Search results for: high risk youth

Authors: Małgorzata Wrzosek, Nina Baruch, Beata Jabłonowska-Lietz

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Background: The fat mass & obesity-associated (FTO) gene is linked to an increased risk of obesity. However, the relation between rs9939609 and eating behaviors or energy expenditure is not fully elucidated. The aim of this study was to investigate the relationship between the rs9939609 polymorphism of the FTO gene and the postprandial satiety, sweets intake, physical activity and depressive symptoms in patients with obesity. Methods: The study group consisted of 585 subjects with a BMI of 42.97.0 kg/m². The rs9939609 polymorphism of the FTO gene was examined using real time – PCR method. The severity of depressive symptoms was assessed with the Beck Depression Inventory (BDI-II). Information was obtained about demographics, eating habits and lifestyle. Results: More than half (63.5%) of the patients reported consumption of sweets between main meals and 30% declared high and very high postprandial satiety and the frequency of TA/AA carriers in rs9939609 (FTO) compared with TT carriers was similar. Significantly lower BDI-II scores were found in subjects with higher level of physical activity and it was seen amongst patients with the AA and AT genotypes of the FTO rs9939609 polymorphism. Conclusion: Obesity is a highly heritable trait, but eating habits also appear as major factors affecting obesity development.

Keywords: FTO polymorphism, physical activity, obesity, depression, postprandial satiety, sugary foods, sweets

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Authors: Sadie Khorramnia, Asha Bonney, Kate Galloway, Andrew Kyoong

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Sleep plays a pivotal role in the registration and consolidation of memory. Multiple observational studies have demonstrated that self-reported sleep duration and sleep quality are associated with cognitive performance. Montreal Cognitive Assessment questionnaire is a screening tool to assess mild cognitive (MCI) impairment with a 90% diagnostic sensitivity. In our current study, we used MOCA to identify MCI in patients who underwent sleep study in our sleep department. We then looked at the clinical risk factors and sleep-related parameters in subjects found to have mild cognitive impairment but without a diagnosis of sleep-disordered breathing. Clinical risk factors, including physician, diagnosed hypertension, diabetes, and depression and sleep-related parameters, measured during sleep study, including percentage time of each sleep stage, total sleep time, awakenings, sleep efficiency, apnoea hypopnoea index, and oxygen saturation, were evaluated. A total of 90 subjects who underwent sleep study between March 2019 and October 2019 were included. Currently, there is no pharmacotherapy available for MCI; therefore, identifying the risk factors and attempting to reverse or mitigate their effect is pivotal in slowing down the rate of cognitive deterioration. Further characterization of sleep parameters in this group of patients could open up opportunities for potentially beneficial interventions.

Keywords: apnoea hypopnea index, mild cognitive impairment, sleep architecture, sleep study

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Authors: Kalinina Anastasiya, Pevnaya Mariya

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The authors present the results of research of educational and cultural habitat of international students at Ural Federal University, revealing problem zones in the organization of adaptation program in 2014-2015 as well as innovations in adaptation program for 2015-2016. The research is based on U-curve theory of culture shock and theory of human capital. The authors provide also the first results for all stakeholders of practically implemented pilot adaptation program for foreign students which was based on the human capital approach.

Keywords: adaptation, human capital, international students, student volunteering, social community, youth politics

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Authors: Helen Huang, Francisco Javier Quesada Ocet, Blanca Quesada Oce, Javier Jimenez Bello, Victor Palanca Gil, Alba Cervero Rubio, Ana Paya Chaume, Alejandro Herreros-Pomares, Fernando Vidal-Vanaclocha, Rafael Paya Serrano, Aurelio Quesada Dorador, Monica Soliman

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Background: Cancer favors both the pro-inflammatory state and autonomic dysfunction, two important mechanisms in the genesis of AF. Atrial remodeling might be caused as a result of paraneoplastic conditions or the result of direct expression of neoplasia. Here, we hypothesize that cancer, through inflammatory mediators, may favor the appearance of AF and patients with the first episode of AF could have a higher risk of developing cancer. Method: Data was collected from patients who attended the emergency department of our hospital for the first episode of AF, diagnosed electrocardiographically, between 2010-2015 (n = 712). The minimum follow-up was 2 years, recording the appearance of cancer, total mortality, recurrences of AF and other events. Patients who developed cancer and those who did not during the 2 years after the onset of AF were compared, as well as with the incidence of cancer in Spain in 2012. Results: After 2 years, 35 patients (4.91%) were diagnosed with cancer, with an annual incidence of 2.45%. Hematological neoplasms were the most frequent (34.28%). The cancer group was older (76.68 +/-12.75 years vs 74.16 +/-12.71; p <0.05) and had fewer typical symptoms (palpitations) (33.38% vs 14.28% , p <0.05). The incidence of cancer in Spain during 2012 was 0.46%, much lower than our sample. When comparing the incidence by age, these differences were maintained both in those over 65 years of age and in those under 65 years of age (2.17% vs. 0.28%; 0.28% vs. 0.18% respectively). Discussion: Therefore, a high incidence of cancer in patients with the first episode of AF was observed (the annual incidence of 2.45% after the onset of AF is 6.1 times that of the general population). After the evaluation of patients with AF in their first detected episode, surveillance of the appearance of cancer should be considered in clinical practice.

