Search results for: risk of type 2 diabetes

Authors: Reni M. Sagayaraj, Anand Gnana S. Selvam, Reynald R. Susainathan

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In this paper, we consider stochastic queueing models for Steady-state behavior of a multi-phase M/M/1 queue in random evolution subject to catastrophe failure. The arrival flow of customers is described by a marked Markovian arrival process. The service times of different type customers have a phase-type distribution with different parameters. To facilitate the investigation of the system we use a generalized phase-type service time distribution. This model contains a repair state, when a catastrophe occurs the system is transferred to the failure state. The paper focuses on the steady-state equation, and observes that, the steady-state behavior of the underlying queueing model along with the average queue size is analyzed.

Keywords: M/G/1 queuing system, multi-phase, random evolution, steady-state equation, catastrophe failure

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Authors: Hacer Sule Gonul, Vedat Uyak

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Intensive use of pesticides in agricultural activity causes mixing of these compounds into water sources with surface flow. Especially after the 1970s, a number of limitations imposed on the use of chlorinated pesticides that have a carcinogenic risk potential and regulatory limit have been established. These chlorinated pesticides discharge to water resources, transport in the water and land environment and accumulation in the human body through the food chain raises serious health concerns. Carbon nanotubes (CNTs) have attracted considerable attention from on all because of their excellent mechanical, electrical, and environmental characteristics. Due to CNT particles' high degree of hydrophobic surfaces, these nanoparticles play critical role in the removal of water contaminants of natural organic matters, pesticides and phenolic compounds in water sources. Health concerns associated with chlorinated pesticides requires the removal of such contaminants from aquatic environment. Although the use of aldrin and atrazine was restricted in our country, repatriation of illegal entry and widespread use of such chemicals in agricultural areas cause increases for the concentration of these chemicals in the water supply. In this study, the compounds of chlorinated pesticides such as aldrin and atrazine compounds would be tried to eliminate from drinking water with carbon nanotube adsorption method. Within this study, 2 different types of CNT would be used including single-wall (SWCNT) and multi-wall (MWCNT) carbon nanotubes. Adsorption isotherms within the scope of work, the parameters affecting the adsorption of chlorinated pesticides in water are considered as pH, contact time, CNT type, CNT dose and initial concentration of pesticides. As a result, under conditions of neutral pH conditions with MWCNT respectively for atrazine and aldrin obtained adsorption capacity of determined as 2.24 µg/mg ve 3.84 µg/mg. On the other hand, the determined adsorption capacity rates for SWCNT for aldrin and atrazine has identified as 3.91 µg/mg ve 3.92 µg/mg. After all, each type of pesticide that provides superior performance in relieving SWCNT particles has emerged.

Keywords: pesticide, drinking water, carbon nanotube, adsorption

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Authors: Despoina Andrioti Bygvraa, Ida-Maja Hassellöv, George Charalambous

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Exhaust gas cleaning systems, also known as scrubbers, are today widely used to allow for the use of High Sulphur Heavy Fuel Oil and still comply with the regulations limiting sulphur content in marine fuels. There are extensive concerns about environmental consequences, especially in the Baltic Sea, from the wide-scale use of scrubbers, as the wash water is acidic (ca pH 3) and contains high concentrations of toxic, carcinogenic, and mutagenic substances. The aim of this feasibility study is to investigate the potential adverse effects on seafarers’ health with the ultimate goal of raising awareness of chemical-related health and safety issues in the shipping environment. The project got funding from the Swedish Foundation. The team will extend previously compiled data on scrubber wash water concentrations of hazardous substances and pH to include the use of strong base in closed-loop scrubbers, and scoping assessment on handling and disposing practices. Based on the findings (a), a systematic review of risk assessment will follow to show the risk of exposures, the establishment of the hazardous levels for human health as well as the respective prevention practices. In addition, the researchers will perform (b) a systematic review to identify facilitators and barriers of the crew on compliance with the safe handling of chemicals. The study will run for 12 months, delivering (a) a risk assessment inventory with risk exposures and (b) a course description of safe handling practices. This feasibility study could provide valuable knowledge on how pollutants found in scrubbers should be considered from a human health perspective to facilitate evidence-based informed decisions in future technology- and policy development to make shipping a safer, healthier, and more attractive workplace.

