve those type of problems. However the information which we have for the input parameters are generally ambiguous and the input values can fluctuate around some nominal values. We can not ignore the uncertainty in input values, as they can affect the asset allocation drastically. So we use Robust Optimization approach to the problems where the input parameters comes under box uncertainty. In this paper, we solve the multi criteria robust problem with the help of  E- constraint method.

Keywords: portfolio optimization, multi-objective optimization, ϵ - constraint method, box uncertainty, robust optimization

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Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

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Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Leilani Forby, Farid Pazhoohi, Alan Kingstone

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There is abundant research on the nature and content of mind wandering (MW) in neurotypical (NT) adults, however, there is little to no research in these areas on autistic individuals. The objective of the current study was to uncover any differences between low and high autistic trait individuals in their MW. In particular, we examined their attitudes toward, and the themes and temporal dimensions (past, present, future) of, their MW episodes. For our online study, we recruited 518 students (394 women and 124 men), between the ages of 18 and 51 years (M = 20.93, SD = 3.40) from the undergraduate Human Subject Pool at the University of British Columbia. Participants completed the Short Imaginal Processes Inventory (SIPI), which includes the three subscales Positive-Constructive Daydreaming (SIPI-PC), Guilt and Fear of Failure Daydreaming (SIPI-GFF), and Poor Attentional Control (SIPI-PAC). Participants also completed the Past (IPI-past) and Present (IPI-present) subscales of the Imaginal Processes Inventory (IPI), the Deliberate (MW-D) and Spontaneous (MW-S) Mind Wandering scales, the Short Form Perceived Stress Scale (PSS-4), and the 10-item Autism Quotient (AQ-10). Results showed that overall, participant AQ-10 scores were significantly correlated with MW-S, SIPI-GFF, and PSS-4 scores, such that as the number of autistic traits endorsed by participants increased, so did their reports of spontaneous mind wandering, guilt and fear of failure themed day dreaming, and stress levels. This same pattern held for female participants, however, AQ-10 scores were positively correlated with only PSS-4 scores for males. These results suggest that compared to males with autistic traits, MW in females with autistic traits is more similar to individuals with low autistic traits in terms of content and intentionality. Results are discussed in terms of clinical implications, their limitations, and suggested directions for future research.

Keywords: autism, deliberate, mind wandering, spontaneous, perceived stress

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Authors: R. Mofeed, N. Elgendy

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Cinema constructs mind-spaces that reflect inherent human thoughts and emotions. As a representational art, Cinema would introduce comprehensive images of life phenomena in different ways. The term “represent” suggests verity of meanings; bring into presence, replace or typify. In that sense, Cinema may present a phenomenon through direct embodiment, or introduce a substitute image that replaces the original phenomena, or typify it by relating the produced image to a more general category through a process of abstraction. This research is interested in questioning the type of images that Egyptian Cinema introduces to informal urbanism and how these images were conditioned and reshaped in the last twenty years. The informalities/slums phenomenon first appeared in Egypt and, particularly, Cairo in the early sixties, however, this phenomenon was completely ignored by the state and society until the eighties, and furthermore, its evident representation in Cinema was by the mid-nineties. The Informal City represents the illegal housing developments, and it is a fast growing form of urbanization in Cairo. Yet, this expanding phenomenon is still depicted as the minority, exceptional and marginal through the Cinematic lenses. This paper aims at tracing the forms of representations of the urban informalities in the Egyptian Cinema between 1994 and 2014, and how did that affect the popular mind and its perception of these areas. The paper runs two main lines of inquiry; the first traces the phenomena through a chronological and geographical mapping of the informal urbanism has been portrayed in films. This analysis is based on an academic research work at Cairo University in Fall 2014. The visual tracing through maps and timelines allowed a reading of the phases of ignorance, presence, typifying and repetition in the representation of this huge sector of the city through more than 50 films that has been investigated. The analysis clearly revealed the “portrayed image” of informality by the Cinema through the examined period. However, the second part of the paper explores the “perceived image”. A designed questionnaire is applied to highlight the main features of that image that is perceived by both inhabitants of informalities and other Cairenes based on watching selected films. The questionnaire covers the different images of informalities proposed in the Cinema whether in a comic or a melodramatic background and highlight the descriptive terms used, to see which of them resonate with the mass perceptions and affected their mental images. The two images; “portrayed” and “perceived” are then to be encountered to reflect on issues of repetitions, stereotyping and reality. The formulated stereotype of informal urbanism is finally outlined and justified in relation to both production consumption mechanisms of films and the State official vision of informalities.

