Search results for: risk factor prevention paradigm

Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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Authors: Cinzia Cruder, Deborah Falla, Francesca Mangili, Laura Azzimonti, Liliana Araujo, Aaron Williamon, Marco Barbero

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Background and aims: According to the existing literature, musicians are at risk to experience a range of musculoskeletal painful conditions. Recently, digital technology has been developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing analysis. Additionally, the association between pain drawing (PD) variables and clinical features in musicians with pain were explored. Materials and Methods: One hundred fifty-eight musicians (90 women and 68 men; age 22.4±3.6 years) were recruited from Swiss and UK conservatoires. Participants were asked to complete a survey including both background musical information and clinical features, the Quick Dash (QD) questionnaire and the digital PDs. Results: Of the 158 participants, 126 musicians (79.7%) reported having pain, with more prevalence in the areas of the neck and shoulders, the lower back and the right arm. The mean of pain extent was 3.1% ±6.5. The mean of QD was larger for musicians showing the presence of pain than for those without pain. Additionally, the results indicated a positive correlation between QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity. Conclusions: The high prevalence of pain among musicians has been confirmed using a digital PD. In addition, positive correlations between pain extent and upper limb disability has been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.

Keywords: pain location, pain extent, musicians, pain drawings

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Authors: Rajan Jakhu, Rohit Mehra

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Radon (²²²Rn) and its decay products are the major sources of natural radiation exposure to general population. The activity concentrations of radon, thoron gasses, and their unattached and attached short-lived progeny in indoor environment of the Jaipur and Ajmer districts of Rajasthan had been calculated via passive measurements using the Pinhole cup dosimeter, deposition based progeny sensors (DRPS/DTPS) and wire mesh capped (DRPS/DTPS) progeny sensors. The results of this study revealed that radon and thoron concentrations (CRn, CTn) are highest in the winter season. The variation of the radon and its decay products are observed to vary seasonally, but these environmental parameters seem not to be affecting the thoron and its decay product concentrations in a regular manner. The average values of the radon and its decay products are maximum in winter and minimum in summer. The equilibrium factor for radon is observed to be 0.50, 0.47 and 0.49 in winter, rainy and summer seasons. The annual average value of the unattached fraction of the radon progeny comes out to be 0.34. On the other hand, the average value of thoron (²²⁰Rn) concentration and its equilibrium factor in the studied area comes to be 74, 39, 45 Bq m⁻³ and 0.07, 0.11, 0.07 respectively for the winter, rainy and summer seasons with the annual average value of the unattached fraction of about 0.18. The annual average radiological dose from exposure to indoor radon and thoron progeny comes out to be 0.88 and 0.78 mSv.

Keywords: equilibrium factor, radon, seasonal variation, thoron, unattached fraction

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Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

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Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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Authors: Nisha Harry, Keshia Sing

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Orientation: The Multifactor Leadership Questionnaire (MLF) and the sense of coherence-29 (SCS) is an effective tools to assess the prevalence and underlying structures of empirically based taxonomies related to leadership and wellbeing. Research purpose: The purpose of the study was to test the psychometric properties of the SCS and Multifactor Leadership Questionnaire (MLQ) to screen for psychological wellness indices within the banking industry in South Africa. Motivation for the study: The contribution of these two instruments for the purpose of determining psychological wellness in a banking work environment is unique. Research design, approach, or method: The sample consisted of (N = 150) financial staff employed in a South African banking organisation. The age of the sample was: 37% (30 -40 yrs), 31% (20-30 yrs), 26% (40- 50 yrs), and 6% (50+yrs), of which 52% were males, 48% were females. The white race group was the majority at 29%, African at 26%, Coloured at 23%, and Indian was 22%. Main findings: Results from the exploratory factor analysis revealed a two-factor structure as the most satisfactory. Confirmatory factor analyses revealed the two-factor model displayed better good of-fit indices. Practical implications: The factor structure of the Sense of Coherence-29 scale (SCS), and the Multifactor Leadership Questionnaire (MLQ), have a value-added focus to determine psychological wellness within banking staff. It is essential to take into account these constructs when developing employee wellness interventions. Contribution/value add: Understanding the psychometric properties of the SCS, the self-reported form, and the MLQ questionnaire contributes to screening psychological wellness indices such as coping within the banking industry in a developing country like South Africa. Leaders are an important part of the implementation process of organisational employee wellness practices.

