Search results for: process risk assessment

Authors: Sila Akhan, Muge Toygar, Murat Sayan, Simge Fidan

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Chronic viral hepatitis B, C, and D can cause hepatocellular carcinoma (HCC), cirrhosis and death. The proper treatment reduce the risk of development of HCC importantly, but not to zero point. Materials and Methods: We analysed retrospectively our chronic viral hepatitis B, C and D patients who attended to our Infectious Diseases policlinic between 2004-2018. From 589 biopsy-proven chronic hepatitis patients 3 have hepatocellular carcinoma on our follow up. First case is 74 years old patient. His HCV infection diagnosis was made 8 years ago. First treatment was pegylated interferon plus ribavirin only 28 weeks, because of HCV RNA breakthrough under treatment. In 2013 he was retreated with telaprevir, pegylated interferon plus ribavirin 24 weeks. But at the end of the therapy HCV RNA was found 1.290.000 IU/mL. He has abdominal ultrasonography (US) controls and alpha-fetoprotein (AFP) at 6 months intervals. All seemed normal until 2015 then he has an abdominal magnetic resonance imaging (MRI) and found HCC by chance. His treatment began in Oncology Clinic after verified with biopsy of HCC. And then sofosbuvir/ledipasvir was given to him for HCV 24 weeks. Sustained virologic response (SVR) was obtained. He is on cure for HCV infection and under control of Oncology for HCC. Second patient is 36 years old man. He knows his HBV infection since 2008. HBsAg and HBeAg positive; HDV RNA negative. Liver biopsy revealed grade:4, stage 3-4 according modified Knodell scoring system. In 2010 tenofovir treatment was began. His abdominal US and AFP were normal. His controls took place at 6 months intervals and HBV DNA negative, US, and AFP were normal until 2016 continuously. AFP found 37 above the normal range and then HCC was found in MRI. Third patient is 57 years old man. As hepatitis B infection was first diagnosed; he has cirrhosis and was began tenofovir as treatment. In short time he has HCC despite normal AFP values. Conclusion: In Mediterranian countries including Turkey naturally occurring pre-S/S variants are more than 75% of all chronic hepatitis B patients. This variants may contribute to the development of progressive liver damage and hepatocarcinogenesis. HCV-induced development of HCC is a gradual process and is affected by the duration of disease and viral genotype. All the chronic viral hepatitis patients should be followed up in 6 months intervals not only with US and AFP for HCC. Despite they have proper treatment there is always the risk development of HCC. Chronic hepatitis patients cannot be dropped from follow up even treated well.

Keywords: HCC, HCV, HBV, DAA

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Authors: Jiri Barta

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This paper deals with a simulation programs and technologies using in the educational process for members of the crisis management. Risk analysis, simulation, preparation and planning are among the main activities of workers of crisis management. Made correctly simulation of emergency defines the extent of the danger. On this basis, it is possible to effectively prepare and plan measures to minimize damage. The paper is focused on simulation programs that are trained at the University of Defence. Implementation of the outputs from simulation programs in decision-making processes of crisis staffs is one of the main tasks of the research project.

Keywords: crisis management, continuity, critical infrastructure, dangerous substance, education, flood, simulation programs

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Authors: Jarmila Štěpánová, Martin Kudláček, Lukáš Jakubec