Keywords: health and safety, seafarers, scrubbers, chemicals, risk exposures

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Authors: Allaeddine Athmani, Abdelhacine Gouasmia, Tiago Ferreira, Romeu Vicente

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Seismic vulnerability assessment of masonry buildings is a fundamental issue even for moderate to low seismic hazard regions. This fact is even more important when dealing with old structures such as those located in Annaba city (Algeria), which the majority of dates back to the French colonial era from 1830. This category of buildings is in high risk due to their highly degradation state, heterogeneous materials and intrusive modifications to structural and non-structural elements. Furthermore, they are usually shelter a dense population, which is exposed to such risk. In order to undertake a suitable seismic risk mitigation strategies and reinforcement process for such structures, it is essential to estimate their seismic resistance capacity at a large scale. In this sense, two seismic vulnerability index methods and damage estimation have been adapted and applied to a pilot-scale building area located in the moderate seismic hazard region of Annaba city: The first one based on the EMS-98 building typologies, and the second one derived from the Italian GNDT approach. To perform this task, the authors took the advantage of an existing data survey previously performed for other purposes. The results obtained from the application of the two methods were integrated and compared using a geographic information system tool (GIS), with the ultimate goal of supporting the city council of Annaba for the implementation of risk mitigation and emergency planning strategies.

Keywords: Annaba city, EMS98 concept, GNDT method, old city center, seismic vulnerability index, unreinforced masonry buildings

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Authors: Jake Tempo, Taylor Smithurst, Jen Leah, Skye Waddingham, Amanda Catlin, Richard Cetti

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Introduction: Percutaneous nephrolithotomy (PCNL) is the gold-standard procedure for removing large or complex renal stones. Many operating positions can be used, and the debate over the ideal position continues. PCNL can be a long procedure during which patients can sustain pressure injuries. These injuries are often underreported in the literature. Interface pressure mapping records the pressure loading between a surface and the patient. High pressures with prolonged loading result in ischaemia, muscle deformation, and reperfusion which can cause skin breakdown and muscular injury. We compared the peak pressure indexes of common PCNL positions to identify positions which may be at high risk of pressure injuries. We hope the data can be used to adapt high-risk positions so that the PPI can be lessened by either adapting the positions or by using adjuncts to lower PPI. Materials and Methods: We placed a 23-year-old male subject in fourteen different PCNL positions while performing interface pressure mapping. The subject was 179 cm with a weight of 63.3 kg, BMI 19.8kg/m². Results: Supine positions had a higher mean PPI (119mmHg (41-137)) compared to prone positions (64mmHg (32-89)) (p=0.046 two tailed t-test). The supine flexed position with a bolster under the flank produced the highest PPI (194mmHg), and this was at the sacrum. Peak pressure indexes >100mmHg were recorded in eight PCNL positions. Conclusion: Supine PCNL positions produce higher PPI than prone PCNL positions. Our study shows where ‘at risk’ bony prominences are for each PCNL position. Surgeons must ensure these areas are protected during prolonged operations.

Keywords: PCNL, pressure ulcer, interface pressure mapping, surgery

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Authors: Pallavi Srivastava, Ajay Singh

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Hematological assay has used for evaluation of blood changes according to its environment. It’s studies employed to evaluate possible eco-toxic risk due to the exposure of chemicals and pesticides in aquatic organisms. Fishes serve as a sensitive bio-indicator, as changes occur in its surrounding environment. The aim of present study has two-folds first we observed that after exposure of two doses of each class of fungicide i.e. 1.11mg/l, 2.23mg/l for Propiconazole and 11.43mg/l, 22.87mg/l for Mancozeb show maximum blood changes. Second we conclude that toxic effects and blood changes induced by Propiconazole is greater than Mancozeb.

Keywords: hematological assay, fungicides, bio-indicator, eco-toxic risk

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Authors: Achsania Hendratmi, Nisful Laila, Fatin Fadhilah Hasib, Puji Sucia Sukmaningrum

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This study aims to compare and see the differences between Islamic bank in Indonesia and Islamic bank in Malaysia using RGEC method (Risk Profile, Good Corporate Governance, Earnings, and Capital). This study examines the comparison in business and social performance of eleven Islamic banks in Indonesia and fifteen Islamic banks in Malaysia. This research used quantitative approach and the collections of data was done by collecting all the annual reports of banks that has been created as a sample over the period 2011-2015. The test result of the Independent Samples T-test and Mann-Whitney Test showed there were differences in the business performance of Islamic Bank in Indonesia and Malaysia as seen from the aspect of Risk profile (FDR), GCG, and Earnings (ROA). Also, there were differences of business and social performance as seen from Earnings (ROE), Capital (CAR), and Sharia Conformity Indicator (PSR and ZR) aspects.

Keywords: business performance, Islamic banks, RGEC, social performance

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Authors: Minna Theres James, Nirmal K Sebastian, Shoubhik Mandal, Pramita Mishra, R Ganesan, P S Anil Kumar

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We report the temperature-dependent evolution of Raman spectra of type-II Dirac semimetal (DSM) NiTe2 (001) in the form of bulk single crystal and a nanoflake (200 nm thick) for the first time. A physical model that can quantitatively explain the evolution of out of plane A1g and in-plane E1g Raman modes is used. The non-linear variation of peak positions of the Raman modes with temperature is explained by anharmonic three-phonon and four-phonon processes along with thermal expansion of the lattice. We also observe prominent effect of electron-phonon coupling from the variation of FWHM of the peaks with temperature, indicating the metallicity of the samples. Raman mode E1 1g corresponding to an in plane vibration disappears on decreasing the thickness from bulk to nanoflake.