Keywords: cinema, informal urbanism, popular mind, representation

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Authors: Eva L. Suarez, Daniel E. Meeroff, Yan Yong

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The U.S. Federal Emergency Management Agency (FEMA) developed flood maps based on experts’ experience and estimates of the probability of flooding. Current flood-risk models evaluate flood risk with regional and subjective measures without impact from torrential rain and nuisance flooding at the neighborhood level. Nuisance flooding occurs in small areas in the community, where a few streets or blocks are routinely impacted. This type of flooding event occurs when torrential rainstorm combined with high tide and sea level rise temporarily exceeds a given threshold. In South Florida, this threshold is 1.7 ft above Mean Higher High Water (MHHW). The National Weather Service defines torrential rain as rain deposition at a rate greater than 0.3-inches per hour or three inches in a single day. Data from the Florida Climate Center, 1970 to 2020, shows 371 events with more than 3-inches of rain in a day in 612 months. The purpose of this research is to develop a data-driven method to determine comprehensive analytical damage-avoidance criteria that account for nuisance flood events at the single-family home level. The method developed uses the Failure Mode and Effect Analysis (FMEA) method from the American Society of Quality (ASQ) to estimate the Damage Avoidance (DA) preparation for a 1-day 100-year storm. The Consequence of Nuisance Flooding (CoNF) is estimated from community mitigation efforts to prevent nuisance flooding damage. The Probability of Nuisance Flooding (PoNF) is derived from the frequency and duration of torrential rainfall causing delays and community disruptions to daily transportation, human illnesses, and property damage. Urbanization and population changes are related to the U.S. Census Bureau's annual population estimates. Data collected by the United States Department of Agriculture (USDA) Natural Resources Conservation Service’s National Resources Inventory (NRI) and locally by the South Florida Water Management District (SFWMD) track the development and land use/land cover changes with time. The intent is to include temporal trends in population density growth and the impact on land development. Results from this investigation provide the risk of nuisance flooding as a function of CoNF and PoNF for coastal areas of South Florida. The data-based criterion provides awareness to local municipalities on their flood-risk assessment and gives insight into flood management actions and watershed development.

Keywords: flood risk, nuisance flooding, urban flooding, FMEA

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Authors: Hsin-Chih Lai, Yung-Lung Lee, Yun-Yao Chi, Ching-Yi Horng, Pei-Chih Wu, Hsien-Chang Wang

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Taiwan, a climatically challenged island, has always been keen on the issue of water resource management due to its limitations in water storage. Since water resource management has been the focal point of many adaptations to climate change, there has been a lack of attention on another issue, water quality. This study chooses the Errer River Basin as the experimental focus for water quality in Taiwan. With the Errer River Basin being one of the most polluted rivers in Taiwan, this study observes the effects of climate change on this river over a period of time. Taiwan is also targeted by multiple typhoons every year, the heavy rainfall and strong winds create problems of pollution being carried to different river segments, including into the ocean. This study aims to create an impact and risk assessment on Errer River Basin, to show the connection from climate change to potential extreme events, which in turn could influence water quality and ultimately human health. Using dynamic downscaling, this study narrows the information from a global scale to a resolution of 1 km x 1 km. Then, through interpolation, the resolution is further narrowed into a resolution of 200m x 200m, to analyze the past, present, and future of extreme events. According to different climate change scenarios, this study designs an assessment index on the vulnerability of the Errer River Basin. Through this index, Errer River inhabitants can access advice on adaptations to climate change and act accordingly.

Keywords: climate change, adaptation, water quality, risk assessment

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Authors: Hongmin Chun

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This paper examines corporate cash holdings and their effect on the cost of equity capital. In addition, this study examines the potentially different effects when the firm belongs to chaebol and non-chaebol groups. Chaebol is a South Korean form of business conglomerate. Chaebol is typically global multinationals and owns numerous international enterprises, controlled by a chairman with power over all the operations. The overall empirical result suggests that higher cash holdings are a risk increasing factor which holds for the chaebol group of firms. This result is valid in a battery of robustness tests and 2SLS regressions. In Korea, higher cash holdings represent a risk premium factor that is closely related to the overinvestment and agency problems between managers and shareholders.