Keywords: factorial structure, leadership, measurement invariance, psychological wellness, sense of coherence

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Authors: Michael Lognoul

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In April 2021, the European Commission released its AI Act Proposal, which is the first policy proposal at the European Union level to target AI systems comprehensively, in a horizontal manner. This Proposal notably aims to achieve an ecosystem of trust in the European Union, based on the respect of fundamental rights, regarding AI. Among many other requirements, the AI Act Proposal aims to impose several generic transparency obligationson all AI systems to the benefit of natural persons facing those systems (e.g. information on the AI nature of systems, in case of an interaction with a human). The Proposal also provides for more stringent transparency obligations, specific to AI systems that qualify as high-risk, to the benefit of their users, notably on the characteristics, capabilities, and limitations of the AI systems they use. Against that background, this research firstly presents all such transparency requirements in turn, as well as related obligations, such asthe proposed obligations on record keeping. Secondly, it focuses on a legal analysis of their scope of application, of the content of the obligations, and on their practical implications. On the scope of transparency obligations tailored for high-risk AI systems, the research notably notes that it seems relatively narrow, given the proposed legal definition of the notion of users of AI systems. Hence, where end-users do not qualify as users, they may only receive very limited information. This element might potentially raise concern regarding the objective of the Proposal. On the content of the transparency obligations, the research highlights that the information that should benefit users of high-risk AI systems is both very broad and specific, from a technical perspective. Therefore, the information required under those obligations seems to create, prima facie, an adequate framework to ensure trust for users of high-risk AI systems. However, on the practical implications of these transparency obligations, the research notes that concern arises due to potential illiteracy of high-risk AI systems users. They might not benefit from sufficient technical expertise to fully understand the information provided to them, despite the wording of the Proposal, which requires that information should be comprehensible to its recipients (i.e. users).On this matter, the research points that there could be, more broadly, an important divergence between the level of detail of the information required by the Proposal and the level of expertise of users of high-risk AI systems. As a conclusion, the research provides policy recommendations to tackle (part of) the issues highlighted. It notably recommends to broaden the scope of transparency requirements for high-risk AI systems to encompass end-users. It also suggests that principles of explanation, as they were put forward in the Guidelines for Trustworthy AI of the High Level Expert Group, should be included in the Proposal in addition to transparency obligations.

Keywords: aI act proposal, explainability of aI, high-risk aI systems, transparency requirements

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Authors: Steven M. Sanders, April T. Berry, David W. Hollingsworth

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Previous research has shown that veterans have higher rates of mental health concerns compared to non-veteran populations. A potential risk factor for the development of mental health concerns (i.e., depression & anxiety), particularly in Black veterans, is psychological inflexibility. Psychological inflexibility, a component of Acceptance & Commitment Therapy (ACT), is a process by which behavior is expressed in ways that attempt to control emotional and psychological reactions to uncomfortable stimuli and situations rather than by direct contingencies or personal values. The present study explored the relationship between psychological inflexibility, symptoms of depression, and symptoms of anxiety in a sample of 131 Black veterans. Results demonstrated that Black veterans who endorsed psychological inflexibility also endorsed higher levels of both depression and anxiety symptomology. These findings indicate the deleterious consequences of experiencing psychological inflexibility, which could be treated through ACT.

Keywords: psychological flexibility, veteran, black, psychological distress

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Authors: Kuan-Jen Lai, Fang-Yi Lin, Shang-Rong Huang, Yun-Zheng Zeng, Po-Chieh Hsu, Jay Wu

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The normalized glandular dose (DgN) estimates the energy deposition of mammography in clinical practice. The Monte Carlo simulations frequently use uniformly mixed phantom for calculating the conversion factor. However, breast tissues are not uniformly distributed, leading to errors of conversion factor estimation. This study constructed a three-layer phantom to estimated more accurate of normalized glandular dose. In this study, MCNP code (Monte Carlo N-Particles code) was used to create the geometric structure. We simulated three types of target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh), six voltages (25 ~ 35 kVp), six HVL parameters and nine breast phantom thicknesses (2 ~ 10 cm) for the three-layer mammographic phantom. The conversion factor for 25%, 50% and 75% glandularity was calculated. The error of conversion factors compared with the results of the American College of Radiology (ACR) was within 6%. For Rh/Rh, the difference was within 9%. The difference between the 50% average glandularity and the uniform phantom was 7.1% ~ -6.7% for the Mo/Mo combination, voltage of 27 kVp, half value layer of 0.34 mmAl, and breast thickness of 4 cm. According to the simulation results, the regression analysis found that the three-layer mammographic phantom at 0% ~ 100% glandularity can be used to accurately calculate the conversion factors. The difference in glandular tissue distribution leads to errors of conversion factor calculation. The three-layer mammographic phantom can provide accurate estimates of glandular dose in clinical practice.

Keywords: Monte Carlo simulation, mammography, normalized glandular dose, glandularity

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Authors: Ajay Agrawal, Pravin Shah, Shailaja Chhetri, Pappu Rijal

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Background and Objectives: Postpartum hemorrhage (PPH) is a common and occasionally life-threatening complication of labour. Cesarean section (CS) is associated with more blood loss than vaginal delivery. There is a trend for increasing CS rates in both developed and developing countries. This could increase the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of Intravenous Tranexamic Acid (TA) on blood loss during and after elective CS delivery. Materials and Methods: It is a prospective, randomized controlled study. 160 eligible pregnant women of 37 or more POG planned for CS were randomized into two groups either to receive 10ml(1gm) of tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation. Results: The mean estimated blood loss was significantly lower in women treated with TA compared with women in the placebo group (392.13 ml ± 10.06 versus 498.69 ml ± 15.87, respectively; p < 0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the tranexamic acid group than in the control group (0.31 ± 0.18 versus 0.79 ± 0.23, respectively; p < 0.001). Conclusion: Pre-operative use of tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where PPH is a major threat to the life of the mothers, it seems to be a promising option.