Keywords: cancer, cardiovascular outcomes, atrial fibrillation, inflammation

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Authors: Charlotte K. Lee, Henrique R. N. Aguiar, Ralph Smith, James Baldock, Sam Botchey

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Background: Femoral neck stress fractures (FNSF) are uncommon, making up 1 to 7.2% of stress fractures in healthy subjects. FNSFs are prevalent in young women, military recruits, endurance athletes, and individuals with energy deficiency syndrome or female athlete triad. Presentation is often non-specific and is often misdiagnosed following the initial examination. There is limited research addressing the return–to–activity time after FNSF. Previous studies have demonstrated prognostic time predictions based on various imaging techniques. Here, (1) OxSport clinic FNSF practice standards are retrospectively reviewed, (2) FNSF cohort demographics are examined, (3) Regression models were used to predict return–to–activity prognosis and consequently determine bone stress risk factors. Methods: Patients with a diagnosis of FNSF attending Oxsport clinic between 01/06/2020 and 01/01/2020 were selected from the Rheumatology Assessment Database Innovation in Oxford (RhADiOn) and OxSport Stress Fracture Database (n = 14). (1) Clinical practice was audited against five criteria based on local and National Institute for Health Care Excellence guidance, with a 100% standard. (2) Demographics of the FNSF cohort were examined with Student’s T-Test. (3) Lastly, linear regression and Random Forest regression models were used on this patient cohort to predict return–to–activity time. Consequently, an analysis of feature importance was conducted after fitting each model. Results: OxSport clinical practice met standard (100%) in 3/5 criteria. The criteria not met were patient waiting times and documentation of all bone stress risk factors. Importantly, analysis of patient demographics showed that of the population with complete bone stress risk factor assessments, 53% were positive for modifiable bone stress risk factors. Lastly, linear regression analysis was utilized to identify demographic factors that predicted return–to–activity time [R2 = 79.172%; average error 0.226]. This analysis identified four key variables that predicted return-to-activity time: vitamin D level, total hip DEXA T value, femoral neck DEXA T value, and history of an eating disorder/disordered eating. Furthermore, random forest regression models were employed for this task [R2 = 97.805%; average error 0.024]. Analysis of the importance of each feature again identified a set of 4 variables, 3 of which matched with the linear regression analysis (vitamin D level, total hip DEXA T value, and femoral neck DEXA T value) and the fourth: age. Conclusion: OxSport clinical practice could be improved by more comprehensively evaluating bone stress risk factors. The importance of this evaluation is demonstrated by the population found positive for these risk factors. Using this cohort, potential bone stress risk factors that significantly impacted return-to-activity prognosis were predicted using regression models.

Keywords: eating disorder, bone stress risk factor, femoral neck stress fracture, vitamin D

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Authors: A. L. Agarwal, D. A. Mahajan

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Construction industry tumbled along with other industry/sectors during recent economic crash. Construction business could not regain thereafter and still pass through slowdown phase, resulted many real estate as well as infrastructure projects not completed on schedule and within budget. There are many theories, tools, techniques with software packages available in the market to analyze construction schedule. This study focuses on the construction project schedule and uncertainties associated with construction activities. The infrastructure construction project has been considered for the analysis of uncertainty on project activities affecting project duration and analysis is done using @RISK software. Different simulation results arising from three probability distribution functions are compiled to benefit construction project managers to plan more realistic schedule of various construction activities as well as project completion to document in the contract and avoid compensations or claims arising out of missing the planned schedule.

Keywords: construction project, distributions, project schedule, uncertainty

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Authors: Alina Fedossova, Jose Jorge Sierra Molina

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SIP problems are part of non-classical optimization. There are problems in which the number of variables is finite, and the number of constraints is infinite. These are semi-infinite programming problems. Most algorithms for semi-infinite programming problems reduce the semi-infinite problem to a finite one and solve it by classical methods of linear or nonlinear programming. Typically, any of the constraints or the objective function is nonlinear, so the problem often involves nonlinear programming. An investment portfolio is a set of instruments used to reach the specific purposes of investors. The risk of the entire portfolio may be less than the risks of individual investment of portfolio. For example, we could make an investment of M euros in N shares for a specified period. Let yi> 0, the return on money invested in stock i for each dollar since the end of the period (i = 1, ..., N). The logical goal here is to determine the amount xi to be invested in stock i, i = 1, ..., N, such that we maximize the period at the end of ytx value, where x = (x1, ..., xn) and y = (y1, ..., yn). For us the optimal portfolio means the best portfolio in the ratio "risk-return" to the investor portfolio that meets your goals and risk ways. Therefore, investment goals and risk appetite are the factors that influence the choice of appropriate portfolio of assets. The investment returns are uncertain. Thus we have a semi-infinite programming problem. We solve a semi-infinite optimization problem of portfolio selection using the outer approximations methods. This approach can be considered as a developed Eaves-Zangwill method applying the multi-start technique in all of the iterations for the search of relevant constraints' parameters. The stochastic outer approximations method, successfully applied previously for robotics problems, Chebyshev approximation problems, air pollution and others, is based on the optimal criteria of quasi-optimal functions. As a result we obtain mathematical model and the optimal investment portfolio when yields are not clear from the beginning. Finally, we apply this algorithm to a specific case of a Colombian bank.

