Search results for: cardiovascular risk factors in CKD

Authors: R. M. Rajapaksa

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Construction industry is one of the key players in driving the economy of a country to achieve its prosperity. However, a dispute is one of the crucial factors which prevent the completion of construction contracts within the budgeted cost, scheduled time, and accepted quality. Disputes are inevitable in the construction contract. Accordingly, a study has been undertaken to identify the factors affecting contractual disputes in construction projects in Sri Lanka. The study was a mixed approach with major qualitative and minor quantitative. Qualitative study was set in the form of in-depth interviews with eighteen participants, and quantitative study was conducted using a questionnaire with twenty-four respondents from previously implemented projects by the National Water Supply & Drainage Board representing the employer, engineer and the Contractor to identify the factors affecting contractual disputes and to verify most critical factors respectively. Data analysis for qualitative and quantitative studies was carried out by means of transcribing, code & categorizeand average score methods, respectively. The study reveals that there are forty factors affecting the contractual disputes in construction contracts in Sri Lanka. The finding further illustrates that conflicting decisions by inexperience personnel in the higher position of the Employer, ambiguities resulting inadequate descriptions of the preliminary/general items in price schedule, unfair valuation and late confirmation of variations, unfair determination due to lack of experience of the Engineer/Consultant, under certification of progress payments, unfair grant of EOT & application of delay damages, unreasonable claims for variation of works, errors/discrepancies/ambiguities in the contract conditions and discrepancies & errors in designs & specifications are the most critical factors affecting contractual disputes. Finally, the study proposed remedial measures to most critical factors affecting contractual disputes.

Keywords: dispute, contractual, factors, employer, engineer, contractor, construction projects

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Authors: Princes Ann E. Prieto, Denise F. Alpuerto, John Rafael C. Unlayao, Neil Concibido, Monet Concepcion Maguyon-Detras

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Failure Mode and Effects Analysis (FMEA) has been used in the virtual Process Hazard Analysis (PHA) of the Acetone production process through the dehydrogenation of isopropyl alcohol, for which very limited process risk assessment has been published. In this study, the potential failure modes, effects, and possible causes of selected major equipment in the process were identified. During the virtual FMEA mock sessions, the risks in the process were evaluated and recommendations to reduce and/or mitigate the process risks were formulated. The risk was estimated using the calculated risk priority number (RPN) and was classified into four (4) levels according to their effects on acetone production. Results of this study were also used to rank the criticality of equipment in the process based on the calculated criticality rating (CR). Bow tie diagrams were also created for the critical hazard scenarios identified in the study.

Keywords: chemical process safety, failure mode and effects analysis (FMEA), process hazard analysis (PHA), process safety management (PSM)

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Authors: Jaffry Zakaria, Nor Azlina Hasbullah

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The research on water quality based on 'Water Quality Index' (WQI) has been on the run along Kampar River in Perak State of Malaysia. This study was conducted to achieve several key objective that determe the value of the parameters that were studied based on Water Quality Index (WQI). The parameters include Dissolved Oxygen (DO), pH, Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD) and Suspended Solids. In this study, three sampling stations were selected. Through observations from the researchers, several pollutions were found occurring along the research area such as the disposal of waste water directly without treatment from villagers, widespread dumping of solid waste and the development of the surrounding areas that contributed to the pollution of Sungai Kampar in Perak, Malaysia. Sungai Kampar is commonly used for water recreational activities as well as for bathing purposes. Results showed that Sungai Kampar is classified under category III. According to Interim National Water Quality Standard for Malaysia (INWQS), rivers in the third grade are clean but not suitable for river recreational activities. Therefore, there is a requirement to investigate and analysis the water quality of all white water rivers in Malaysia focusing on the area of water activities. The combination of technology and risk management based on risk assessments can help the recreational industry to survive in future.