Keywords: raman spectroscopy, type 2 dirac semimetal, nickel telluride, phonon-phonon coupling, electron phonon coupling, transition metal dichalcogonide

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Authors: Agoubi Belgacem, Adel Kharroubi

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Geothermal groundwater is the main water source to supply various sectors in El Hamma city, southeastern Tunisia. This region was long the destination of thousands of people from Tunisia and neighboring countries for care and bathing. The main objective of this study is to understand the groundwater mineralization origins and factors that control. The second goal is the appraisal of radon in geothermal groundwater in the study area. For this aim, geothermal groundwater was sampled and collected from different locations (thermal baths and deep wells). Physical parameters were measured and major ions were analyzed. Results reveal three water types. The water first type has Na-Mg-Ca-SO4-Cl facies and T>55°C. The second water type dominated by Na-Ca-Cl-SO4 facies with a temperature < 45 °C. However the third water type is dominated by Ca-SO4-Na-Cl-Mg. The three water types may be controlled by depth and geology. The first represent groundwater from deep aquifer (lower cretaceous), the second type was the shallow aquifer and the first is mixed water from deep and shallow water with a temperature ranging from 45 to 55°C. Measured Radon shows that shallow aquifer has a higher 222Rn concentration (677 to 2903 Bq.m-3) than deep water (203 to 1100 Bq.m-3). R-222 in El Hamma thermal aquifer was controlled by structures, porosity and permeability of aquifers. Geostatistical analyses of hydrogeological data and radon activities confirm the vertical flow and communication between deep and shallow aquifers through vertical faults system.

Keywords: Radon-222, geothermal, water, environment, Tunisia

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Authors: Wan-Ling Chang, Hsiu-Ju Huang, Jui-Hsiu Chang

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In 2004, the Ministry of Foreign Affairs Taiwan launched ‘An Arrangement on Working Holiday Scheme’ with 15 countries including New Zealand, Japan, Canada, Germany, South Korea, Britain, Australia and others. The aim of the scheme is to allow young people to work and study English or other foreign languages. Each year, there are 30,000 Taiwanese youths applied for participating in the working holiday schemes. However, frequent accidents could cause huge medical expenses and post-delivery fee, which are usually unaffordable for most families. Therefore, this study explored the relationship among perceived risk toward working holiday, insurance product knowledge, brand image and insurance purchase intention for Taiwanese youths who plan to apply for working holiday. A survey questionnaire was distributed for data collection. A total of 316 questionnaires were collected for data analyzed. Data were analyzed using descriptive statistics, independent samples T-test, one-way ANOVA, correlation analysis, regression analysis and hierarchical regression methods of analysis and hypothesis testing. The results of this research indicate that perceived risk has a negative influence on insurance purchase intention. On the opposite, product knowledge has brand image has a positive influence on the insurance purchase intention. According to the mentioned results, practical implications were further addressed for insurance companies when developing a future marketing plan.

Keywords: insurance product knowledges, insurance purchase intention, perceived risk, working holiday

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Authors: Nnadi Ezekiel Oluwaseun Ejiofor

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The foundation of this study is the identification of risk variables and their implications on abandoned construction projects in Nigeria. The study's particular goals are to pinpoint the risk factors that lead to the abandonment of public building projects in Nigeria. This study used a hybrid research design that included case studies and descriptive survey research methods. Professionals who work directly in the built environment and are employed by Ministries and Departmental Agencies (MDAs), the public sector, or the private sector are the study's target demographic. This study used a descriptive survey and case study research design to gather data. Nigeria is experiencing a high rate of project abandonment due to housing deficit issues. Factors contributing to this include The study reveals factors contributing to public project abandonment in Abuja FCT include poor cashflow 4.96, inconsistent government policies 4.89, lack of accountability, high corruption, incompetent contractors, non-availability of building materials, lack of utilities, wrong materials, infrastructural facilities, poor planning, and undefined contracts. The study reveals that abandoned projects have a huge impact on the construction industry, such as wastage of resources with a mean value of 3.35, distrust of economic growth, 3.28, and so on. The study found a significant relationship between risk factors and public building construction in Abuja through a T-test value of 0.037, rejecting the null hypothesis and indicating a positive correlation.