Keywords: outer approximation methods, portfolio problem, semi-infinite programming, numerial solution

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Authors: Nora Mohammed Al-Kehayez

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This present investigation was performed to study the effect of low fat yogurt on serum and liver lipids profile of male albino rats (weighing 100 g+or- 5 gram) when fed balanced or high fat high cholesterol diets and given yogurt ad libitum compared with control groups. Rats were divided into 4 groups, each group contains 6 rats. The groups of rats were fed as follows: Group(1) was fed balanced diet + water(control). Group(2) was fed balanced diet + low fat yogurt. Group(3) was fed high fat high cholesterol diet + water(Control). Group(4) was fed high fat high cholesterol diet + low fat yogurt. The obtained results could be summarized as follows: When rats were given low fat yogurt and fed balanced or high fat high cholesterol diets a significantly greater weight gains resulted in comparison with the control groups given water instead of yogurt. The data on the weights of liver and heart expressed' as percentage increased the body weight in case of rats which were fed balanced diet with low fat yogurt while in case of rats which were fed high fat high cholesterol diet with low fat yogurt the increment scenes to be less. Results of serum cholesterol levels in serum of rats were given balanced or high fat high cholesterol diets and consuming low fat yogurt was showed a significant reduction values. However the low fat yogurt produced the highest significant decrease values. The values of serum cholesterol go hand in hand with serum lipoprotein fractions in rats given low fat yogurt with both balanced or high fat high cholesterol diets. An increase of high density lipoprotein HDL-C and a decrease of low density lipoprotein LDL-C values were obtained. When rats ingested low fat yogurt a significant decrease in serum and liver triglycerides content was obtained wether with balanced or high fat high cholesterol diets. Rats consuming high fat high cholesterol diets with water showed a significant increase in liver total lipids, total cholesterol and phospholipides levels in comparison with the same liver parameters in rats given balanced diet with water. Supplement with low fat yogurt significantly suppressed these effects.

Keywords: yogurt, lipids profile, albino, rats

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Authors: Dalal Alghawas, Jetty Lee, Kaisa Poutanen, Hani El-Nezami

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Oat β-glucan a water soluble non starch linear polysaccharide has been approved as a cholesterol lowering agent by various food safety administrations and is commonly used to reduce the risk of heart disease. The molecular weight of oat β-glucan can vary depending on the extraction and fractionation methods. It is not clear whether the molecular weight has a significant impact at reducing the acceleration of atherosclerosis. The aim of this study was to investigate three different oat β-glucan fractionations on the development of atherosclerosis in vivo. With special focus on plaque stability and the intestinal barrier function. To test this, ApoE-/- female mice were fed a high fat diet supplemented with oat bran, high molecular weight (HMW) oat β-glucan fractionate and low molecular weight (LMW) oat β-glucan fractionate for 16 weeks. Atherosclerosis risk markers were measured in the plasma, heart and aortic tree. Plaque size was measured in the aortic root and aortic tree. ICAM-1, VCAM-1, E-Selectin, P-Selectin, protein levels were assessed from the aortic tree to determine plaque stability at 16 weeks. The expression of p22phox at the aortic root was evaluated to study the NADPH oxidase complex involved in nitric oxide bioavailability and vascular elasticity. The tight junction proteins E-cadherin and beta-catenin from western blot analyses were analysed as an intestinal barrier function test. Plasma LPS, intestinal D-lactate levels and hepatic FMO gene expression were carried out to confirm whether the compromised intestinal barrier lead to endotoxemia. The oat bran and HMW oat β-glucan diet groups were more effective than the LMW β-glucan diet group at reducing the plaque size and showed marked improvements in plaque stability. The intestinal barrier was compromised for all the experimental groups however the endotoxemia levels were higher in the LMW β-glucan diet group. The oat bran and HMW oat β-glucan diet groups were more effective at attenuating the development of atherosclerosis. Reasons for this could be due to the LMW oat β-glucan diet group’s low viscosity in the gut and the inability to block the reabsorption of cholesterol. Furthermore the low viscosity may allow more bacterial endotoxin translocation through the impaired intestinal barrier. In future food technologists should carefully consider how to incorporate LMW oat β-glucan as a health promoting food.