Keywords: cash holdings, implied cost of equity capital, chaebol, agency problem

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Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

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Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Correlation, Hypertension, Iraq, Risk factors

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Authors: Mariem Saadi, Sabri Kanzari, Adel Zghibi

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In semi-arid areas like the Kairouan region, the constant irrigation with saline water and the overuse of groundwater resources, soils and aquifers salinization has become an increasing concern. In this study, a methodology has been developed to evaluate the groundwater contamination risk based on the unsaturated zone hydraulic properties. Two soil profiles with different ranges of salinity, one located in the north of the plain and another one in the south of plain (each 30 m deep) and both characterized by direct recharge of the aquifer were chosen. Simulations were conducted with Hydrus-1D code using measured precipitation data for the period 1998-2003 and calculated evapotranspiration for both chosen profiles. Four combinations of initial conditions of water content and salt concentration were used for the simulation process in order to find the best match between simulated and measured values. The success of the calibration of Hydrus-1D allowed the investigation of some scenarios in order to assess the contamination risk under different natural conditions. The aquifer risk contamination is related to the natural conditions where it increased while facing climate change and temperature increase and decreased in the presence of a clay layer in the unsaturated zone. Hydrus-1D was a useful tool to predict the groundwater level and quality in the case of a direct recharge and in the absence of any information related to the soil layers except for the texture.

Keywords: Hydrus-1D, Kairouan, salinization, semi-arid region, solute transport, unsaturated zone

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Authors: Florence Ncube

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This paper examines the military and post-military experiences of soldiers who deserted from the Rwanda Defence Force (RDF) and tried to make a living in South Africa. Because they are deserters, they try to hide their military identity, yet it is simultaneously somewhat coercively ascribed to them by the Rwandan state and can put them in potential danger. The paper attends to the constructions, experiences, practices, and subjective understanding of the deserters’ being in exile to examine how, under circumstances of perceived threat, these men navigate real or perceived state-sponsored surveillance and threat in non-military settings in South Africa where they have become potential political and disciplinary targets. To make sense of the deserters’ experiences in these circumstances, the paper stitches together a number of useful theoretical concepts, including Bourdieu’s (1992) theory of practice and Vigh’s (2009; 2018) concept of social navigation because no single approach can coherently analyze the specificity of this study. Conventional post-military literature privileges an understanding of army desertion as a malignancy and somewhat problematic. Little is known about the military and post-military experiences of deserters who believe that army desertion is in fact a building block towards achieving subjective peace, even in the context of exile. The paper argues that the presence of Rwandan state agents in South Africa strips the context of the exile of its capacity to provide the deserters with peace, safety, and security. This paper recenters army desertion in analyses of militarism, soldiering, and transition in African contexts and complicates commonsense understandings of army desertion which assume that it is entirely problematic. This paper is drawn from an ethnography conducted among 30 junior-rank Rwandan army deserters exiled in Johannesburg and Cape Town. The researcher employed life histories, in-depth interviews, and deep hangouts to collect data.

Keywords: army deserter, military, identity, exile, peacebuilding, South Africa

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Authors: Lidia Sanchis-Marco, Antonio Rubia

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In this paper we analyze the state-dependent risk-spillover in different economic areas. To this end, we apply the quantile regression-based methodology developed in Adams, Füss and Gropp approach to examine the spillover in conditional tails of daily returns of indices of the banking industry in the US, BRICs, Peripheral EMU, Core EMU, Scandinavia, the UK and Emerging Markets. This methodology allow us to characterize size, direction and strength of financial contagion in a network of bilateral exposures to address cross-border vulnerabilities under different states of the economy. The general evidence shows as the spillover effects are higher and more significant in volatile periods than in tranquil ones. There is evidence of tail spillovers of which much is attributable to a spillover from the US on the rest of the analyzed regions, specially on European countries. In sharp contrast, the US banking system show more financial resilience against foreign shocks.