Keywords: cost, tetfund, construction projects, public university

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Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

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The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

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Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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Authors: Hamid Fallah

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Asphalt is generally a mixture of stone materials with continuous granulation and a binder, which is usually bitumen. Asphalt is made in different shapes according to its use. The most familiar type of asphalt is hot asphalt or hot asphalt concrete. Stone materials usually make up more than 90% of the asphalt mixture. Therefore, stone materials have a significant impact on the quality of the resulting asphalt. According to the method of application and mixing, asphalt is divided into three categories: hot asphalt, protective asphalt, and cold asphalt. Cold mix asphalt is a mixture of stone materials and mixed bitumen or bitumen emulsion whose raw materials are mixed at ambient temperature. In some types of cold asphalt, the bitumen may be heated as necessary, but other materials are mixed with the bitumen without heating. Protective asphalts are used to make the roadbed impermeable, increase its abrasion and sliding resistance, and also temporarily improve the existing asphalt and concrete surfaces. This type of paving is very economical compared to hot asphalt due to the speed and ease of implementation and the limited need for asphalt machines and equipment. The present article, which is prepared in descriptive library form, introduces asphalt, its types, characteristics, and its application.

Keywords: asphalt, type of asphalt, asphalt concrete, sulfur concrete, bitumen in asphalt, sulfur, stone materials

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Authors: Rebeca V. Tholen, Elaine Bundy

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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

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Authors: Michael Scott Evans, Andrew Smith

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The feeling of fatigue at work could potentially have devastating consequences. The aim of this study was to investigate whether the well-established objective indicator of fatigue – the Fatigue Risk Index (FRI) calculator used by the rail industry is an effective indicator to the number of safety incidents, in which fatigue could have been a contributing factor. The study received ethics approval from Cardiff University’s Ethics Committee (EC.16.06.14.4547). A total of 901 safety incidents were recorded from a single British rail franchise between 1st June 2010 – 31st December 2016, into the Safety Management Information System (SMIS). The safety incident types identified that fatigue could have been a contributing factor were: Signal Passed at Danger (SPAD), Train Protection & Warning System (TPWS) activation, Automatic Warning System (AWS) slow to cancel, failed to call, and station overrun. From the 901 recorded safety incidents, the scheduling system CrewPlan was used to extract the Fatigue Index (FI) score and Risk Index (RI) score of all train drivers on the day of the safety incident. Only the working rosters of 64.2% (N = 578) (550 men and 28 female) ranging in age from 24 – 65 years old (M = 47.13, SD = 7.30) were accessible for analyses. Analysis from all 578 train drivers who were involved in safety incidents revealed that 99.8% (N = 577) of Fatigue Index (FI) scores fell within or below the identified guideline threshold of 45 as well as 97.9% (N = 566) of Risk Index (RI) scores falling below the 1.6 threshold range. Their scores represent good practice within the rail industry. These findings seem to indicate that the current objective indicator, i.e. the FRI calculator used in this study by the British rail franchise was not an effective predictor of train driver’s FI scores and RI scores, as safety incidents in which fatigue could have been a contributing factor represented only 0.2% of FI scores and 2.1% of RI scores. Further research is needed to determine whether there are other contributing factors that could provide a better indication as to why there is such a significantly large proportion of train drivers who are involved in safety incidents, in which fatigue could have been a contributing factor have such low FI and RI scores.

Keywords: fatigue risk index calculator, objective indicator of fatigue, rail industry, safety incident

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Authors: Marek Kuźniewski, Magdalena B. Kaziuk , Danuta Fedak, Paulina Dumnicka, Ewa Stępień, Beata Kuśnierz-Cabala, Władysław Sułowicz

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Background: The high prevalence of cardiovascular morbidity and mortality among patients with chronic kidney disease (CKD) is observed especially in those undergoing dialysis. Osteoprotegerin (OPG) and its ligands, receptor activator of nuclear factor kappa-B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been associated with cardiovascular complications. Our aim was to study their role as cardiovascular risk factors in stage 5 CKD patients. Methods: OPG, RANKL and TRAIL concentrations were measured in 69 hemodialyzed CKD patients and 35 healthy volunteers. In CKD patients, cardiovascular dysfunction was assessed with aortic pulse wave velocity (AoPWV), carotid artery intima-media thickness (CCA-IMT), coronary artery calcium score (CaSc) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentration. Cardiovascular and overall mortality data were collected during a 7-years follow-up. Results: OPG plasma concentrations were higher in CKD patients comparing to controls. Total soluble RANKL was lower and OPG/RANKL ratio higher in patients. Soluble TRAIL concentrations did not differ between the groups and OPG/TRAIL ratio was higher in CKD patients. OPG and OPG/TRAIL positively predicted long-term mortality (all-cause and cardiovascular) in CKD patients. OPG positively correlated with AoPWV, CCA-IMT and NT-proBNP whereas OPG/TRAIL with AoPWV and NT-proBNP. Described relationships were independent of classical and non-classical cardiovascular risk factors, with exception of age. Conclusions: Our study confirmed the role of OPG as a biomarker of cardiovascular dysfunction and a predictor of mortality in stage 5 CKD. OPG/TRAIL ratio can be proposed as a predictor of cardiovascular dysfunction and mortality.