Keywords: Atherosclerosis, beta glucan, endotoxemia, intestinal barrier function

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: James Freeman, Andry Rakotonirainy

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Train pedestrian collisions are common and are the most likely to result in severe injuries and fatalities when compared to other types of rail crossing accidents. However, there is limited research that has focused on understanding the reasons why some pedestrians’ break level crossings rules, which limits the development of effective countermeasures. As a result, this study undertook a deeper exploration into the origins of risky pedestrian behaviour through structured interviews. A total of 40 pedestrians who admitted to either intentionally breaking crossing rules or making crossing errors participated in an in-depth telephone interview. Qualitative analysis was undertaken via thematic analysis that revealed participants were more likely to report deliberately breaking rules (rather than make errors), particular after the train had passed the crossing as compared to before it arrives. Predominant reasons for such behaviours were identified to be: calculated risk taking, impatience, poor knowledge of rules and low likelihood of detection. The findings have direct implications for the development of effective countermeasures to improve crossing safety (and managing risk) such as increasing surveillance and transit officer presence, as well as installing appropriate barriers that either deter or incapacitate pedestrians from violating crossing rules. This paper will further outline the study findings in regards to the development of countermeasures as well as provide direction for future research efforts in this area.

Keywords: crossings, mistakes, risk, violations

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Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

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Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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Authors: Ananya Das, Arun Kumar, Gazala Habib, Vivekanandan Perumal

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Regulatory bodies has proposed limits on Particulate Matter (PM) concentration in air; however, it does not explicitly indicate the incorporation of effects of toxicities of constituents of PM in developing regulatory limits. This study aimed to provide a structured approach to incorporate toxic effects of components in developing regulatory limits on PM. A four-step human health risk assessment framework consists of - (1) hazard identification (parameters: PM and its constituents and their associated toxic effects on health), (2) exposure assessment (parameters: concentrations of PM and constituents, information on size and shape of PM; fate and transport of PM and constituents in respiratory system), (3) dose-response assessment (parameters: reference dose or target toxicity dose of PM and its constituents), and (4) risk estimation (metric: hazard quotient and/or lifetime incremental risk of cancer as applicable). Then parameters required at every step were obtained from literature. Using this information, an attempt has been made to determine limits on PM using component-specific information. An example calculation was conducted for exposures of PM_2.5 and its metal constituents from Indian ambient environment to determine limit on PM values. Identified data gaps were: (1) concentrations of PM and its constituents and their relationship with sampling regions, (2) relationship of toxicity of PM with its components.

Keywords: air, component-specific toxicity, human health risks, particulate matter

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Authors: Bennani Zoubir Nada, El Hiri Abderrazak, El Hajri Aimad

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In context of economic and health crisis, sustainable entrepreneurship has become one of the best solutions to economic recovery. This study is about the third program of the Moroccan national human development initiative in her third phase which began in 2019 and continuous until 2023, and which deals with income improvement and social inclusion of young people, under the high patronage of his majesty the king of Morocco. What is the approach of this program and how entrepreneurship training of young people can be a pillar to generate income and create jobs? Starting on the effectuation theory, we adopted an exploratory qualitative approach through semi-structured interviews with national human development initiative stakeholders in the area of Meknes-Morocco, which allowed us the state of progress of this program. We carried out a survey based on a grid of questions to collect information that we processed using NVIVO software. The most relevant results are that people eligible are jobless young people, who are between 18 and 35 years old, who reside in Meknes and surroundings and who have a project idea. They are trained by experts in entrepreneurship and management through targeted and diversified courses. To ensure the sustainability of projects, the project organisers have provided measures to ensure the sustainability of the companies through continuous monitoring and evaluation as well as support during all phases from the project idea to the realisation and progress.

Keywords: sustainable entrepreneurship, training, social inclusion, national human development initiative in Morocco (INDH), youth entrepreneurship, the effectuation theory

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Authors: Hillary Onyeka Abugu, Valentine Chinakwugwo Ezea, Janefrances Ngozi Ihedioha, Nwachukwu Romanus Ekere

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The study assessed the spring water quality in Igbo-Etiti, Nigeria, for drinking and irrigation application using Physico-chemical parameters, water quality index, mineral and trace elements, pollution indices and risk assessment. Standard methods were used to determine the physicochemical properties of the spring water in rainy and dry seasons. Trace metals such as Pb, Cd, Zn and Cu were determined with atomic absorption spectrophotometer. The results showed that most of the physicochemical properties studied were within the guideline values set by Nigeria Standard for Drinking Water Quality (NSDWQ), WHO and US EPA for drinking water purposes. However, pH of all the spring water (4.27- 4.73; and 4.95- 5.73), lead (Pb) (0.01-1.08 mg/L) and cadmium (Cd) (0.01-0.15 mg/L) concentrations were above the guideline values in both seasons. This could be attributed to the lithography of the study area, which is the Nsukka formation. Leaching of lead and sulphides from the embedded coal deposits could have led to the increased lead levels and made the water acidic. Two-way ANOVA showed significant differences in most of the parameters studied in dry and rainy seasons. Pearson correlation analysis and cluster analysis showed strong significant positive and negative correlations in some of the parameters studied in both seasons. The water quality index showed that none of the spring water had excellent water status. However, one spring (Iyi Ase) had poor water status in dry season and is considered unsafe for drinking. Iyi Ase was also considered not suitable for irrigation application as predicted by most of the pollution indices, while others were generally considered suitable for irrigation application. Probable cancer and non-cancer risk assessment revealed a probable risk associated with the consumption of the spring in the Igbo-Ettiti area, Nigeria.