Keywords: blood loss, cesarean section, postpartum hemorrhage, tranexamic acid

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Authors: Ebrahim Ghanbari, Mohammad Reza Nematollahi

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Integrating deterministic and probabilistic safety assessment (IDPSA) is one of the most commonly used issues in the field of safety analysis of power plant accident. It has also been recognized today that the role of human error in creating these accidents is not less than systemic errors, so the human interference and system errors in fault and event sequences are necessary. The integration of these analytical topics will be reflected in the frequency of core damage and also the study of the use of water resources in an accident such as the loss of all electrical power of the plant. In this regard, the SBO accident was simulated for the pressurized water reactor in the deterministic analysis issue, and by analyzing the operator's behavior in controlling the accident, the results of the combination of deterministic and probabilistic assessment were identified. The results showed that the best performance of the plant operator would reduce the risk of an accident by 10%, as well as a decrease of 6.82 liters/second of the water sources of the plant.

Keywords: IDPSA, human error, SBO, risk

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Authors: Aysegul Alyamac, Sukru Gulec

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Ankaferd Blood Stopper (ABS) is a plant extract used to stop bleeding caused by injuries and surgical interventions. ABS also involved in wound healing of intestinal mucosal damage due to oxidative stress and inflammation. Inflammatory Bowel Disease (IBD) is a common chronic disorder of the gastrointestinal tract that causes abdominal pain, diarrhea, and gastrointestinal bleeding, and increases the risk of colon cancer. Inflammation is an essential factor in the development of IBD. The various studies have been performed about the physiological effects of ABS; however, ABS dependent mechanism on colonic inflammation has not been elucidated. Thus, the protective effect of ABS on colonic inflammation was investigated in this study. The Caco-2 and RAW 264.7 murine macrophage cells were used as a model of in vitro colonic inflammation. RAW 264.7 cells were treated with lipopolysaccharide (LPS) for 12 hours to induce the inflammation, and a conditional medium was obtained. Caco-2 cells were treated with 15 µl/ml ABS for 4 hours, then incubated with conditional medium and the cells also were incubated with 15 µl/ml ABS and conditional medium together for 4 hours. Tumor necrosis factor alpha (TNF-α) protein levels were targeted in testing inflammatory condition and its level was significantly increased (25 fold, p<0.001) compared to the control group by using Enzyme-Linked Immunosorbent Assay (ELISA) method. The COX-2 mRNA level was used as a marker gene to show the possible anti-inflammatory effect of ABS in Caco-2 cells. RAW cells-derived conditional medium significantly (3.3 fold, p<0.001) induced cyclooxygenase-2 (COX-2) mRNA levels in Caco-2 cells. The pretreatment of Caco-2 cells caused a significant decrease (3.3 fold, p<0.001) in COX-2 mRNA levels relative to conditional medium given group. Furthermore, COX-2 mRNA level was significantly reduced (4,7 fold, p<0.001) in ABS and conditional medium treated group. These results suggest that ABS might have an anti-inflammatory effect in vitro.

Keywords: Ankaferd blood stopper, CaCo-2, colonic inflammation, RAW 264.7

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Authors: Tai Mei Kin, Omar Abdull Kareem

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In light of globalization, educational reform has become a top priority for many countries. However, the task of leading change effectively requires a multidimensional set of competencies. Over the past two decades, technical competencies of principal change leadership have been extensively analysed and discussed. Comparatively, little research has been conducted in Malaysian education context on non-technical competencies or popularly known as emotional intelligence, which is equally crucial for the success of change. This article provides a validation of the Principal Change Leadership Non-Technical Competencies (PCLnTC) Scale, a tool that practitioners can easily use to assess school principals’ level of change leadership non-technical competencies that facilitate change and maximize change effectiveness. The overall coherence of the PCLnTC model was constructed by incorporating three theories: a)the change leadership theory whereby leading change is the fundamental role of a leader; b)competency theory in which leadership can be taught and learned; and c)the concept of emotional intelligence whereby it can be developed, fostered and taught. An exploratory factor analysis (EFA) was used to determine the underlying factor structure of PCLnTC model. Before conducting EFA, five important pilot test approaches were conducted to ensure the validity and reliability of the instrument: a)reviewed by academic colleagues; b)verification and comments from panel; c)evaluation on questionnaire format, syntax, design, and completion time; d)evaluation of item clarity; and e)assessment of internal consistency reliability. A total of 335 teachers from 12 High Performing Secondary School in Malaysia completed the survey. The PCLnTCS with six points Liker-type scale were subjected to Principal Components Analysis. The analysis yielded a three-factor solution namely, a)Interpersonal Sensitivity; b)Flexibility; and c)Motivation, explaining a total 74.326 per cent of the variance. Based on the results, implications for instrument revisions are discussed and specifications for future confirmatory factor analysis are delineated.