Keywords: risk assessments, White Water River, water quality index (WQI), Interim National Water Quality Standard for Malaysia (INWQS)

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Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Rendong Cai, Bei Peng, Yanping Dong

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In risk decision making, individuals are found to be susceptible to 'frames': people tend to be risk averse when the choice is described in terms of potential 'gains' (gain frame), whereas they tend to be risk seeking when the same choice is described in terms of potential 'losses' (loss frame); this effect is termed the framing effect. The framing effect has been well documented and some studies even find a developmental reversal in the framing effect: The more experience an individual has in a certain field, the easier for him to be influenced by the frame relevant to the field, resulting in greater decision inconsistency. Recent studies reported that using a foreign language can reduce the framing effect. However, it is not clear whether foreign language use can overcome the developmental reversal in the framing effect. The present study investigated three potential factors that may influence the developmental reversal in the framing effect: specialized knowledge of the participants, the language in which the problem is presented, and the types of problems. The present study examined the decision making behavior of 188 Chinese-English bilinguals who majored in Finance, with a group of 277 English majors as the control group. They were asked to solve a financial problem (experimental condition) and a life problem (control condition). Each problem was presented in one of the following four versions: native language-gain frame, foreign language-gain frame, native language-loss frame, and foreign language-loss frame. Results revealed that for the life problem, under the native condition, both groups were affected by the frame; but under the foreign condition, this framing effect disappeared for the financial majors. This confirmed that foreign language use modulates framing effects in general decision making, which served as an effective baseline. For the financial problem, under the native condition, only the financial major was observed to be influenced by the frame, which was a developmental reversal; under the foreign condition, however, this framing effect disappeared. The results provide further empirical evidence for the universal of the developmental reversal in risky decision making. More importantly, the results suggest that using a foreign language can overcome such reversal, which has implications for the reduction of decision biases in professionals. The findings also shed new light on the complex interaction between general decision-making and bilingualism.

Keywords: the foreign language effect, developmental reversals, the framing effect, bilingualism

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Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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Authors: Manh-Dung Ho, Van-Giap Pham, Van-Doanh Ho, Quang-Thien Tran, Tuan-Anh Tran

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The k0-factors and related nuclear data, i.e. the Q0-factors and effective resonance energies (Ēr) of the selected radionuclides which are used in the k0-based neutron activation analysis (k0-NAA), were critically reviewed to be integrated in the “k0-DALAT” software. The k0- and Q0-factors of some short-lived radionuclides: 46mSc, 110Ag, 116m2In, 165mDy, and 183mW, were experimentally determined at the Dalat research reactor. The other radionuclides selected are: 20F, 36S, 49Ca, 60mCo, 60Co, 75Se, 77mSe, 86mRb, 115Cd, 115mIn, 131Ba, 134mCs, 134Cs, 153Gd, 153Sm, 159Gd, 170Tm, 177mYb, 192Ir, 197mHg, 239U and 239Np. The reviewed data as compared with the literature data were biased within 5.6-7.3% in which the experimental re-determined factors were within 6.1 and 7.3%. The NIST standard reference materials: Oyster Tissue (1566b), Montana II Soil (2711a) and Coal Fly Ash (1633b) were used to validate the new reviewed data showing that the new data gave an improved k0-NAA using the “k0-DALAT” software with a factor of 4.5-6.8% for the investigated radionuclides.

Keywords: neutron activation analysis, k0-based method, k0 factor, Q0 factor, effective resonance energy

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Authors: O. Sunantha, S. Zhenfeng, S. Phattraporn, A. Zeeshan

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The decline of soil organic carbon (SOC) in global agriculture is a critical issue requiring rapid and accurate estimation for informed policymaking. Previous studies have demonstrated the variability of SOC predictors derived from remote sensing data and environmental variables. However, the specific parameters most suitable for accurately estimating SOC in agricultural areas remain unclear. This study utilizes remote sensing data to precisely estimate SOC and identify influential factors in diverse agricultural areas, such as paddy, corn, sugarcane, cassava, and perennial crops. Extreme gradient boosting (XGBoost), random forest (RF), and support vector regression (SVR) models are employed to analyze these factors impact on SOC estimation. The results show key factors influencing SOC estimation include slope, vegetation indices (EVI), spectral reflectance indices (red index, red edge2), temperature, land use, and surface soil moisture, as indicated by their averaged importance scores across XGBoost, RF, and SVR models. Therefore, using different machine learning algorithms for SOC estimation reveals varying influential factors from remote sensing data and environmental variables. This approach emphasizes feature selection, as different machine learning algorithms identify various key factors from remote sensing data and environmental variables for accurate SOC estimation.