Keywords: water quality, pollution index, risk assessment, physico-chemical parameters

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Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

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Authors: Karakhalis N. B.

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This study aimed to determine the prevalence of heparin resistance among cardiac surgical pediatric and neonatal patients and identify associated risk factors. Materials and Methods: The study included 306 pediatric and neonatal patients undergoing on-pump cardiac surgery. Patients whose activated clotting time (ACT) targets were achieved after the first administration of heparin formed the 1st group (n=280); the 2nd group (n=26) included patients with heparin resistance. The initial assessment of the haemostasiological profile included determining the PT, aPPT, FG, AT III activity, and INR. Intraoperative control of heparinization was carried out with a definition of ACT using a kaolin activator. A weight-associated protocol at the rate of 300 U/kg with target values of ACT >480 sec was used for intraoperative heparinization. Results: The heparin resistance was verified in 8.5% of patients included in the study. Repeated heparin administration at the maximum dose of≥600 U/kg is required in 80.77% of cases. Despite additional heparinization, 19.23% of patients had FFP infusion. There was reduced antithrombin activity in the heparin resistance group (p=0.01). Most patients with heparin resistance (57.7%) were pretreated with low molecular weight heparins during the preoperative period. Conclusion: Determining the initial level of antithrombin activity can predict the risk of developing heparin resistance. The factor analysis verified hidden risk factors for heparin resistance to the heparin pretreatment, chronic hypoxia, and chronic heart failure.

Keywords: congenital heart disease, heparin, antithrombin, activated clotting time, heparin resistance

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Authors: Yu-Mei Hsueh, Wei-Jen Chen, Yung-Kai Huang, Cheng-Shiuan Tsai, Kuo-Cheng Yeh

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Prostate cancer occurs in men over the age of 50, and rank sixth of the top ten cancers in Taiwan, and the incidence increased gradually over the past decade in Taiwan. Arsenic is confirmed as a carcinogen by International Agency for Research on (IARC). Arsenic induces oxidative stress may be a risk factor for prostate cancer, but the mechanism is not clear. Selenium is an important antioxidant element. Whether the association between plasma selenium levels and risk of prostate cancer are modified by different genotype of selenoprotein is still unknown. Glutathione peroxidase, selenoprotein P (SEPP1) and 15 kDa selenoprotein (SEP 15) are selenoprotein and regulates selenium transport and the oxidation and reduction reaction. However, the association between gene polymorphisms of selenoprotein and prostate cancer is not yet clear. The aim of this study is to determine the relationship between plasma selenium, polymorphism of selenoprotein, urinary total arsenic concentration and prostate cancer. This study is a hospital-based case-control study. Three hundred twenty-two cases of prostate cancer and age (±5 years) 1:1 matched 322 control group were recruited from National Taiwan University Hospital, Taipei Medical University Hospital, and Wan Fang Hospital. Well-trained personnel carried out standardized personal interviews based on a structured questionnaire. Information collected included demographic and socioeconomic characteristics, lifestyle and disease history. Blood and urine samples were also collected at the same time. The Research Ethics Committee of National Taiwan University Hospital, Taipei, Taiwan, approved the study. All patients provided informed consent forms before sample and data collection. Buffy coat was to extract DNA, and the polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) was used to measure the genotypes of SEPP1 rs3797310, SEP15 rs5859, GPX1 rs1050450, GPX2 rs4902346, GPX3 rs4958872, and GPX4 rs2075710. Plasma concentrations of selenium were determined by inductively coupled plasma mass spectrometry (ICP-MS).Urinary arsenic species concentrations were measured by high-performance liquid chromatography links hydride generator and atomic absorption spectrometer (HPLC-HG-AAS). Subject with high education level compared to those with low educational level had a lower prostate cancer odds ratio (OR) Mainland Chinese and aboriginal people had a lower OR of prostate cancer compared to Fukien Taiwanese. After adjustment for age, educational level, subjects with GPX1 rs1050450 CT and TT genotype compared to the CC genotype have lower, OR of prostate cancer, the OR and 95% confidence interval (Cl) was 0.53 (0.31-0.90). SEPP1 rs3797310 CT+TT genotype compared to those with CC genotype had a marginally significantly lower OR of PC. The low levels of plasma selenium and the high urinary total arsenic concentrations had the high OR of prostate cancer in a significant dose-response manner, and SEPP1 rs3797310 genotype modified this joint association.