Keywords: exploratory factor analysis, principal change leadership non-technical competencies (PCLnTC), interpersonal sensitivity, flexibility, motivation

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Authors: Majid Bayatian, Mohammadreza Ashouri

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Releasing hazardous chemicals is one of the major problems for office buildings in the chemical industry and, therefore, environmental risks are inherent to these environments. The adverse health effects of the airborne concentration of benzene have been a matter of significant concern, especially in oil refineries. The chronic and acute adverse health effects caused by benzene exposure have attracted wide attention. Acute exposure to benzene through inhalation could cause headaches, dizziness, drowsiness, and irritation of the skin. Chronic exposures have reported causing aplastic anemia and leukemia at the occupational settings. Association between chronic occupational exposure to benzene and the development of aplastic anemia and leukemia were documented by several epidemiological studies. Numerous research works have investigated benzene emissions and determined benzene concentration at different locations of the refinery plant and stated considerable health risks. The high cost of industrial control measures requires justification through lifetime health risk assessment of exposed workers and the public. In the present study, a Computational Fluid Dynamics (CFD) model has been proposed to assess the exposure risk of office building around a refinery due to its release of benzene. For simulation, GAMBIT, FLUENT, and CFD Post software were used as pre-processor, processor, and post-processor, and the model was validated based on comparison with experimental results of benzene concentration and wind speed. Model validation results showed that the model is highly validated, and this model can be used for health risk assessment. The simulation and risk assessment results showed that benzene could be dispersion to an office building nearby, and the exposure risk has been unacceptable. According to the results of this study, a validated CFD model, could be very useful for decision-makers for control measures and possibly support them for emergency planning of probable accidents. Also, this model can be used to assess exposure to various types of accidents as well as other pollutants such as toluene, xylene, and ethylbenzene in different atmospheric conditions.

Keywords: health risk assessment, office building, Benzene, numerical simulation, CFD

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Authors: Jacquelene Swanepoel, J. C. Visagie, H. M. Linde

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Purpose: The aim of this article is to investigate the psychosocial risk environment influencing employee behaviour, and subsequently the trust relationship between employer and employee. Design/methodology/approach: The unique nature and commonness of negative acts, such as unsafe behaviour, human errors, poor performance and negligence, also referred to as unsafe practice, are explored. A literature review is formulated to investigate the nature of negative acts or unsafe behaviour. The findings of this study are used to draw comparisons between unsafe behaviour/misconduct and accidents in the workplace and finally conclude how it should be addressed from a labour relations point of view. Findings: The results indicate comparisons between unsafe practice/misconduct and occupational injuries and accidents, as a result of system flaws, human error or psychosocial risk.

Keywords: occupational risks, unsafe practice, misconduct, organisational safety culture, ergonomics, management commitment and leadership, labour relations

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Authors: Teguh Nurhidayat, Nurhamid, Dicky Muslim, Zufialdi Zakaria, Irvan Sophian

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This paper presents the role of climate change as the factor that induces landslide. Case study is located at Lahat Regency, South Sumatera Province, Indonesia. Study area has high economic value of coal reserves (mostly subbituminous – bituminous), which is developable for open pit coal mining in the future. Seams are found in Muara Enim Formation. This formation is at south Sumatera basin which is formed at Tertiary as a result of collision between the indian plate and eurasian plate. South Sumatera basin which is a basin located in back arc basin. This study aims to unravel the relationship between slope stability with different season condition in tropical climate. Undisturbed soil samples were obtained in the field along with other geological data. Laboratory works were carried out to obtain physical and mechanical properties of soils. Methodology to analyze slope stability is bishop method. Bishop methods are used to identify safety factor of slope. Result shows that slopes in rainy season conditions are more prone to landslides than in dry season. In the dry seasons with moisture content is 22.65%, safety factor is 1.28 the slope in stable condition. If rain is approaching with moisture content increasing to 97.8%, the slope began to be critical. On wet condition groundwater levels is increased, followed by γ (unit weight), c (cohesion), and φ (angle of friction) at 18.04, 5,88 kN/m2, and 28,04°, respectively, which ultimately determines the security factor FS to be 1.01 (slope in unstable conditions).