Keywords: spillover effects, Bank Contagion, SDSVaR, expected shortfall, VaR, expectiles

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Authors: Savjot Kaur, Mridula Mahajan, AJS Bhanwer, Santokh Singh, Kawaljit Matharoo

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Background: Disorders of lipid metabolism and genetic predisposition are CAD risk factors. ApoA1 is the apolipoprotein component of anti-atherogenic high density lipoprotein (HDL) particles. The protective action of HDL and ApoA1 is attributed to their central role in reverse cholesterol transport (RCT). Aim: This study was aimed at identifying sequence variations in ApoA1 (-75G>A) and its association with serum ApoA1 levels. Methods: A total of 300 CAD patients and 300 Normal individuals (controls) were analyzed. PCR-RFLP method was used to determine the DNA polymorphism in the ApoA1 gene, PCR products digested with restriction enzyme MspI, followed by Agarose Gel Electrophoresis. Serum apolipoprotein A1 concentration was estimated with immunoturbidimetric method. Results: Deviation from Hardy- Weinberg Equilibrium (HWE) was observed for this gene variant. The A- allele frequency was higher among Coronary Artery disease patients (53.8) compared to controls (45.5), p= 0.004, O.R= 1.38(1.11-1.75). Under recessive model analysis (AA vs. GG+GA) AA genotype of ApoA1 G>A substitution conferred ~1 fold increased risk towards CAD susceptibility (p= 0.002, OR= 1.72(1.2-2.43). With serum ApoA1 levels < 107 A allele frequency was higher among CAD cases (50) as compared to controls (43.4) [p=0.23, OR= 1.2(0.84-2)] and there was zero % occurrence of A allele frequency in individuals with ApoA1 levels > 177. Conclusion: Serum ApoA1 levels were associated with ApoA1 promoter region variation and influence CAD risk. The individuals with the APOA1 -75 A allele confer excess hazard of developing CAD as a result of its effect on low serum concentrations of ApoA1.

Keywords: apolipoprotein A1 (G>A) gene polymorphism, coronary artery disease (CAD), reverse cholesterol transport (RCT)

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Authors: Iulia E. Falcan

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The transition of the European power sector towards a clean, renewable energy (RE) system faces the challenge of meeting power demand in times of low wind speed and low solar radiation, at a reasonable cost. This is likely to be achieved through a combination of 1) energy storage technologies, 2) development of the cross-border power grid, 3) installed overcapacity of RE and 4) dispatchable power sources – such as biomass. This paper uses NASA; derived hourly data on weather patterns of sixteen European countries for the past twenty-five years, and load data from the European Network of Transmission System Operators-Electricity (ENTSO-E), to develop a stochastic optimization model. This model aims to understand the synergies between the four classes of technologies mentioned above and to determine the optimal configuration of the energy technologies portfolio. While this issue has been addressed before, it was done so using deterministic models that extrapolated historic data on weather patterns and power demand, as well as ignoring the risk of an unbalanced grid-risk stemming from both the supply and the demand side. This paper aims to explicitly account for the inherent uncertainty in the energy system transition. It articulates two levels of uncertainty: a) the inherent uncertainty in future weather patterns and b) the uncertainty of fully meeting power demand. The first level of uncertainty is addressed by developing probability distributions for future weather data and thus expected power output from RE technologies, rather than known future power output. The latter level of uncertainty is operationalized by introducing a Conditional Value at Risk (CVaR) constraint in the portfolio optimization problem. By setting the risk threshold at different levels – 1%, 5% and 10%, important insights are revealed regarding the synergies of the different energy technologies, i.e., the circumstances under which they behave as either complements or substitutes to each other. The paper concludes that allowing for uncertainty in expected power output - rather than extrapolating historic data - paints a more realistic picture and reveals important departures from results of deterministic models. In addition, explicitly acknowledging the risk of an unbalanced grid - and assigning it different thresholds - reveals non-linearity in the cost functions of different technology portfolio configurations. This finding has significant implications for the design of the European energy mix.

Keywords: cross-border grid extension, energy storage technologies, energy system transition, stochastic portfolio optimization

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Authors: Beatriz González-rodrigo, Diego Hidalgo-leiva, Omar Flores, Claudia Germoso, Maribel Jiménez-martínez, Laura Navas-sánchez, Belén Orta, Nicola Tarque, Orlando Hernández- Rubio, Miguel Marchamalo, Juan Gregorio Rejas, Belén Benito-oterino

Abstract:

Cities facing seismic hazard necessitate detailed risk assessments for effective urban planning and vulnerability identification, ensuring the safety and sustainability of urban infrastructure. Comprehensive studies involving seismic hazard, vulnerability, and exposure evaluations are pivotal for estimating potential losses and guiding proactive measures against seismic events. However, broad-scale traditional risk studies limit consideration of specific local threats and identify vulnerable housing within a structural typology. Achieving precise results at neighbourhood levels demands higher resolution seismic hazard exposure, and vulnerability studies. This research aims to bolster sustainability and safety against seismic disasters in three Central American and Caribbean capitals. It integrates geospatial techniques and artificial intelligence into seismic risk studies, proposing cost-effective methods for exposure data collection and damage prediction. The methodology relies on prior seismic threat studies in pilot zones, utilizing existing exposure and vulnerability data in the region. Emphasizing detailed building attributes enables the consideration of behaviour modifiers affecting seismic response. The approach aims to generate detailed risk scenarios, facilitating prioritization of preventive actions pre-, during, and post-seismic events, enhancing decision-making certainty. Detailed risk scenarios necessitate substantial investment in fieldwork, training, research, and methodology development. Regional cooperation becomes crucial given similar seismic threats, urban planning, and construction systems among involved countries. The outcomes hold significance for emergency planning and national and regional construction regulations. The success of this methodology depends on cooperation, investment, and innovative approaches, offering insights and lessons applicable to regions facing moderate seismic threats with vulnerable constructions. Thus, this framework aims to fortify resilience in seismic-prone areas and serves as a reference for global urban planning and disaster management strategies. In conclusion, this research proposes a comprehensive framework for seismic risk assessment in high-risk urban areas, emphasizing detailed studies at finer resolutions for precise vulnerability evaluations. The approach integrates regional cooperation, geospatial technologies, and adaptive fragility curve adjustments to enhance risk assessment accuracy, guiding effective mitigation strategies and emergency management plans.

Keywords: assessment, behaviour modifiers, emergency management, mitigation strategies, resilience, vulnerability

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Authors: Dainius Genys, Vylius Leonavicius, Ricardas Krikstolaitis

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Energy security problems in Lithuania are analyzed on a regular basis; however, there is no comprehensive research on the very issue of the concept of public energy security. There is a lack of attention not only to social determinants of perception of energy security, but also a lack of a deeper analysis of the public opinion. This article aims to research the Lithuanian public perception of energy security. Complex tasks were set during the sociological study. Survey questionnaire consisted of different sets of questions: view of energy security (risk perception, political orientation, and energy security; comprehensiveness and energy security); view of energy risks and threats (perception of energy safety factors; individual dependence and burden; disobedience and risk); view of the activity of responsible institutions (energy policy assessment; confidence in institutions and energy security), demographic issues. In this article, we will focus on two aspects: a) We will analyze public opinion on the most important aspects of energy security and social factors influencing them; The hypothesis is made that public perception of energy security is related to value orientations: b) We will analyze how public opinion on energy policy executed by the government and confidence in the government are intertwined with the concept of energy security. Data of the survey, conducted on May 10-19 and June 7-17, 2013, when Seimas and the government consisted of the coalition dominated by Social Democrats with Labor, Order and Justice Parties and the Electoral Action of Poles, were used in this article. It is important to note that the survey was conducted prior to Russia’s occupation of the Crimea.

Keywords: energy security, public opinion, risk, energy threat, energy security policy

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Authors: Yan Ping Chen, Hau Yin Chung

Abstract:

The Ideal Profile Method (IPM) is a newly developed descriptive sensory analysis conducted by consumers without previous training. To perform this test, both the perceived and the ideal intensities from the judgements of consumers on products’ attributes, as well as their hedonic ratings were collected for formulating an ideal product (the most liked one). In addition, Ideal Profile Analysis (IPA) was conducted to check the consistency of the ideal data at both the panel and consumer levels. In this test, 12 commercial plain sufus bought from Hong Kong local market were tested by 113 consumers according to the IPM, and rated on 22 attributes. Principal component analysis was used to profile the perceived and the ideal spaces of tested products. The consistency of ideal data was then checked by IPA. The result showed that most consumers shared a common ideal. It was observed that the sensory product space and the ideal product space were structurally similar. Their first dimensions all opposed products with intense fermented related aroma to products with less fermented related aroma. And the predicted ideal profile (the estimated liking score around 7.0 in a 9.0-point scale) got higher hedonic score than the tested products (the average liking score around 6.0 in a 9.0-point scale). For the majority of consumers (95.2%), the stated ideal product considered as a potential ideal through checking the R2 coefficient value. Among all the tested products, sample-6 was the most popular one with consumer liking percentage around 30%. This product with less fermented and moldy flavour but easier to melt in mouth texture possessed close sensory profile according to the ideal product. This experiment validated that data from untrained consumers could be guided as useful information. Appreciated sensory characteristics could be served as reference in the optimization of the commercial plain sufu.