Keywords: prostate cancer, plasma selenium concentration, urinary total arsenic concentrations, glutathione peroxidase, selenoprotein P, selenoprotein 15, gene polymorphism

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Authors: Sylvester S. Horvey, Jones Mensah

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The growing complexities and dynamics in the business environment have led to a new approach to risk management, known as enterprise risk management (ERM). ERM is a system and an approach to managing the risks of an organization in an integrated manner to achieve the corporate goals and strategic objectives. Regardless of the diversities in the business environment, ERM has become an essential factor in managing individual and business risks because ERM is believed to enhance shareholder value and firm growth. Despite the growing number of literature on ERM, the question about what factors drives ERM remains limited. This study provides a comprehensive literature review of the main factors that contribute to ERM implementation. Google Scholar was the leading search engine used to identify empirical literature, and the review spanned between 2000 and 2020. Articles published in Scimago journal ranking and Scopus were examined. Thirteen firm characteristics and sixteen articles were considered for the empirical review. Most empirical studies agreed that firm size, institutional ownership, industry type, auditor type, industrial diversification, earnings volatility, stock price volatility, and internal auditor had a positive relationship with ERM adoption, whereas firm size, institutional ownership, auditor type, and type of industry were mostly seen be statistically significant. Other factors such as financial leverage, profitability, asset opacity, international diversification, and firm complexity revealed an inconclusive result. The growing literature on ERM is not without limitations; hence, this study suggests that further research should examine ERM determinants within a new geographical context while considering a new and robust way of measuring ERM rather than relying on a simple proxy (dummy) for ERM measurement. Other firm characteristics such as organizational culture and context, corporate scandals and losses, and governance could be considered determinants of ERM adoption.

Keywords: enterprise risk management, determinants, ERM adoption, literature review

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Authors: Fasil Wagnew, Kerri Viney, Kefyalew Addis Alene, Matthew Kelly, Darren Gray

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Background: Undernutrition is a risk factor for tuberculosis (TB), including poor treatment outcomes. However, evidence regarding the effect of undernutrition on TB treatment outcomes is not well understood. We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multi-drug resistance (MDR)-TB. Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases without restrictions on geography or year of publication. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Two reviewers independently assessed the study eligibility, extracted the necessary information, and assessed the risk of bias. Depending on the nature of the data, odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger’s tests. Results: Of 2358 records screened, 59 studies comprising a total of 31,254 people with MDR-TB were included. Undernutrition was significantly associated with a lower sputum culture conversion rate (HR 0·7, 95% CI 0·6–0·9, I2=67·1%) and a higher rate of mortality (OR 2·9, 95%CI 2·1–3·8, I2=23·7%) and unfavourable treatment outcomes (OR 1·8, 95%CI 1·5–2·0, I2=72·7%). There was no statistically significant publication bias in the included studies. Three studies were low, forty-two studies were moderate, and fourteen studies were high quality. Interpretations: Undernutrition was significantly associated with unfavourable treatment outcomes, including mortality and lower sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardised second-line TB drugs.

Keywords: undernutrition, MDR-TB, sputum culture conversion, treatment outcomes, meta-analysis

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Authors: Majid Khan

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Introduction: In this era of microsurgery, free flap holds a remarkable spot in reconstructive surgery. A free flap is well suited for composite defects as it provides sufficient and well-vascularized tissue for coverage. We report our experience with the use of the free flaps for the reconstruction of composite defects. Methods: This is a retrospective case series (chart review) of patients who underwent reconstruction of composite defects with a free flap at Aga Khan University Hospital, Karachi (Pakistan) from January 01, 2015, to December 31, 2019. Data were collected for patient demographics, size of the defect, size of flap, recipient vessels, postoperative complications, and outcome of the free flap. Results: Over this period, 532 free flaps are included in this study. The overall success rate is 95.5%. The mean age of the patient was 44.86 years. In 532 procedures, there were 448 defects from tumor ablation of head and neck cancer. The most frequent free flap was the anterolateral thigh flap in 232 procedures. In this study, the risk factor hypertension (p=0.004) was found significant for wound dehiscence, preop radiation/chemotherapy (p=0.003), and malnutrition (p=0.005) were found significant for fistula formation. Malnutrition (p=0.02) and use of vein grafts (p=0.025) were significant factors for flap failure. Conclusion: Free tissue transfer is a reliable option for the reconstruction of large and composite defects. Hypertension, malnutrition, and preoperative radiotherapy can cause significant morbidity.

Keywords: free flap, free flap failure, risk factors for flap failure, free flap outcome

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Authors: Benedicta Asante, Brenna Bath, Olugbenga Adebayo, Catherine Trask

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Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, reports of injuries and fatal accidents in the industry demand notice particularly common and debilitating musculoskeletal disorders such as low back pain (LBP). WCWs are likely exposed to diverse work-related hazards that could contribute to LBP. However, to our knowledge there has never been a systematic review or other synthesis of LBP findings within this workforce. The aim of this systematic review was to determine the prevalence and risk factors of LBP among WCWs. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back pain’ and ‘waste collection workers’. Articles were screened at title, abstract, and full-text stages by two reviewers. Data were extracted on study design, sampling strategy, socio-demographic, geographical region, and exposure definition, definition of LBP, risk factors, response rate, statistical techniques, and LBP prevalence. Risk of bias (ROB) was assessed based on Hoy Damien’s ROB scale. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; thirteen full-text articles met the study criteria at the full-text stage. Seven articles (54%) reported prevalence within 12 months of LBP between 42-82% among WCW. The major risk factors for LBP among WCW included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Summary data and syntheses of findings was presented in trend-lines and tables to establish the several prevalence periods based on age and region distribution. Public health implications: LBP is a major occupational hazard among WCWs. In light of these risks and future growth in this industry, further research should focus on more detail ergonomic exposure assessment and LBP prevention efforts.