Keywords: rainfall, moisture content, slope analysis, landslide prone

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Authors: Anne Camille P. Balabag, Via B. Cabarda, Ruffa Mae Lomboy, Aira Joyce Nesus

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Nowadays, Filipinos seem to dominate the outsourcing industry, one factor that affects quality service is organization mismanagement. Traditionally, Filipino promotions are based on tenure rather than competence. Seniority refers to a superior rank that an employee holds in an industrial setting based on a position withheld in a company. Yet, seniority also holds the paradigm for Filipino family structures. With this, the researchers believe that Filipinos have a deeper take on seniority, which became the motivation for this study. The researchers wanted to contextualize the Filipino concept of seniority, the perception, and reactions of Filipino employees to its existence, and uncover their relevant experiences within the industrial setting. Following a phenomenological research design, data collected from ten (10) participants with various demographic backgrounds, chosen through purposive sampling, and interviewed utilizing a semi-structured interview and analyzed using thematic analysis revealed seven primary themes: (1) Reality of Tenureship and Competence, (2) Disparity in Age Influence, (3) Special Power of Seniority, (4) Seniority is Necessity, (5) The Filipino Organizational Values, (6) Art of Seniority in Human Resource, and (7) Confessions of the Inner Child. The findings suggest that seniority exists based on a ranking system created through human resource management and mirrored from traditional Filipino values. Also, the researchers identified three Filipino industrial values: respect, pakikipagkapwa-tao (treating others as a fellow human being), and utang na loob (debt of gratitude). Lastly, birth order was found to have direct and indirect effects on their conduct in an industrial context.

Keywords: organizational psychology, human resource management, filipino psychology, industrial values

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Authors: Ali Mortazavi

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The main objective of this research project is to delve into a multitude of geomechanical risks associated with various mining methods employed within the underground mining industry. Controlling geotechnical design parameters and operational factors affecting the selection of suitable mining techniques for a given underground mining condition will be considered from a risk assessment point of view. Important geomechanical challenges will be investigated as appropriate and relevant to the commonly used underground mining methods. Given the complicated nature of rock mass in-situ and complicated boundary conditions and operational complexities associated with various underground mining methods, the selection of a safe and economic mining operation is of paramount significance. Rock failure at varying scales within the underground mining openings is always a threat to mining operations and causes human and capital losses worldwide. Geotechnical design is a major design component of all underground mines and basically dominates the safety of an underground mine. With regard to uncertainties that exist in rock characterization prior to mine development, there are always risks associated with inappropriate design as a function of mining conditions and the selected mining method. Uncertainty often results from the inherent variability of rock masse, which in turn is a function of both geological materials and rock mass in-situ conditions. The focus of this research is on developing a methodology which enables a geomechanical risk assessment of given underground mining conditions. The outcome of this research is a geotechnical risk analysis algorithm, which can be used as an aid in selecting the appropriate mining method as a function of mine design parameters (e.g., rock in-situ properties, design method, governing boundary conditions such as in-situ stress and groundwater, etc.).

Keywords: geomechanical risk assessment, rock mechanics, underground mining, rock engineering

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Authors: Arianna Nativio, Zoran Kapelan, Jan Peter van der Hoek

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Bio-composite materials are becoming increasingly popular in various applications, such as the automotive industry. Usually, bio-composite materials are made from natural resources recovered from plants, now, a new type of bio-composite material has begun to be produced in the Netherlands. This material is made from resources recovered from drinking water treatments (calcite), wastewater treatment (cellulose), and material from surface water management (aquatic plants). Surface water, raw drinking water, and wastewater can be contaminated with pathogens and chemical compounds. Therefore, it would be valuable to develop a framework to assess, monitor, and control the potential risks. Indeed, the goal is to define the major risks in terms of human health, quality of materials, and environment associated with the production and application of these new materials. This study describes the general risk assessment framework, starting with a qualitative risk assessment. The qualitative risk analysis was carried out by using the HAZOP methodology for the hazard identification phase. The HAZOP methodology is logical and structured and able to identify the hazards in the first stage of the design when hazards and associated risks are not well known. The identified hazards were analyzed to define the potential associated risks, and then these were evaluated by using the qualitative Event Tree Analysis. ETA is a logical methodology used to define the consequences for a specific hazardous incidents, evaluating the failure modes of safety barriers and dangerous intermediate events that lead to the final scenario (risk). This paper shows the effectiveness of combining of HAZOP and qualitative ETA methodologies for hazard identification and risk mapping. Then, key risks were identified, and a quantitative framework was developed based on the type of risks identified, such as QMRA and QCRA. These two models were applied to assess human health risks due to the presence of pathogens and chemical compounds such as heavy metals into the bio-composite materials. Thus, due to these contaminations, the bio-composite product, during its application, might release toxic substances into the environment leading to a negative environmental impact. Therefore, leaching tests are going to be planned to simulate the application of these materials into the environment and evaluate the potential leaching of inorganic substances, assessing environmental risk.

Keywords: bio-composite, risk assessment, water reuse, resource recovery

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Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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Authors: T. Varazi, M. Pruidze, M. Kurashvili, N. Gagelidze, M. Sutton

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The complex phytoremediation approach given in the presented work implies joint application of natural sorbents, microorganisms, natural biosurfactants and plants. The approach is based on using the natural mineral composites, microorganism strains with high detoxification abilities, plants-phytoremediators and natural biosurfactants for enhancing the uptake of intermediates of pollutants by plant roots. In this complex strategy of phytoremediation technology, the sorbent serves to uptake and trap the pollutants and thus restrain their emission in the environment. The role of microorganisms is to accomplish the first stage biodegradation of organic contaminants. This is followed by application of a phytoremediation technology through purposeful planting of selected plants. Thus, using of different tools will provide restoration of polluted environment and prevention of toxic compounds’ dissemination from hotbeds of pollution for a considerable length of time. The main idea and novelty of the carried out work is the development of a new approach for the ecological safety. The wide spectrum of contaminants: Organochlorine pesticide – DDT, heavy metal –Cu, oil hydrocarbon (hexadecane) and wax have been used in this work. The presented complex biotechnology is important from the viewpoint of prevention, providing total rehabilitation of soil. It is unique to chemical pollutants, ecologically friendly and provides the control of erosion of soils.