Keywords: ideal profile method, product development, sensory evaluation, sufu (fermented soybean curd)

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Authors: A. Wahid Uddin

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Obstetric anal sphincter injury carries significant morbidity for a woman and affects the quality of life to the extent of permanent damage to anal sphincter musculature. The study was undertaken in a district general hospital by retrospectively reviewing random 63 case notes of patients diagnosed with a significant third or fourth-degree perineal tear admitted between the year of 2015 to 2018. The observations were collected by a pre-designed questionnaire. All variables were expressed as percentages. The major risk factors noted were nulliparity (37%), instrumental delivery (25%), and birth weight of more than 4 kg (14%). Forceps delivery with or without episiotomy was the major contributing factor (75%). In the majority of the cases (71%), no record of any perineal protection measures undertaken. The study concluded that recommended perineal protection measures should be adopted as a routine practise.

Keywords: forceps, obstetrics, perineal, sphincter

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Authors: Nuha Alamro

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Besides achieving of weight loss, Bariatric surgery (BS) shown metabolic improvement including reduction of cardiovascular disease, insulin resistance and diabetes. This study aimed to measure BS effects on Framingham Risk Score (FRS) and metabolic syndrome (MetS) among patients who underwent BS. Additionally, to determine the effect of BS on TSH among euthyroid obese patients. A Retrospective follow-up study was conducted in King Abdullah Medical City. A total of 160 participants who underwent BS and completed one year of follow ups. Medical history, biochemical, anthropometric, and hormonal parameters were evaluated at baseline and 3-12 months after BS. International Diabetes Federation (IDF) criteria were used to diagnose MetS pre and postoperative. The mean age of participants was 41.9 ± 10.6 with Body Mass Index (BMI) of 48.8 ± 7.3. After 3 months, Systolic, Diastolic blood pressure (SBP, DBP), glycated haemoglobin (HBA1C), Low-density lipoprotein (LDL), cholesterol, triglycerides and Thyroid stimulating hormone (TSH) were significantly decrease (P < 0.001). Significant decrease was seen in Mets, BMI, FRS, SBP, DBP, HBA1C, LDL, triglycerides, cholesterol, liver enzyme, with significant increase in high-density lipoprotein (HDL) level 12 months post-op (P < 0.001). After 1 year, the prevalence of MetS, DM, HTN, FRS were significantly decrease from 72.5%, 43.1%, 78.1%, 11.4 to 16.3%, 9.4%, 22.5% and 5.4, respectively. Besides achieving substantial weight loss, MetS resolution was linked to improvement in cardiovascular risk profile.

Keywords: bariatric surgery, cardiovascular disease, metabolic syndrome, thyroid stimulating hormone

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Authors: Marjan Moradi Fard, Hossein Rassi, Masoud Houshmand

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Aim: Breast cancer is one of the most common cancers affecting the morbidity and mortality of Iranian women. This disease is a result of collective alterations of oncogenes and tumor suppressor genes. Studies have produced conflicting results concerning the role of p53 codon 72 polymorphism (G>C) and miR-146a rs2910164 polymorphism (G>C) on the risk of several cancers; therefore, a research was performed to estimate the association between the p53 codon 72 polymorphism and miR-146a rs2910164 polymorphism in breast cancer. Methods and Materials: A total of 45 archival breast cancer samples from khatam hospital and 40 healthy samples were collected. Verification of each cancer reported in a relative was sought through the pathology reports of the hospital records. Then, DNA extracted from all samples by standard methods and p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes were analyzed using multiplex PCR. The tubules, mitotic activity, necrosis, polymorphism and grade of breast cancer were staged by Nottingham histological grading and immunohistochemical staining of the sections from the paraffin wax embedded tissues for the expression of ER, PR and p53 was carried out using a standard method. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of breast cancer in the study population. In this study, we established that tumors of p53 GG genotype and miR-146a rs2910164 CC genotype exhibited higher mitotic activity, higher polymorphism, lower necrosis, lower tubules, higher ER- and PR-negatives and lower TP53-positives than the other genotypes. Conclusion: The present study provided preliminary evidence that a p53 GG genotype may effect breast cancer risk in the study population, interacting synergistically with miR-146a rs2910164 CC genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with clinical parameters can serve as major risk factors in the early identification of breast cancers.