Keywords: factors influencing SOC estimation, remote sensing data, environmental variables, machine learning

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Authors: Maher El-Masri, Jamie Crawley, Judy Bornais, Abeer Omar

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Background: Misuse of Emergency Department (ED) for non-urgent healthcare results in unnecessary crowdedness that can result in long ED waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death Objectives: The main purpose of this study was to explore the independent predictors of non-urgent ED visits in Erie St. Clair LHIN. Secondary purposes of the study include comparison of the rates of non-urgent ED visits between urban and rural hospitals Design: A secondary analysis of archived population-based data on 597,373 ED visits in southwestern Ontario Results The results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit ED for non-urgent causes. Non-urgent ED visits during the winter, spring, and fall were 13%, 5.8%, and 7.5%, respectively, lesser than they were during the summer time. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts compared to the day shift. Non-urgent visits were 2.76 times more likely to present to small community hospitals than large community hospitals. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than the decision taken by patients, family member or caretakers. Conclusion: In conclusion, our study highlights a number of important factors that are associated with inappropriate use of ED visits for non-urgent health problems. Knowledge of these factors could be used to address the issue of unnecessary ED crowdedness.

Keywords: emergency department, non-urgent visits, predictors, logistic regression

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Authors: Yuri Teraoka, Cheerawit Rattanapan, Aroonsri Mongkolchati

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This cross sectional analytic study was carried out to determine factors related to protective behavior on indoor pollution among pregnant women in Nakhon Pathom province, Thailand. A total of 319 pregnant women were enrolled at three antenatal care clinics in community hospital. Data were collected using simple random sampling from April 2015 to May 2015 using a structured self-administration questionnaire by well-trained research assistants. The result showed that around 73% pregnant women showed low level of low protective behavior on indoor pollution. Chi-square and multiple logistic regression were used to examine the factors and protective behavior on indoor pollution. After adjusting for confounding factors, this study found that tobacco smoking before pregnancy (AOR=2.15, 95% CI: 0.78-5.95) and low environmental health hazard (AOR=1.94, 95% CI: 1.09-3.49) were significant factors related to protective behavior on indoor pollution among pregnant women (p-value < 0.05). In conclusion, this study suggested that environmental health education campaign and environmental implementation program among pregnant woman are needed.

Keywords: Thailand, environmental health, protective behavior, pregnant women

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Authors: Alaa M. Younis, Ismail S. Ismail, Lamiaa I. Mohamedein, Shimaa F. Ahmed

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Sandy surface sediments collected from fourteen sites along the gulfs of Suez and Aqaba coasts, Egypt were analyzed for heavy metals including Iron, Manganese, Zinc, Chromium, Nickel, Lead, Copper and Cadmium in order to evaluate the pollution status and environmental risk assessment of the study area. The obtained results showed that the concentrations of investigated metals are represented in the following sequence; For Gulf of Aqaba sediments Fe > Mn > Zn > Pb > Cr > Ni > Cu > Cd. While for Gulf of Suez Sediments Fe > Mn > Pb > Zn > Cu > Cr > Ni > Cd. The degree of surface sediment contamination using Geo-accumulation index (I geo) and Metal Pollution Index (MPI) was computed. Higher MPI values were observed at the sites III (Nama Bay) and VIII (Rex Beach). According to Sediment quality guidelines (SQGs) approach, Pb and Cu in the gulf of Suez at station IX (Kabanon Beach) had probably adverse ecological effects to marine organisms.

Keywords: heavy metal, environmental risk, Suez gulf, Aqaba gulf

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Authors: Mitra Sadoughi

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This study presents the knowledge-sharing model based on individual and organizational factors related to faculty members. To achieve this goal, individual and organizational factors were presented through qualitative research in the form of open codes, axial, and selective observations; then, the final model was obtained using structural equation model. Participants included 1,719 faculty members of the Azad Universities, Mazandaran Province, Region 3. The samples related to the qualitative survey included 25 faculty members experienced at teaching and the samples related to the quantitative survey included 326 faculty members selected by multistage cluster sampling. A 72-item questionnaire was used to measure the quantitative variables. The reliability of the questionnaire was 0.93. Its content and face validity was determined with the help of faculty members, consultants, and other experts. For the analysis of quantitative data obtained from structural model and regression, SPSS and LISREL were used. The results showed that the status of knowledge sharing is moderate in the universities. Individual factors influencing knowledge sharing included the sharing of educational materials, perception, confidence and knowledge self-efficiency, and organizational factors influencing knowledge sharing included structural social capital, cognitive social capital, social capital relations, organizational communication, organizational structure, organizational culture, IT infrastructure and systems of rewards. Finally, it was found that the contribution of individual factors on knowledge sharing was more than organizational factors; therefore, a model was presented in which contribution of individual and organizational factors were determined.