Keywords: low back pain, scavenger, waste collection workers, waste pickers

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Toake Endoh

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Cross-border migration of people is a critical driver for sustainable economic development in the Asia-Pacific region. Meanwhile, the region is susceptible to mega-scale natural disasters, such as tsunami, earthquakes, and typhoons. When migrants are stranded in a foreign country by a disaster, who should be responsible for their safety and security? What legal or moral foundation is there to advocate for the protection and assistance of “migrants at risk (M@R)”? How can the states practice “good governance” in their response to displacement of the foreign migrants? This paper inquires how to protect foreign migrants displaced by a natural disaster under international law and proposes protective actions to be taken by of migrant-receiver governments. First, the paper discusses the theoretical foundation for protection of M@R and argues that the nation-states are charged of responsibility to protect at-risk foreigners as “internally displaced persons” in the light of the United Nations’ Guiding Principles of Internal Displacement (1998). Second, through the case study of the Kobe Earthquake in Japan (1995), the Tsunami in Thailand (2004), and the Hurricane Katrina in the U.S. (2005), the paper evaluates how effectively (or poorly) institutions and state actors addressed the specific vulnerability felt by M@R in these crises.

Keywords: internal displaced persons, natural disaster, international migration, responsibility to protect

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Authors: T. Hansen

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Many consumers are uncertain of what financial borrowing behavior may serve their interests in the best way. This is important since consumers’ risky financial decisions may not only negatively affect their short-term liquidity but may haunt them for years after they are made. Obviously, this is especially critical for young adults who often carry large amounts of student loans or credit card debt, which in turn may hinder their future ability to obtain financial healthiness. Even though factors such as financial knowledge, attitudes towards risk, gender, and motivations of borrowing, among others, are known to influence consumer borrowing behavior, no existing model comprehensibly describes the mechanisms behind young adults’ risky borrowing behavior. This is unfortunate since a better understanding of the relationships between such factors and young adults’ risky borrowing behavior may be of value to financial service providers and financial authorities aiming to improve young adults’ borrowing behavior. This research extends prior research by developing a conceptual framework for the purpose of understanding young adults’ risky borrowing behavior. The study is based on two survey samples comprising 488 young adults aged 18-25 who have not obtained a risky loan (sample 1) and 214 young adults aged 18-25 who already have obtained a risky loan (sample 2), respectively. The results suggest several psychological, sociological, and behavioral factors that may influence young adults’ intentional risky borrowing behavior, which in turn is shown to affect actualized risky borrowing behavior. We also found that the relationship between intentional risky borrowing behavior and actualized risky borrowing behavior is negatively moderated by perceived risk – but not by perceived complexity. In particular, the results of this study indicate that public policy makers, banks and financial educators should seek to eliminate less desirable social norms on how to behave financially. In addition, they should seek to enhance young adults’ risky borrowing perceived risk, thereby preventing that intentional risky borrowing behavior translates into actualized risky behavior.

Keywords: financial services, risky borrowing behavior, young adults, financial knowledge, social norms, perceived risk, financial trust, public financial policy

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Authors: Oscar E. Cariceo

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In Chile, there is a lack of evidence about the impact of polyvictimization on the emergence of suicidal thoughts among children and young people. Thus, this study aims to explore the association between the episodes of polyvictimization suffered by Chilean children and young people and the manifestation of signs related to suicidal tendencies. To achieve this purpose, secondary data from the First Polyvictimization Survey on Children and Adolescents of 2017 were analyzed, and a binomial logistic regression model was applied to establish the probability that young people are experiencing suicidal ideation episodes. The main findings show that women between the ages of 13 and 15 years, who are in seventh grade and second in subsidized schools, are more likely to express suicidal ideas, which increases if they have suffered different types of victimization, particularly physical violence, psychological aggression, and sexual abuse.

Keywords: Chile, polyvictimization, suicidal ideation, youth

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Authors: Nevila Alliu, Saimir Heta, Ilma Robo, Vera Ostreni

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Periodontitis as an oral pathology caused by specific bacterial flora functions as a focal infection for the onset and aggravation of arteriosclerosis. These two distant pathologies, since they affect organs at a distance from each other, communicate with each other with correlation at the level of markers of inflammation in the blood. Fluctuations in the level of fibrinogen in the blood, depending on the active or passive phase of the existing periodontitis, affect the promotion of arteriosclerosis. The study is of the review type to analyze the effect of non-surgical periodontal treatment on fluctuations in the level of fibrinogen in the blood. The reduction of fibrinogen levels in the blood after non-surgical periodontal treatment of periodontitis in the patient's cavity is visible data and supported by literature sources. Also, the influence of a high amount of fibrinogen in the blood on the occurrence of arteriosclerosis is also another important data that again relies on many sources of literature. Conclusions: Thromboembolism and arteriosclerosis, as risk factors expressed in clinical data, have temporary bacteremia in the blood, which can occur significantly and often between phases of non-surgical periodontal treatment of periodontitis, treatments performed with treatment phases and protocols of predetermined treatment. Arterial thromboembolism has a significant factor, such as high levels of fibrinogen in the blood, which are significantly reduced during the period of non-surgical periodontal treatment.