Keywords: breast cancer, p53 codon 72 polymorphism, miR-146a rs2910164 polymorphism, genotypes

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Authors: Anjali Malik

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This paper presents a review of the literature on behavioral addictions with a particular focus on understanding online gaming habits among adolescents. Extant researches yielded many different sets of antecedent factors for developing pathological online gaming behavior. This paper draws findings from the most-cited publications most closely associated with factors explaining why individuals develop such kind of problematic behavior. What emerges as central to understanding this phenomenon is the presence of multiple variable causes that take into account the individual, the environment and their interaction to explain the risk behavior such as pathological online gaming. In addition to that role of some mediating factors and pull factors has also been discussed, along with the consequences on personal, social and academic performance resulting from such kind of addictive behavior. The paper also makes recommendations for future research including developing a deeper understanding of the phenomena studied here by examining the relative contribution of these multiple-risk contexts.

Keywords: pathological gaming, gaming addiction, adolescents, behavior

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Authors: Norita Ahmad, Reza Barkhi, Xiaobo Xu

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We design an experimental study to learn about the cognitive implications of the use of avatars in a Virtual World (VW) (i.e., Second Life). The results support our proposed model, where a positive flow experience with VW influences the attitude towards VW, in turn influencing intention to use VW. Furthermore, VW flow experience can itself be impacted by perceived peer influence, familiarity with VW, and personality of the individuals behind the avatars in VW.

Keywords: avatar, flow experience, personality type, second life, virtual world

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Authors: Mehrnoosh Abouzari

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Artificial intelligence has covered all areas of human life and has helped or replaced many jobs. One of the areas of application of artificial intelligence in the police is to detect crime, identify the accused or victim and prove the crime. It will play an effective role in implementing preventive justice and creating security in the community, and improving judicial decisions. This will help improve the performance of the police, increase the accuracy of criminal investigations, and play an effective role in preventing crime and high-risk behaviors in society. This article presents and analyzes the capabilities and capacities of artificial intelligence in police and similar examples used worldwide to prove the necessity of using artificial intelligence in the police. The main topics discussed include the performance of artificial intelligence in crime detection and prediction, the risk capacity of criminals and the ability to apply arbitray institutions, and the introduction of artificial intelligence programs implemented worldwide in the field of criminal investigation for police.

Keywords: police, artificial intelligence, forecasting, prevention, software

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Authors: Priyanka Mondal, Santosh K. Sarkar

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The present study investigated the spatiotemporal distribution and ecological risk assessment of trace elements of surface sediments (top 0 - 5 cm; grain size ≤ 0.63 µm) in relevance to sediment quality characteristics along the Ganges River Estuary, India. Sediment samples were collected during ebb tide from intertidal regions covering seven sampling sites of diverse environmental stresses. The elements were analyzed with the help of ICPAES. This positive, mixohaline, macro-tidal estuary has global significance contributing ecological and economic services. Presence of fine-clayey particle (47.03%) enhances the adsorption as well as transportation of trace elements. There is a remarkable inter-metallic variation (mg kg-1 dry weight) in the distribution pattern in the following manner: Al (31801± 15943) > Fe (23337± 7584) > Mn (461±147) > S(381±235) > Zn(54 ±18) > V(43 ±14) > Cr(39 ±15) > As (34±15) > Cu(27 ±11) > Ni (24 ±9) > Se (17 ±8) > Co(11 ±3) > Mo(10 ± 2) > Hg(0.02 ±0.01). An overall trend of enrichment of majority of trace elements was very much pronounced at the site Lot 8, ~ 35km upstream of the estuarine mouth. In contrast, the minimum concentration was recorded at site Gangasagar, mouth of the estuary, with high energy profile. The prevalent variations in trace element distribution are being liable for a set of cumulative factors such as hydrodynamic conditions, sediment dispersion pattern and textural variations as well as non-homogenous input of contaminants from point and non-point sources. In order to gain insight into the trace elements distribution, accumulation, and their pollution status, geoaccumulation index (Igeo) and enrichment factor (EF) were used. The Igeo indicated that surface sediments were moderately polluted with As (0.60) and Mo (1.30) and strongly contaminated with Se (4.0). The EF indicated severe pollution of Se (53.82) and significant pollution of As (4.05) and Mo (6.0) and indicated the influx of As, Mo and Se in sediments from anthropogenic sources (such as industrial and municipal sewage, atmospheric deposition, agricultural run-off, etc.). The significant role of the megacity Calcutta in relevance to the untreated sewage discharge, atmospheric inputs and other anthropogenic activities is worthwhile to mention. The ecological risk for different trace elements was evaluated using sediment quality guidelines, effects range low (ERL), and effect range median (ERM). The concentration of As, Cu and Ni at 100%, 43% and 86% of the sampling sites has exceeded the ERL value while none of the element concentration exceeded ERM. The potential ecological risk index values revealed that As at 14.3% of the sampling sites would pose relatively moderate risk to benthic organisms. The effective role of finer clay particles for trace element distribution was revealed by multivariate analysis. The authors strongly recommend regular monitoring emphasizing on accurate appraisal of the potential risk of trace elements for effective and sustainable management of this estuarine environment.