Keywords: knowledge sharing, social capital, organizational communication, knowledge self-efficiency, perception, trust, organizational culture

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Authors: Marina Shargorodsky

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Aim: Gestational weight gain (GWG) has been related to altering future weight-gain curves and increased risks of obesity later in life. Obesity may contribute to vascular atherosclerotic changes as well as excess cardiovascular morbidity and mortality observed in these patients. Noninvasive arterial testing, such as ultrasonographic measurement of carotid IMT, is considered a surrogate for systemic atherosclerotic disease burden and is predictive of cardiovascular events in asymptomatic individuals as well as recurrent events in patients with known cardiovascular disease. Currently, there is no consistent evidence regarding the vascular impact of excessive GWG. The present study was designed to investigate the impact of GWG on early atherosclerotic changes during late pregnancy, using intima-media thickness, as well as placental vascular circulation and inflammatory lesions and pregnancy outcomes. Methods: The study group consisted of 59 pregnant women who gave birth and underwent a placental histopathological examination at the Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Israel, in 2019. According to the IOM guidelines the study group has been divided into two groups: Group 1 included 32 women with pregnancy weight gain within recommended range; Group 2 included 27 women with excessive weight gain during pregnancy. The IMT was measured from non-diseased intimal and medial wall layers of the carotid artery on both sides, visualized by high-resolution 7.5 MHz ultrasound (Apogee CX Color, ATL). Placental histology subdivided placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion according to the criteria of the Society for Pediatric Pathology, subdividing placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion, as well as the inflammatory response of maternal and fetal origin. Results: IMT levels differed between groups and were significantly higher in Group 1 compared to Group 2 (0.7+/-0.1 vs 0.6+/-0/1, p=0.028). Multiple linear regression analysis of IMT included variables based on their associations in univariate analyses with a backward approach. Included in the model were pre-gestational BMI, HDL cholesterol and fasting glucose. The model was significant (p=0.001) and correctly classified 64.7% of study patients. In this model, pre-pregnancy BMI remained a significant independent predictor of subclinical atherosclerosis assessed by IMT (OR 4.314, 95% CI 0.0599-0.674, p=0.044). Among placental lesions related to fetal vascular malperfusion, villous changes consistent with fetal thrombo-occlusive disease (FTOD) were significantly higher in Group 1 than in Group 2, p=0.034). In Conclusion, the present study demonstrated that excessive weight gain during pregnancy is associated with an adverse effect on early stages of subclinical atherosclerosis, placental vascular circulation and neonatal complications. The precise mechanism for these vascular changes, as well as the overall clinical impact of weight control during pregnancy on IMT, placental vascular circulation as well as pregnancy outcomes, deserves further investigation.

Keywords: obesity, pregnancy, complications, weight gain

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Authors: Mohammad Rajabalinejad

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Safety is often seen as a requirement or a performance indicator through the design process, and this does not always result in optimally safe products or systems. This paper suggests integrating the best safety practices with the design process to enrich the exploration experience for designers and add extra values for customers. For this purpose, the commonly practiced safety standards and design methods have been reviewed and their common blocks have been merged forming Safety Cube. Safety Cube combines common blocks for design, hazard identification, risk assessment and risk reduction through an integral approach. An example application presents the use of Safety Cube for design of machinery.

Keywords: safety, safety cube, product, system, machinery, design

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Authors: Ayantika Biswas

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Hypertension still remains one of the most important preventable contributors to adult mortality and morbidity and a major public health challenge worldwide. Studying regional and rural-urban differences in prevalence and assessment of the contributions of different indicators is essential in determining the drivers of this condition. The 2015-16 National Family Health Survey data has been used for the study. Bivariate analysis, multinomial regression analysis, concentration indices and decomposition of concentration indices assessing contribution of factors has been undertaken in the present study. An overall concentration index of 0.003 has been found for hypertensive population, which shows its concentration among the richer wealth quintiles. The contribution of factors like age 45 to 49 years, years of schooling between 5 to 9 years are factors that are important contributors to inequality in hypertension occurrence. Studies should be conducted to find approaches to prevent or delay the onset of the condition.