Keywords: fibrinogen, refractory periodontitis, atherosclerosis, non-surgical, periodontal treatment

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Authors: Supattra Pranee

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The purposes of this research are to study the current business of health spa and to study the customers’ level of expectation as well as level of satisfaction of the health spa business in Ranong, Thailand. This paper drew upon data collected from health spa customers by using questionnaire. In addition, an in-depth interview was utilized to collect data from health spa entrepreneurs. The findings revealed that the health spa business is growing very fast and the coming ASEAN Economic Community (AEC) will ameliorate the business growth and increase the customer base. There is a need to improve staff’s ability to communicate in English. However, the economic size of Ranong province is still small which has resulted in the hesitation of investors to increase their investment in this business. The findings also revealed four categories of level of expectation and satisfaction as follows: (1) Service: overall, customers had a high expectation with a mean of 3.80 and 0.873 SD and a high level of satisfaction with a mean of 3.66 and 0.704 SD. (2) Staff: overall, customers had a high expectation with a mean of 3.95 and 0.865 SD and a high level of satisfaction with a mean of 3.84 and 0.783 SD. (3) Product, Equipment, and Tools: overall, customers had a high expectation with a mean of 4.02 and 0.913 SD and a high level of satisfaction with a mean of 3.88 and 0.772 SD. (4) Place, Atmosphere, and Environment: overall, customers had a high expectation with a mean of 3.95 and 0.906 SD and a high level of satisfaction with a mean of 3.86 and 0.785 SD.

Keywords: expectation, health spa business, satisfaction, ranong province

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Authors: S. Selman, T. Gout

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Microbial keratitis is a serious complication of contact lens wear that can be vision and eye-threatening. Diverse presentations relating to contact lens wear include dry corneal surface, corneal infiltrate, ulceration, scarring, and complete corneal melt leading to perforation. Contact lens wear is a major risk factor and, as such, is an important consideration in any patient presenting with a red eye in the primary care setting. This paper aims to provide an overview of the risk factors, common organisms, and spectrum of contact lens-associated keratitis (CLAK) complications. It will highlight some of the salient points relevant to the assessment and workup of patients suspected of CLAK in the emergency department based on the recent literature and therapeutic guidelines. An overview of the management principles will also be provided.

Keywords: microbial keratitis, corneal pathology, contact lens-associated complications, painful vision loss

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Authors: Sora Suh, Catherine Michener

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This paper examines the collaborative forms of advocacy that a group of four public school teachers took for their emergent bilingual students in one public school district. While teacher advocacy takes many forms in and out of the classroom, much advocacy work is done by individuals and less by collective action. As a result, individual teachers risk isolation or marginalization in their school contexts when they advocate for immigrant youth. This paper is intended to contribute to the documentation and understanding of teachers’ advocacy work as a collaborative act in teacher education research. The increase of ELs in US classrooms and a corresponding lack of teacher preparation to meet the needs of ELs has motivated the training of educators in linguistically responsive education (e.g., ESL, sheltered English instruction [SEI], bilingual education). Drawing from educational theories of linguistically responsive teaching for preparing educators, we trace the linguistically responsive advocacy work of the teachers. The paper is a multiple case study that tracks how teachers’ discussions on advocacy during a teacher preparation program leading to collaborative actions in their daily teaching lives in and out of school. Data collected includes online discussion forums on the topic of advocacy, course assignments on the topic of advocacy, video-audio recordings of classroom teaching observations, and video-audio recordings of individual and focus group interviews. The findings demonstrate that the teachers’ understanding of advocacy developed through collaborative partnerships formed in the teacher preparation program and grew into active forms of collaborative advocacy in their teaching practice in and out of school. The teachers formed multi-level and collaborative partnerships with teachers, families, community members, policymakers from the local government, and educational researchers to advocate for their emergent bilingual students by planning advocacy events such as new family orientations for emergent bilinguals, professional development for general education teachers on the topic of linguistically responsive instruction, and family nights hosted by the district. The paper’s findings present types of advocacy work in which teachers engage (pedagogical, curricular, out-of-school work) and provide evidence of collaborative advocacy work by a group of engaged educators. The paper highlights the increased agency and effective advocacy of teachers through teacher education and collaborative partnerships and suggests a need for more research on collaborative forms of teacher advocacy for emergent bilinguals.

Keywords: language education, teacher advocacy, language instruction, teacher education

Procedia PDF Downloads 115