Keywords: osteoprotegerin, tumor necrosis factor-related apoptosis-inducing ligand, receptor activator of nuclear factor kappa-B ligand, hemodialysis, chronic kidney disease, cardiovascular disease

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Authors: Navpreet Kaur, Randhir Singh

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Diabetic neuropathy is one of the most common microvascular complications of diabetes mellitus which affects more than 50% of diabetic patients. The present study targeted oxidative stress mediated nerve damage in diabetic rats using a hydro-alcohol extract of Cucurbita pepo L. (Family: Cucurbitaceae) and its potential in treatment of diabetic neuropathy. Diabetes neuropathy was induced in Wistar rats by injection of streptozotocin (65 mg/kg, i.p.) 15 min after Nicotinamide (230 mg/kg, i.p.) administration. Hydro-alcohol extract of C. pepo seeds was assessed by oral administration at 100, 200 and 400 mg/kg in STZ-nicotinamide induced diabetic rats. Thermal hyperalgesia (Eddy's hot plate and tail immersion), mechanical hyperalgesia (Randall-Selitto) and tactile allodynia (Von Frey hair tests) were evaluated in all groups of streptozotocin diabetic rats to assess the extent of neuropathy. Tissue (sciatic nerve) antioxidant enzymes (SOD, CAT, GSH and LPO) levels were measured along with the formation of AGEs in serum to assess the effect of hydro-alcohol extract of C. pepo in ameliorating oxidative stress. Diabetic rats exhibited significantly decreased tail-flick latency in the tail-immersion test and decreased paw withdrawal threshold in both Randall-Selitto and von-Frey hair test. A decrease in the nociceptive threshold was accompanied by significantly increased oxidative stress in sciatic nerve of diabetic rats. Treatment with the C. pepo hydro-alcohol extract significantly attenuated all the behavioral and biochemical alterations in a dose-dependent manner. C. pepo attenuated the diabetic condition and also reversed neuropathic pain through modulation of oxidative stress and thus it may find application as a possible therapeutic agent against diabetic neuropathy.

Keywords: advanced glycation end products, antioxidant enzymes, cucurbita pepo, hyperglycemia

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Authors: Anna Rinaldi, Pierfrancesco Dellino

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COVID-19 vaccine hesitancy can be observed at different rates in different countries. In June 2021, 1,068 people were surveyed in France and Italy to inquire about individual potential acceptance, focusing on time preferences in a risk-return framework: having the vaccination today, in a month, and in 3 months; perceived risks of vaccination and COVID-19; and expected benefit of the vaccine. A randomized controlled trial was conducted to understand how everyday stimuli like fact-based news about vaccines impact an audience's acceptance of vaccination. The main experiment involved two groups of participants and two different articles about vaccine-related thrombosis taken from two Italian newspapers. One article used a more abstract description and language, and the other used a more anecdotal description and concrete language; each group read only one of these articles. Two other groups were assigned categorization tasks; one was asked to complete a concrete categorization task, and the other an abstract categorization task. Individual preferences for vaccination were found to be variable and unstable over time, and individual choices of accepting, refusing, or delaying could be affected by the way news is written. In order to understand these dynamic preferences, the present work proposes a new model based on seven categories of human behaviors that were validated by a neural network. A treatment effect was observed: participants who read the articles shifted to vaccine hesitancy categories more than participants assigned to other treatments and control. Furthermore, there was a significant gender effect, showing that the type of language leading to a lower hesitancy rate for men is correlated with a higher hesitancy rate for women and vice versa. This outcome should be taken into consideration for an appropriate gender-based communication campaign aimed at achieving herd immunity. The trial was registered at ClinicalTrials.gov NCT05582564 (17/10/2022).

Keywords: vaccine hesitancy, risk elicitation, neural network, covid19

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Authors: M. Keršič, M. Lužnik, J. Lužnik

Abstract:

Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

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Authors: Sergey V. Vinogradov

Abstract:

Coastal communities are presently facing increased vulnerabilities due to rising sea levels and shifts in global climate patterns, a trend expected to escalate in the long run. To address the needs of government entities, the public sector, and private enterprises, there is an urgent need to thoroughly investigate, assess, and manage the present and projected risks associated with coastal flooding, including storm surges, sea level rise, and nuisance flooding. In response to these challenges, a practical approach to evaluating storm surge inundation risks has been developed. This methodology offers an integrated assessment of potential flood risk in targeted coastal areas. The physical modeling framework involves simulating synthetic storms and utilizing hydrodynamic models that align with projected future climate and ocean conditions. Both publicly available and site-specific data form the basis for a risk assessment methodology designed to translate inundation model outputs into statistically significant projections of expected financial and operational consequences. This integrated approach produces measurable indicators of impacts stemming from floods, encompassing economic and other dimensions. By establishing connections between the frequency of modeled flood events and their consequences across a spectrum of potential future climate conditions, our methodology generates probabilistic risk assessments. These assessments not only account for future uncertainty but also yield comparable metrics, such as expected annual losses for each inundation event. These metrics furnish stakeholders with a dependable dataset to guide strategic planning and inform investments in mitigation. Importantly, the model's adaptability ensures its relevance across diverse coastal environments, even in instances where site-specific data for analysis may be limited.

Keywords: climate, coastal, surge, risk

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Authors: Greg Zimmerman

Abstract:

Background: Major depression is a common illness that affects millions of people globally. It is the leading cause of disability and is projected to become the number one cause of the global burden of disease by 2030. Many of those who suffer from depression also suffer from Irritable Bowel Syndrome (IBS). Acupuncture has been shown to help depression. The aim of this study was to investigate the effectiveness of acupuncture in reducing the risk of IBS in patients with depression. Methods: We enrolled patients diagnosed with depression through the Taiwanese National Health Insurance Research Database (NHIRD). Propensity score matching was used to match equal numbers (n=32971) of the acupuncture cohort and no-acupuncture cohort based on characteristics including sex, age, baseline comorbidity, and medication. The Cox regression model was used to compare the hazard ratios (HRs) of IBS in the two cohorts. Results: The basic characteristics of the two groups were similar. The cumulative incidence of IBS was significantly lower in the acupuncture cohort than in the no-acupuncture cohort (Log-rank test, p<0.001). Conclusion: The results provided real-world evidence that acupuncture may have a beneficial effect on IBS risk reduction in patients with depression.

Keywords: acupuncture, depression, irritable bowel syndrome, national health insurance research database, real-world evidence

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Authors: Espinosa Carlos, Nobrega Doris

Abstract:

Children are at high risk for lead (Pb) exposure. The objective of this study was to identify risk factors that contribute to high blood lead (PbB) levels in Venezuelan children. The concentration of PbB was determined in 60 children (ages 4-9 years old), coming from the Michelena sector, Valencia District, Carabobo State. The relationship between these concentrations and socio-economical parameters (A: high quality life; B: fair quality life; C: critic poverty), Pb levels of faucet water (Pb-water) and dust Pb levels of floor (Pb-dust) of their houses, was established. Living areas were classified according to sectors and socio-economical status. Forty [40=66.7%] children resulted with PbB levels above the permissible concentration (LAPC). Average PbB was not significantly higher than the permissible levels. Odds ratio proved that children from status C are 7.28 times more likely to have LAPC of PbB than the ones coming from A or B. Thirty-four percent (34%) of the children with LAPC come from status C which could be considered the most critical status from the exposure risk point of view. The 76,3% of the sampled houses reported VSLP of Pb-water, being the Pb-water average in 35 ± 25.5 ug/L. This average significantly went superior to the permissible limit established by Venezuela and international organisms (10 ug/L). When grouping the results of PbB and Pb-water by sex, were that 50,8% of the children who presented/displayed VSLP of Pb-water and PbB. Was a significant relation (p ≤ 0.05), between masculine sex and the VSLP of PbB and Pb-water (x² = 3,672). In relation to the Pb-Dust analyses, were not statistically significant differences with respect to their permissible limit value (40 ug/pie²). This study shows that by correlating geographical and health data, we can identify 'high risk' areas, leading to a proactive public health action. The results of this study are excellent, in order to take preventive measures for the care from the health. Later studies are suggested predicting main to determine of more conclusive form of levels elevated of PbB in the investigated population.

Keywords: demographic, lead, risk, socio-economical status

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Authors: Aly Kassem, Eman Sapet, Eman Abdelbaset, Hosam Mahmoud