Keywords: bioremediation, phytoremediation, pollutants, soil contamination

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Authors: Bakr Ali Al-Gamrh, Ku Nor Izah B. Ku Ismail

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We investigate the relationship between corporate governance, leverage, risk, and firm performance. We use a firm level panel that spans the period 2008 to 2012 of all listed firms on Abu Dhabi Stock Exchange and Dubai Financial Market. After constructing an index of corporate governance strength, we find a negative effect of corporate governance on firm performance. We, however, discover that corporate governance strength indirectly improves the negative influence of leverage on firm performance in normal times. On the contrary, the results completely reversed when there is a black swan event. Corporate governance strength plays a significantly negative role in moderating the relationship between leverage and firm performance during the financial crisis. We also reveal that corporate governance strength increases firms’ risk and deteriorates performance during crisis. Results provide evidence that corporate governance indirectly plays a completely different role in different time periods.

Keywords: corporate governance, firm performance, risk, leverage, the UAE

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Authors: Ibrahim Mohammed

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Background: Diabetes mellitus is a chronic disease that can cause devastating secondary complications, reducing the quality and length of life as well as increasing medical costs for the patient and society. The guidelines recommend both clinical and preventive strategies for diabetes management and are regularly updated. The aim of the study is to assess the level of adherence of physicians to American Diabetes Association Guidelines. Method: Observational multicenter retrospective study will be conducted among different hospitals in the central region. Patient data will be collected from the records of the last three years (2017- 2020). Records will be selected randomly after a complete randomized design. The study focuses on the management of type 2 according to ADA not changed in the last three updating; those standards; all patients should be taking Metformin 1500 to 2000 mg/day as recommended dose and should be received a high dose of statin if the high risk to ASCVD or moderate statin if not at risk, patients with hypertension and diabetes should taking ACE or ARBS. Result: The study aimed to evaluate the commitment of physicians in the central region to the ADA. Out of the 153 selected patients, only 17 % were able to control their diabetes with an average A1c below 7. ADA stated that to reach the minimum benefit of using Metformin, the daily dose should be between 1500 and 2000 mg. Results showed that 110 patients were on Metformin, where 68% of them were on the recommended dose. ADA recommended the intake of high statin for diabetic patients with ASCVD risk, while diabetic patients without ASCVD risk should be on a moderate statin. Results showed that 61.5% of patients with ASCVD risk were at high statin while only 36% of patients without ASCVD risk were at moderate statin. Results showed that 89 patients have hypertension, and 80% of them are getting ACE/ARBs as recommended by the ADA. Recommendation: It is necessary to implement periodic training courses for some physicians to enhance and update their knowledge.

Keywords: American Diabetic Association, diabetes mellitus, atherosclerotic cardiovascular disease, ACE inhibitors

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Authors: Pichamon Chansuchai

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The study of Thai consumer behavior toward buying goods on the Internet is a survey research. The five-level rating scale and open-ended questionnaire are applied for this research procedure, which has more than 400 random sampling of Thai people aged between 15-40 years old. The summary findings are: The analysis of respondents profile were female 55.3% and male 44.8% , 35.3% aged between 20-30 years old, had been employed 29.5% with average income up to 11,000 baht/month 50.2% and expenditure more than 11,000 baht per month 29.3%. The internet usage behavior of respondents mostly found that objectives of the internet usage are: 1) Communication 93.3% 2) the categories of websites usage was trading 42.8% 3) The marketing mix effected to trading behavior via internet which can be analyzed in term of marketing factor as following: Product focused on product quality was the most influenced factor with average value 4.75. The cheaper price than overview market was the most effect factor to internet shopping with mean value 4.53. The average value 4.67 of the available place that could reduce spending time for shopping. The effective promotion of the buy 1 get 1 was the stimulus factor for internet shopping with mean value 4.60. For hypothesis testing, the different sex has relationship with buying decision. It presented that male and female have vary purchasing decision via internet with value of significant difference 0.05. Furthermore, the variety occupations of respondents related to the use of selected type of website. It also found that the vary of personal occupation effected to the type of website selection dissimilar with value of significant difference 0.05.