Keywords: hypertension, decomposition, inequalities, India

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Authors: O. Alaa, D. Ahmed, R. Baher, K. Matjaz

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This paper provides a study of the factors influencing the purchasing of low emission vehicles. In order to achieve the objectives of the paper, and in the light of the pool of literature and availability of data, the authors relied on qualitative methods to offers a comparison between Egypt as a developing country and Slovenia as a developed country, through analysing a survey that involves an Egyptian sample and Slovenian samples, it also studies the effect of different push and pull methods on different buyers in order to help the governments as well as the manufacturers to understand the most significant factors that affect the purchasing behaviour of LEV in the future. The results of this paper show the important vehicle performance factors, financial considerations, and environmental considerations along with the gender and age of the consumer show that consumers are more interested in the total price of the car than in different taxes.

Keywords: low emission vehicles, purchasing behavior, developed countries, developing countries

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Yutaro Kyuma, Sung-Jun Yoo, Kazuhide Ito

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A commuter bus remains important as a means to network public transportation between railway stations and terminals within cities. In some cases, the boarding time becomes longer, and the boarding rate tends to be higher corresponding to the development of urban cities. The interior environmental quality, e.g. temperature and air quality, in a commuter bus is relatively heterogeneous and complex compared to that of an indoor environment in buildings due to several factors: solar radiative heat – which comes from large-area windows –, inadequate ventilation rate caused by high density of commuters, and metabolic heat generation from travelers themselves. In addition to this, under conditions where many passengers ride in the enclosed space, contact and airborne infectious risk have attracted considerable attention in terms of public health. From this point of view, it is essential to develop the prediction method for assessment of interior environmental quality and infection risk in commuter bus cabins. In this study, we developed a numerical commuter bus model integrated with computer simulated persons to reproduce realistic indoor environment conditions with high occupancy during commuting. Here, computer simulated persons were newly designed considering different types of geometries, e.g., standing position, seating position, and individual differences. Here we conducted coupled computational fluid dynamics (CFD) analysis with radiative heat transfer analysis under steady state condition. Distributions of heterogeneous air flow patterns, temperature, and moisture surrounding the human body under some different ventilation system were analyzed by using CFD technique, and skin surface temperature distributions were analyzed using thermoregulation model that integrated into computer simulated person. Through these analyses, we discussed the interior environmental quality in specific commuter bus cabins. Further, inhaled air quality of each passenger was also analyzed. This study may have possibility to design the ventilation system in bus for improving thermal comfort of occupants.

Keywords: computational fluid dynamics, CFD, computer simulated person, CSP, contaminant, indoor environment, public health, ventilation

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Authors: H. Salonen, E. Castagnoli, C. Vornanen-Winqvist, R. Mikkola, C. Duchaine, L. Morawska, J. Kurnitski

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A wide range of health effects among occupants are associated with the exposure to bioaerosols from fungal sources. Although the accurate role of these aerosols in causing the symptoms and diseases is poorly understood, the important effect of bioaerosol exposure on human health is well recognized. Thus, there is a need to determine all of the contributing factors related to the concentration of fungi in indoor air. In this study, we reviewed and summarized the different factors affecting the concentrations of viable fungi in school buildings. The literature research was conducted using Pubmed and Google Scholar. In addition, we searched the lists of references of selected articles. According to the literature, the main factors influencing the concentration of viable fungi in the school buildings are moisture damage in building structures, the season (temperature and humidity conditions), the type and rate of ventilation, the number and activities of occupants and diurnal variations. This study offers valuable information that can be used in the interpretation of the fungal analysis and to decrease microbial exposure by reducing known sources and/or contributing factors. However, more studies of different local factors contributing to the human microbial exposure in school buildings—as well as other type of buildings and different indoor environments—are needed.