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Objective: Hypertension is an important public health challenge being one of the most common worldwide disease-affecting human. Our aim is to study the clinical characteristics, therapeutic regimens, treatment compliance, and risk factors in a sector of of hypertensive patients at Sohag City. Subject and Methods: A cross sectional study; conducted in Sohag city; it involved 520 patients; males (45.7 %) and females (54.3 %). Their ages ranged between 35-85 years. BP measurements, BMI, blood glucose, Serum creatinine, urine analysis, serum Lipids, blood picture and ECG were done all the studied patients. Results: Hypertension presented more between non-smokers (72.55%), females (54.3%), educated patients (50.99%) and patients with low SES (54.9%). CAD presented in (51.63%) of patients, while laboratory investigations showed hyperglycaemia in (28.7%), anemia in (18.3%), high serum creatinine level in (8.49%) and proteinuria in (10.45%) of patient. Adequate BP control was achieved in (49.67%); older patients had lower adequacy of BP control in spite of the extensive use of multiple-drug therapy. Most hypertensive patients had more than one coexistent CV risk factor. Aging, being a female (54.3%), DM (32.3%), family history of hypertension (28.7%), family history of CAD (25.4%), and obesity (10%) were the common contributing risk factors. ACE-inhibitors were prescribed in (58.16%), Beta-blockers in (34.64%) of the patients. Monotherapy was prescribed for (41.17%) of the patients. (75.81%) of patients had regular use of their drug regimens. (49.67%) only of patients had their condition under control, the number of drugs was inversely related to BP control. Conclusion: Hypertensive patients in Sohag city had a profile of high CV risks, and poor blood pressure control particularly in the elderly. A multidisciplinary approach for routine clinical check-up, follow-up, physicians and patients training, prescribing simple once-daily regimens and encouraging life style modifications are recommended. Anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance.

Keywords: anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance

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Authors: Kevin T. Inks

Abstract:

India’s Brahmaputra River Valley has, since independence, experienced consistent low-intensity guerrilla warfare between ethnic and religious groups. These groups are often organized around perceived ethnic territoriality, and target civilians, communities, and especially migrants belonging to other ethnic and religious groups. Intense flooding and erosion have led to widespread displacement, and disaster relief funds are largely tied to legal land tenure. Displaced residents of informal settlements receive little or no resettlement aid, and their subsequent migration strategies and risk from guerrilla violence are poorly understood. Semi-structured interviews and comprehensive surveys focused on perceptions of risk, efficacy of disaster relief, and migration and adaptation strategies were conducted with households identified as being ‘at-risk’ of catastrophic flooding and erosion in Majuli District, Assam. Interviews with policymakers and government workers were conducted to assess disaster relief efforts in informal settlements, and remote sensing methods were used to identify informal settlement and hydrogeomorphic change. The results show that various ethnic and religious groups have differential strategies and preferences for resettlement. However, these varying strategies are likely to lead to differential levels of risk from guerrilla violence. Members of certain ethnic groups residing in informal settlements, in the absence of resettlement assistance, are more likely to seek out unofficial settlement on land far from the protection of the state and experience greater risk of becoming victims of political violence. As climate change and deforestation are likely to increase the severity of the displacement crisis in the Brahmaputra River Valley, more comprehensive disaster relief and surveying efforts are vital for limiting migration and informal settlement in potential sites of guerrilla warfare.

Keywords: climate, displacement, flooding, India, violence

Procedia PDF Downloads 102

Authors: Merab Mamuladze, Mixeil Lejava, Fadiko Abuselidze

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At present, where most of the soils of Georgia have a small contour, the demand for small-capacity technical means, in particular motoblocks, has increased. Motoblocks perform agricultural work for various purposes, where the work process is performed by the operator, who experiences various magnitudes of vibration, impact, noise, and in general, as a result of long-term work production, causes body damage, dynamic load, and respiratory diseases in people. In the scientific paper, the dependence on the vibration of different types of diesel fuel is investigated in the case of five different revolutions in the internal combustion engine. Studies have shown that fuel and engine speed are the only risk factors that contradict the ISO 5349-2(2004) international standard. The experience of four years of work studies showed that 10% of operators received various types of injuries as a result of working with motoblocks. Experiments also showed that the amount of vibration decreases when the number of revolutions of the engine increases, and in the case of using biodiesel fuel, the damage risk factor is 5-10%, and in the case of using conventional diesel, this indicator has gone up to 20%.

Keywords: engine, vibration, biodiesel, high risk factor, working conditions

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Authors: Maja Andrić, Josip Pečarić

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Over the last five decades, an enormous amount of work has been done on Opial’s integral inequality, dealing with new proofs, various generalizations, extensions and discrete analogs. The Opial inequality is recognized as a fundamental result in the analysis of qualitative properties of solution of differential equations. We use submultiplicative convex functions, appropriate representations of functions and inequalities involving means to obtain generalizations and extensions of certain known multidimensional integral and discrete Opial-type inequalities.