Keywords: behavior, internet, consumer, goods

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Authors: R. S. Dinesh Madhavan, M. Logaraj

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Background: Recent studies have documented an increase in the risk of cardiovascular diseases (CVD) and a high rate of progression to hypertension in persons with pre hypertension. The risk factors for the growing burden of cardiovascular diseases especially hypertension, diabetes, overweight or obesity and waist hip ratio are increasing. Much study has not been done on cardiovascular risk factors associated with blood pressure (BP) among college students in Indian population. Objectives: The objective of our study was to estimate the prevalence of prehypertension among male students and to assess the association between prehypertension and risk factors for cardiovascular diseases. Material and Methods: A cross-sectional study was conducted among students of a university situated in the suburban area of Chennai. A total of 403 students was studied which included 200 medical and 203 engineering students. The information on selected socio-demographic variables were collected with the help of pre tested structured questionnaire. Measurements of height, weight, blood pressure and postprandial blood glucose were carried out as per standard procedure. Results: The mean age of the participants was 19.56 ± 1.67years. The mean systolic and diastolic blood pressure were 125.80±10.03 mm of Hg and 78.96 ±11.75mm of Hg. The average intake of fruits and vegetable per week were 4.34 ±3.47days and 6.55±4.39 days respectively. Use of smoke and smokeless tobacco were 27.3% and 3% respectively. About 30.3% of the students consume alcohol. Nearly 45.9 % of them did not practice regular exercise. About 29 % were overweight and 5.7% were obese, 24.8% were with waist circumference above 90 centimeters. The prevalence of pre hypertension and hypertension was 49.6% and 19.1% among male students. The prevalence of pre hypertension was higher in medical students (51.5%) compared to engineering students (47.8%). Higher risk of being pre hypertensive were noted above the age of 20 years (OR=4.32), fruit intake less than 3 days a week (OR= 1.03), smokers (OR= 1.13), alcohol intake (OR=1.56), lack of physical exercise (OR=1.90), BMI of more than 25 kg/m2 (OR=1.99). But statistically significant difference was noted between pre hypertensive and normotensive for age (p<0.0001), lack of physical exercise (p=0.004) and BMI (p=0.015). Conclusion: In conclusion nearly half of the students were pre hypertensive. Higher prevalence of smoking, alcohol intake, lack of physical exercise, overweight and increased waist circumference and postprandial blood sugar more than 140 mg/dl was noted among pre-hypertensive compared to normotensive.

Keywords: cardiovascular diseases, prehypertension, risk factors, undergraduate Students

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Authors: Y. Kamarulzaman, A. Madun, F. D. Yusop, N. Abdullah, N. K. Hoong

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In 2011, the Malaysian Government has initiated a nationwide project called 1BestariNet which will adopt the using of technology in teaching and learning, resulting in the construction of telecommunication towers inside the public schools’ premise. Using qualitative approach, this study investigated public perception of risks associated with the project, particularly the telecommunication towers. Data collection involved observation and in-depth interviews with 22 individuals consist of a segment of public that was anxious about the risks of radio frequency electromagnetic field (RFEMF) which include two employees of telecommunication companies (telcos) and five employees of Government agencies. Observation of the location of the towers at 10 public schools, a public forum, and media reports provide valuable information in our analysis. The study finds that the main concern is related to the health risks. This study also shows that it is not easy for the Government to manage public perception mainly because it involves public trust. We find that risk perception is related with public trust, as well as the perceived benefits and level of knowledge. Efficient communication and continuous engagement with the local communities help to build and maintain public trust, reduce public fear and anxiety, hence mitigating the risk perception among the public.

Keywords: risk perception, risk communication, trust, telecommunication tower, radio frequency electromagnetic field (RFEMF)

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Authors: Jesika A. Walker, Mohammed Aswad, Guy Lacroix, Denis Cousineau

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There is a fundamental disconnect between the experience of time passing and the chronometric units by which time is quantified. Specifically, there appears to be no relationship between the passage of time judgments (PoTJs) and verbal duration estimates at short durations (e.g., < 2000 milliseconds). When a duration is longer than several minutes, however, evidence suggests that a slower feeling of time passing is predictive of overestimation. Might the length of a task moderate the relation between PoTJs and duration estimates? Similarly, the estimation paradigm (prospective vs. retrospective) and the mental effort demanded of a task (task demand) have both been found to influence duration estimates. However, only a handful of experiments have investigated these effects for tasks of long durations, and the results have been mixed. Thus, might the length of a task also moderate the effects of the estimation paradigm and task demand on duration estimates? To investigate these questions, 273 participants performed either an easy or difficult visual and memory search task for either eight or 58 minutes, under prospective or retrospective instructions. Afterward, participants provided a duration estimate in minutes, followed by a PoTJ on a Likert scale (1 = very slow, 7 = very fast). A 2 (prospective vs. retrospective) × 2 (eight minutes vs. 58 minutes) × 2 (high vs. low difficulty) between-subjects ANOVA revealed a two-way interaction between task demand and task duration on PoTJs, p = .02. Specifically, time felt faster in the more challenging task, but only in the eight-minute condition, p < .01. Duration estimates were transformed into RATIOs (estimate/actual duration) to standardize estimates across durations. An ANOVA revealed a two-way interaction between estimation paradigm and task duration, p = .03. Specifically, participants overestimated the task more if they were given prospective instructions, but only in the eight-minute task. Surprisingly, there was no effect of task difficulty on duration estimates. Thus, the demands of a task may influence ‘feeling of time’ and ‘estimation time’ differently, contributing to the existing theory that these two forms of time judgement rely on separate underlying cognitive mechanisms. Finally, a significant main effect of task duration was found for both PoTJs and duration estimates (ps < .001). Participants underestimated the 58-minute task (m = 42.5 minutes) and overestimated the eight-minute task (m = 10.7 minutes). Yet, they reported the 58-minute task as passing significantly slower on a Likert scale (m = 2.5) compared to the eight-minute task (m = 4.1). In fact, a significant correlation was found between PoTJ and duration estimation (r = .27, p <.001). This experiment thus provides evidence for a compensatory effect at longer durations, in which people underestimate a ‘slow feeling condition and overestimate a ‘fast feeling condition. The results are discussed in relation to heuristics that might alter the relationship between these two variables when conditions range from several minutes up to almost an hour.