Keywords: fungi, concentration, indoor, school, contributing factor

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Authors: Paul Buchana, Patrick E. Mc Sharry

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In 2017 there will be about 38 wind farms in the North Sea belonging to 5 different countries. The North Sea is ideal for offshore wind power generation and is thus attractive to offshore wind energy developers and investors. With concerns about the potential for offshore wind turbines to sustain substantial damage as a result of extreme weather conditions, particularly windstorms, this poses a unique challenge to insurers and reinsurers as to adequately quantify the risk and offer appropriate insurance cover for these assets. The need to manage this risk also concerns regulators, who provide the oversight needed to ensure that if a windstorm or a series of storms occur in this area over a one-year time frame, the insurers of these assets in the EU remain solvent even after meeting consequent damage costs. In this paper, using available European windstorm data for the past 33 years and actual wind farm locations together with information pertaining to each of the wind farms (number of turbines, total capacity and financial value), we present a Monte Carlo simulation approach to assess the number of turbines that would be buckled in each of the wind farms using maximum wind speeds reaching each of them. These wind speeds are drawn from historical windstorm data. From the number of turbines buckled, associated financial loss and output capacity can be deduced. The results presented in this paper are targeted towards offshore wind energy developers, insurance and reinsurance companies and regulators.

Keywords: catastrophe modeling, North Sea wind farms, offshore wind power, risk analysis

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Rungrawin Promkul, Chetsadakon Jenpanitpong, Pajit Bunta, Suthap Jaiboon

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Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times. The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: supraventricular tachycardia, recurrance, emergency department, adenosine

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Authors: Abduladim Maitieg, Mark Johnson

Abstract:

Developing a coastal oil spill management plan for the Misratah coast is the motivating factor for building a database for coastal and marine systems and energy resources. Wind direction and speed, currents, bathymetry, coastal topography and offshore dynamics influence oil spill deposition in coastal water. Therefore, oceanographic and climatological data can be used to understand oil slick movement and potential oil deposits on shoreline area and the behaviour of oil spill trajectories on the sea surface. The purpose of this study is to investigate the effects of the coastal and marine physical factors under strong wave conditions and various bathymetric and coastal topography gradients in the western coastal area of Libya on the movement of oil slicks. The movement of oil slicks was computed using a GNOME simulation model based on current and wind speed/direction. The results in this paper show that (1) Oil slick might reach the Misratah shoreline area in two days in the summer and winter. Seasons. (2 ) The North coast of Misratah is the potential oil deposit area on the Misratah coast. (3) Tarball pollution was observed along the North coast of Misratah. (4) Two scenarios for the summer and the winter season were run, along the western coast of Libya . (5) The eastern coast is at a lower potential risk due to the influence of wind and current energy in the Gulf of Sidra. (6) The Misratah coastline is more vulnerable to oil spill movement in the summer than in winter seasons. (7) Oil slick takes from 2 to 5 days to reach the saltmarsh in the eastern Misratah coast. (8) Oil slick moves 300 km in 30 days from the spill resource location near the Libyan western border to the Misratah coast.(9) Bathymetric features have a profound effect on oil spill movement. (9)Oil dispersion simulations using GNOME are carried out taking into account high-resolution wind and current data.

Keywords: oil spill movement, coastal and marine physical factors, coast area, Libyan

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Authors: Sogol Zarafshan

Abstract:

The present study aimed to identify important factors affecting the effectiveness of quality control circles in a hospital, as well as rank them using a combination of fuzzy VIKOR and Grey Relational Analysis (GRA). The study population consisted of five academic members and five experts in the field of nursing working in a hospital, who were selected using a purposive sampling method. Also, a sample of 107 nurses was selected through a simple random sampling method using their employee codes and the random-number table. The required data were collected using a researcher-made questionnaire which consisted of 12 factors. The validity of this questionnaire was confirmed through giving the opinions of experts and academic members who participated in the present study, as well as performing confirmatory factor analysis. Its reliability also was verified (α=0.796). The collected data were analyzed using SPSS 22.0 and LISREL 8.8, as well as VIKOR–GRA and IPA methods. The results of ranking the factors affecting the effectiveness of quality control circles showed that the highest and lowest ranks were related to ‘Managers’ and supervisors’ support’ and ‘Group leadership’. Also, the highest hospital performance was for factors such as ‘Clear goals and objectives’ and ‘Group cohesiveness and homogeneity’, and the lowest for ‘Reward system’ and ‘Feedback system’, respectively. The results showed that although ‘Training the members’, ‘Using the right tools’ and ‘Reward system’ were factors that were of great importance, the organization’s performance for these factors was poor. Therefore, these factors should be paid more attention by the studied hospital managers and should be improved as soon as possible.