Keywords: Opial's inequality, Jensen's inequality, integral inequality, discrete inequality

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Authors: Zohreh Mohammadi, Jan Kaspar, Peter Lohmander, Robert Marusak, Harald Vacik, Ljusk Ola Eriksson

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Storms are important damaging agents in European forest ecosystems. In the latest decades, significant economic losses in European forestry occurred due to storms. This study investigates the problem of optimal harvest planning when forest stands risk to be felled by storms. One of the most applicable mathematical methods which are being used to optimize forest management is stochastic dynamic programming (SDP). This method belongs to the adaptive optimization class. Sequential decisions, such as harvest decisions, can be optimized based on sequential information about events that cannot be perfectly predicted, such as the future storms and the future states of wind protection from other forest stands. In this paper, stochastic dynamic programming is used to maximize the expected present value of the profits from an area consisting of several forest stands. The region of analysis is the Czech Republic. The harvest decisions, in a particular time period, should be simultaneously taken in all neighbor stands. The reason is that different stands protect each other from possible winds. The optimal harvest age of a particular stand is a function of wind speed and different wind protection effects. The optimal harvest age often decreases with wind speed, but it cannot be determined for one stand at a time. When we consider a particular stand, this stand also protects other stands. Furthermore, the particular stand is protected by neighbor stands. In some forest stands, it may even be rational to increase the harvest age under the influence of stronger winds, in order to protect more valuable stands in the neighborhood. It is important to integrate wind risk in forestry decision-making.

Keywords: Czech republic, forest stands, stochastic dynamic programming, wind risk

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Authors: Tamas Madl

Abstract:

Sudden cardiac death (SCD) constitutes a large proportion of cardiovascular mortalities, provides little advance warning, and the risk is difficult to recognize based on ubiquitous, low cost medical equipment such as the standard, 12-lead, ten second ECG. Autonomic abnormalities have been shown to be strongly predictive of SCD risk; yet current methods are not trivially applicable to the brevity and low temporal and electrical resolution of standard ECGs. Here, we build horizontal visibility graph representations of very short inter-beat interval time series, and perform unsuper- vised representation learning in order to convert these variable size objects into fixed-length vectors preserving similarity rela- tions. We show that such representations facilitate classification into healthy vs. at-risk patients on two different datasets, the Mul- tiparameter Intelligent Monitoring in Intensive Care II and the PhysioNet Sudden Cardiac Death Holter Database. Our results suggest that graph representation learning of heartbeat interval time series facilitates robust classification even in sequences as short as ten seconds.

Keywords: sudden cardiac death, heart rate variability, ECG analysis, time series classification

Procedia PDF Downloads 228

Authors: Daniel Puciato, Piotr Oleśniewicz, Julita Markiewicz-Patkowska, Krzysztof Widawski, Michał Rozpara, Władysław Mynarski, Agnieszka Gawlik, Małgorzata Dębska, Soňa Jandová

Abstract:

Physical activity as a part of people’s everyday life reduces the risk of many diseases, including those induced by lifestyle, e.g. obesity, type 2 diabetes, osteoporosis, coronary heart disease, degenerative arthritis, and certain types of cancer. That refers particularly to professionally active people, including the early senior group working on non-manual positions. The aim of the study is to evaluate the relationship between physical activity and the socio-economic status of non-manual workers from Wroclaw—one of the biggest cities in Poland, a model setting for such investigations in this part of Europe. The crucial problem in the research is to find out the percentage of respondents who meet the health-related recommendations of the World Health Organization (WHO) concerning the volume, frequency, and intensity of physical activity, as well as to establish if the most important socio-economic factors, such as gender, age, education, marital status, per capita income, savings and debt, determine the compliance with the WHO physical activity recommendations. During the research, conducted in 2013, 1,170 people (611 women and 559 men) aged 21–60 years were examined. A diagnostic poll method was applied to collect the data. Physical activity was measured with the use of the short form of the International Physical Activity Questionnaire with extended socio-demographic questions, i.e. concerning gender, age, education, marital status, income, savings or debts. To evaluate the relationship between physical activity and selected socio-economic factors, logistic regression was used (odds ratio statistics). Statistical inference was conducted on the adopted ex ante probability level of p<0.05. The majority of respondents met the volume of physical effort recommended for health benefits. It was particularly noticeable in the case of the examined men. The probability of compliance with the WHO physical activity recommendations was highest for workers aged 21–30 years with secondary or higher education who were single, received highest incomes and had savings. The results indicate the relations between physical activity and socio-economic status in the examined women and men. People with lower socio-economic status (e.g. manual workers) are physically active primarily at work, whereas those better educated and wealthier implement physical effort primarily in their leisure time. Among the investigated subjects, the youngest group of non-manual workers have the best chances to meet the WHO standards of physical activity. The study also confirms that secondary education has a positive effect on the public awareness on the role of physical activity in human life. In general, the analysis of the research indicates that there is a relationship between physical activity and some socio-economic factors of the respondents, such as gender, age, education, marital status, income per capita, and the possession of savings. Although the obtained results cannot be applied for the general population, they show some important trends that will be verified in subsequent studies conducted by the authors of the paper.

Keywords: IPAQ, nonmanual workers, physical activity, socioeconomic factors, WHO

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