Keywords: duration estimates, long durations, passage of time judgements, task demands

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Authors: Chao Jen-Chih, Hsu Kuo-Wei

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Climate change and natural disasters take effect on urban development. It has been discussed urban renewals can prevent natural disasters. Integrating green infrastructure and urban renewals may have great effect on adapting the impact of climate change. To highlight the economic value of green infrastructure development on urban renewals, some strategies need to be carry on to reduce environmental impact. A number of urban renewals studies has been conducted on right transfer, financial risk, urban renewal policy, and public participation. Little research has been devoted on the subject of the economic value of green infrastructure development on urban renewals. The purpose of this study is to investigate the affecting factors on the economic value of green infrastructure development on urban renewals. This study will present the benefits of green infrastructure development and summarize the critical factors of green infrastructure develop on urban renewals for real essence and non-real essence on economic value from literature. Our results indicate that factors of housing price, land value, floor area incentive, and facilitation of the construction industry affect the outcome of real essence economic value. Factors of enhancement of urban disaster prevention, improvement of urban environment and landscape, crime reduction, climate control, pollution reduction, biological diversity, health impacts, and leisure space affects the outcome of non-real essence economic value.

Keywords: economic value, green infrastructure, urban renewals, urban development

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Authors: Nnadi Ezekiel Ejiofor

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The construction industry plays a decisive role in the healthy development of any nation. Not only large but even small construction projects contribute to a country’s economic growth. There is a need for good management to ensure successful delivery and sustainability because of the plethora of risks that have resulted in low-profit margins for contractors, cost and schedule overruns, poor quality delivery, and abandoned projects. This research reviewed Capitalization on Sustainable Risk Management. Questionnaires and oral interviews conducted were utilized as means of data collection. One hundred and ninety-eight (198) large construction firms in Nigeria form the population of this study. 15 (fifteen) companies that emanated from merger and acquisition were used for the study. The instruments used for data collection were a researcher-developed structured questionnaire based on a five-point rating scale, interviews, focus group discussion, and secondary sources (bill of quantities and stock and exchange commission). The instrument was validated by two experts in the field. The reliability of the instrument was established by applying the split-half method. Kendall’s coefficient of concordance was used to test the data, and a degree of agreement was obtained. Data were subjected to descriptive statistics and analyzed using analysis of variance, t-test, and SPSS. The identified impacts of capitalization were an increase in turnover (24.5%), improvement in the image (24.5%), risk reduction (20%), business expansion (17.3%), and geographical spread (13.6%). The study strongly advocates the inclusion of risk management evaluation as part of the construction procurement process.

Keywords: capitalization, project delivery, risks, risk management, sustainability

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Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

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Authors: B. K. Umesh Kumar, Waleed Al Shukaili

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Air travel is one of the safest modes of travel. Inflight injuries occur due to various factors such as air turbulence, spillage of hot liquids, and fall of improperly stowed overhead baggage. Injuries occur not only to passengers but also to the flight attendants who are handling the passengers throughout the flight. A retrospective study of all records of crew safety report by the captain of the aircraft for all the flights from 01 Mar 2015 to 31 Mar 2019 in a National Carrier of Middle Eastern country, were analyzed. There was one injury to Flight attendant every 1200 flights. Commonest aircraft involved was Boeing. Inflight phase had 82% of all injuries. 63% of accidents involved female Attendants. Commonest age group involved was from 25-30 years. Cart and container injuries were the commonest and accounted for nearly 62% of the total injuries followed by turbulence. Back injuries were the commonest injuries followed by ankle, shoulder, and burns. Mean days of absence from work seen in shoulder injuries 40 days followed by injuries to back, which accounted for 38 Days. Reduction in injuries to flight attendants can be brought about by proper selection of crew, reduction in cart load. Proper maintenance of cart and container plays a major role in prevention of occupational accidents.

Keywords: flight attendants, in-flight injuries, types of injuries, work related injury prevention

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