Keywords: Quality control circles, Fuzzy VIKOR, Grey Relational Analysis, Importance–Performance Analysis

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Authors: Anna Paola Micheli, Anna Maria Calce, Loris Di Nallo

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Sustainable finance identifies the process that leads, in the adoption of investment decisions, to take into account environmental and social factors, with the aim of orienting investments towards sustainable and long-term activities. Considering that the topic is at the center of the interest of national agendas, long-term investments will no longer be analyzed only by looking at financial data, but environmental, social, and governance (ESG) factors will be increasingly important and will play a fundamental role in determining the risk and return of an investment. Although this perspective does not deny the orientation to profit, ESG mutual funds represent sustainable finance applied to the world of mutual funds. So the goal of this paper is to verify this attitude, in particular in the energy sector. The choice of the sector is not casual: ESG is the acronym for environmental, social, and governance, and energy companies are strictly related to the environmental theme. The methodology adopted leads to a comparison between a sample of ESG funds and a sample of ESG funds with similar characteristics, using the most important indicators of literature: yield, standard deviation, and Sharpe index. The analysis is focused on equity funds. Results that are partial, due to the lack of historicity, show a good performance of ESG funds, testifying how a sustainable approach does not necessarily mean lower profits. It is clear that these first findings do not involve an absolute preference for ESG funds in terms of performance because the persistence of results is requested. Furthermore, these findings are to be verified in other sectors and in bond funds.

Keywords: mutual funds, ESG, performance, energy

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Authors: Pankaj Kumar

Abstract:

Despite few works reported about fluoride enrichment in the groundwater, no studies have done on exposure analysis for biological components in Patan district, Gujarat, Western India. Considering its vital importance, this study strives to quantify the bioaccumulation of fluoride in seven different crops and vegetables, viz. Spinach and Mustard leaves, Cauliflower, Wheat grains, Amaranth seed, Radish, and Garlic grown in the potentially fluoride contaminated area. Result shows that the order for fluoride accumulation among different analyzed plants are spinach (63.3 mg/kg) > mustard (48.9 mg/kg) > cauliflower (41.1 mg/kg) > radish (35.7 mg/kg) > garlic (33.2 mg/kg) > amaranth seed (26.7 mg/kg) > wheat (22.5 mg/kg). Fluoride concentration was highest in leafy vegetable, whereas the lowest was in wheat grains. Finally, estimated daily intake (EDI) and hazard index (HI) were calculated for local consumers of different age group, where it was found that young people (4-15 years) are at the highest risk of fluorosis. This study is relevant for better crop management, like substituting crops with woody plants, flowers, and people awareness.

Keywords: fluoride, bioaccumulation, health risk, water

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Authors: Jolanta Jonak, Sylvia Tolczyk

Abstract:

Students demonstrate various learning preferences and learning styles that range from visual, auditory to kinesthetic preferences. These learning preferences are further impacted by individual cognitive make up that characterizes itself in linguistic strengths, logical- special, inter-or intra- personal, just to name a few. Students from culturally and linguistically diverse backgrounds (CLD) have an increased risk of being misunderstood by many school systems and even medical personnel. CLD students are influenced by many factors (like acculturation and experience) that may impact their achievements and functioning levels. CLD students who develop initial or basic interpersonal communication proficiency skills in the target language are even at a higher risk for being suspected of learning disability when they are underachieving academically. Research indicates that large numbers of students arenot provided the type of education and types of supports they need in order to be successful in an academicenvironment. Multiple research findings indicate that significant numbers of school staff self-reports that they do not feel adequately prepared to work with CLD students. It is extremely important for the school staff, especially school psychologists, who often are the first experts that are consulted, to be educated about overlapping symptoms and settle differences between learning difference and disability. It is equally important for medical personnel, mainly pediatricians, psychologists, and psychiatrists, to understand the subtle differences to avoid inaccurate opinions. Having the knowledge, school staff can avoid unnecessary referrals for special education evaluations and avoid inaccurate decisions about the presence of a disability. This presentation will illustrate distinctions based on research between learning differences and disabilities, how to recognize them, and how to assess for them.