Keywords: pollution assessment, sediment contamination, sediment quality, trace elements

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Authors: Adebusoye Michael, Anthony Gloria, Fasan Temitope, Jacob Anayo

Abstract:

Background: The culture of fast food consumption has gradually become a common lifestyle in Nigeria especially among young people in urban areas, in spite of the associated adverse health consequences. The adolescent pattern of fast foods consumption and their perception of this practice, as a risk factor for Non-Communicable Diseases (NCDs), have not been fully explored. This study was designed to assess fast food consumption pattern and the perception of it as a risk factor for NCDs among undergraduates of Federal Polytechnic, Bauchi. Methodology: The study was descriptive cross-sectional in design. One hundred and eighty-five students were recruited using systematic random sampling method from the two halls of residence. A structured questionnaire was used to assess the consumption pattern of fast foods. Data collected from the questionnaires were analysed using statistical package for the social sciences (SPSS) version 16. Simple descriptive statistics, such as frequency counts and percentages were used to interpret the data. Results: The age range of respondents was 18-34 years, 58.4% were males, 93.5% singles and 51.4% of their parents were employed. The majority (100%) were aware of fast foods and (75%) agreed to its implications as NCD. Fast foods consumption distribution included meat pie (4.9%), beef roll/ sausage (2.7%), egg roll (13.5%), doughnut (16.2%), noodles(18%) and carbonated drinks (3.8%). 30.3% consumed thrice in a week and 71% attached workload to high consumption of fast food. Conclusion: It was revealed that a higher social pressure from peers, time constraints, class pressure and school programme had the strong influence on high percentages of higher institutions’ students consume fast foods and therefore nutrition educational campaigns for campus food outlets or vendors and behavioural change communication on healthy nutrition and lifestyles among young people are hereby advocated.

Keywords: fast food consumption, Nigerian polytechnic, risk factors, undergraduate

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Authors: Christen Kutz

Abstract:

Objective: The aim of this study is to review a case series of 4 high-level Olympic and Division 1 wrestlers who experienced debilitating posterior circulation ischemic strokes during or after a competitive wrestling event and to identify risk factors, etiology and outcomes of stroke in young, healthy elite wrestlers. Background: Stroke occurs in one in 10,000 people under age 64. In young adults, the most common causes of stroke are cardiac embolism, hypercoagulable state, and vasculopathy. One-third of these strokes occur in young, fit individuals. There is little published literature about ischemic strokes that occur in wrestlers. Based on the nature of wrestling, the risk of injury or dissection to neurovascular structures may be a possible theory, but very few case reports exist. Methodology: 4 wrestlers under the age of 44 with a known history of ischemic stroke participated in individual interviews either in person or virtually. Each of the wrestlers provided their demographic information, wrestling background, clinical presentation at the time of stroke, imaging results, identification of potential risk factors, acute treatment and recovery. Results: 3 white male Division 1 wrestlers (2 Lehigh University, 1 Lock Haven University) and 1 black male 2008 Olympian experienced posterior circulation strokes. Case #1 felt a “pop” while wrestling (lateral medullary infarct, possible vertebral artery dissection); Case #2 awoke with severe vertigo, sweating, and vomiting after wrestling the previous day (left cerebellar infarct, (+) protein S deficiency); Case #3 severe vertigo, ataxia, and sensation of impending doom after wrestling earlier that week (left cerebellar infarct, hypoplastic left vertebral artery (+) anti-cardiolipin antibodies). Case #4 severe dizziness, confusion (left cerebellar stroke, vertebral artery dissection, small PFO). Conclusion: 3 wrestlers were started on anti-platelet therapy, risk factors were modified, and returned to their sport. 1 wrestler was placed on anti-coagulation and retired from competition.

Keywords: stroke, wrestling, Olympic, posterior circulation

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