Keywords: special education, learning disability, differentiation, differences

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Authors: Muhammed Auwal Umar, M. Saleh

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The main purpose of this research is to examine the relationship between entrepreneurial orientation (innovativeness, risk-taking propensity, and proactiveness) and SME's growth in Bauchi metropolis. The study is quantitative in nature using a cross-sectional survey. The population of the study was 364 SMEs. Using simple random sampling, 183 questionnaires were personally distributed, out of which 165 (90%) were found valid for the analysis. Kregcie and Morgan (1970) table was used to determine the sample size. Pearson correlation was used to test the hypotheses. The analysis was conducted with the aid of IBM Statistical Package for Social Sciences (SPSS) version 20. The results established that innovativeness, risk-taking propensity, and proactiveness have significant positive relationship with SME's growth. It is therefore recommended that SMEs’ owners/managers should change their attitude by changing their product and mode of operation in line with customer demand, being proactive ahead of other competitors in trying a better way of doing things, and taking calculated risks in anticipation of high return in order for their businesses to survive and grow.

Keywords: SMEs growth, innovativeness, risk-taking propensity, proactiveness

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Authors: Shoji Katagiri

Abstract:

This study deals with wage inequality in organization and shows the relationship between ICT and wage in organization. To do so, we incorporate ICT’s factors in organization into our model. ICT’s factors are efficiencies of Enterprise Resource Planning (ERP), Computer Assisted Design/Computer Assisted Manufacturing (CAD/CAM), and NETWORK. The improvement of ICT’s factors decrease the learning cost to solve problem pertaining to the hierarchy in organization. The improvement of NETWORK increases the wage inequality within workers and decreases within managers and entrepreneurs. The improvements of CAD/CAM and ERP increases the wage inequality within all agent, and partially increase it between the agents in hierarchy.

Keywords: endogenous economic growth, ICT, inequality, capital accumulation

Procedia PDF Downloads 246

Authors: M. Mydlárová Blaščáková, J. Poráčová, Z. Tomková, Ľ. Blaščáková, M. Nagy, M. Konečná, E. Petrejčíková, Z. Gogaľová, V. Sedlák, J. Mydlár, M. Zahatňanská, K. Hricová

Abstract:

Osteoporosis is a multifactorial disease that results in reduced quality of life, causes decreased bone strength, and changes in their microarchitecture. Mostly postmenopausal women are at risk. In our study, we measured anthropometric parameters of postmenopausal women (104 women of control group – CG and 105 women of osteoporotic group - OG) and determined TSH hormone levels and PTH as well as mineral elements - Ca, P, Mg and enzyme alkaline phosphatase. Through the correlation analysis in CG, we have found association based on age and BMI, P and Ca, as well as Mg and Ca; in OG we determined interdependence based on an association of age and BMI, age and Ca. Using the Student's t test, we found significantly important differences in biochemical parameters of Mg (p ˂ 0,001) and TSH (p ˂ 0,05) between CG and OG.

Keywords: factors, bone mass density, Central Europe, biomarkers

Procedia PDF Downloads 183

Authors: Elham Rajabian

Abstract:

The ascent of cybersecurity incidents is a rising threat to most organisations in general, while the impact of the incidents is unique to each of the organizations. It is a need for behavioural sciences to concentrate on employees’ behaviour in order to prepare key security mitigation opinions versus cybersecurity incidents. There are noticeable differences among users of a computer system in terms of complying with security behaviours. We can discuss the people's differences under several subjects such as delaying tactics on something that must be done, the tendency to act without thinking, future thinking about unexpected implications of present-day issues, and risk-taking behaviours in security policies compliance. In this article, we introduce high-profile cyber-attacks and their impacts on weakening cyber resiliency in organizations. We also give attention to human errors that influence network security. Human errors are discussed as a part of psychological matters to enhance compliance with the security policies. The organizational challenges are studied in order to shape a sustainable cyber risks management approach in the related work section. Insiders’ behaviours are viewed as a cyber security gap to draw proper cyber resiliency in section 3. We carry out the best cybersecurity practices by discussing four CIS challenges in section 4. In this regard, we provide a guideline and metrics to measure cyber resilience in organizations in section 5. In the end, we give some recommendations in order to build a cybersecurity culture based on individual behaviours.

Keywords: cyber resilience, human factors, cybersecurity behavior, attitude, usability, security culture

Procedia PDF Downloads 79