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The people with spinal cord injury are one of the least sport active members of our society. Their hypoactivity is determined by primary injury, i.e., the loss of motor function, the injured part of the body is connected with health complications and social handicap. Study performs one part of the standardization process of semi-structured interview PARA-SCI.CZ (Czech version of the Physical Activity Recall Assessment for People with Spinal Cord Injury), which measures the type, frequency, duration, and intensity of physical activity of people with spinal cord injury. The study focused on persons with paraplegia who use a wheelchair as their primary mode of mobility. The aim of this study was to perform a process to determine the criterion validity of PARA-SCI.CZ. The actual physical activity of wheelchair users was monitored during three days by using accelerometers Actigraph GT3X fixed on the non-dominant wrist, and semi-structured interview PARA-SCI.CZ. During the PARA-SCI.CZ interview, participants were asked to recall activities they had done over the past 3 days, starting with the previous day. PARA-SCI.CZ captured frequency, duration, and intensity (low, moderate, and heavy) of two categories of physical activity (leisure time physical activity and activities of a usual day). Accelerometer Actigraph GT3X captured duration and intensity (low and moderate + heavy) of physical activity during three days and nights. The study presented three potential recalculations of measured data. Standardization process of PARA-SCI.CZ is essential to critically approach issues of health and active lifestyle of persons with spinal cord injury in the Czech Republic. Standardized PARA-SCI.CZ can be used in practice by physiotherapists and sports pedagogues from the field of adapted physical activities.

Keywords: physical activity, lifestyle, paraplegia, semi-structure interview, accelerometer

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Authors: Ashraf M. Khalifa, Hwat Bing So, Greg Maddocks

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Changes to the mining environmental approvals process in Queensland have been rolled out under the MERFP Act (2018). This includes requirements for a Progressive Rehabilitation and Closure Plan (PRC Plan). Key considerations of the landform design report within the PRC Plan must include: (i) identification of materials available for landform rehabilitation, including their ability to achieve the required landform design outcomes, (ii) erosion assessments to determine landform heights, gradients, profiles, and material placement, (iii) slope profile design considering the interactions between soil erodibility, rainfall erosivity, landform height, gradient, and vegetation cover to identify acceptable erosion rates over a long-term average, (iv) an analysis of future stability based on the factors described above e.g., erosion and /or landform evolution modelling. ACARP funded an extensive and thorough erosion assessment program using rainfall simulators from 1998 to 2010. The ACARP program included laboratory assessment of 35 soil and spoil samples from 16 coal mines and samples from a gold mine in Queensland using 3 x 0.8 m laboratory rainfall simulator. The reliability of the laboratory rainfall simulator was verified through field measurements using larger flumes 20 x 5 meters and catchment scale measurements at three sites (3 different catchments, average area of 2.5 ha each). Soil cover systems are a primary component of a constructed mine landform. The primary functions of a soil cover system are to sustain vegetation and limit the infiltration of water and oxygen into underlying reactive mine waste. If the external surface of the landform erodes, the functions of the cover system cannot be maintained, and the cover system will most likely fail. Assessing a constructed landform’s potential ‘long-term’ erosion stability requires defensible erosion rate thresholds below which rehabilitation landform designs are considered acceptably erosion-resistant or ‘stable’. The process used to quantify erosion rates using rainfall simulators (flumes) to measure rill and inter-rill erosion on bulk samples under laboratory conditions or on in-situ material under field conditions will be explained.

Keywords: open-cut, mining, erosion, rainfall simulator

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Authors: Elham Delzendeh, Song Wu, Mustafa Al-Adhami, Rima Alaaeddine

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Over the last 15 years, prediction of energy consumption has become a common practice and necessity at different stages of the building’s lifecycle, particularly, at the design and post-occupancy stages for planning and maintenance purposes. This is due to the ever-growing response of governments to address sustainability and reduction of CO₂ emission in the building sector. However, there is a level of uncertainty in the estimation of energy consumption in buildings. The accuracy of energy consumption predictions is directly related to the precision of the initial inputs used in the energy assessment process. In this study, multiple cases of large non-residential buildings at design, construction, and post-occupancy stages are investigated. The energy consumption process and inputs, and the actual and predicted energy consumption of the cases are analysed. The findings of this study have pointed out and evidenced various parameters that cause uncertainty in the prediction of energy consumption in buildings such as modelling, location data, and occupant behaviour. In addition, unavailability and insufficiency of energy-consumption-related inputs at different stages of the building’s lifecycle are classified and categorized. Understanding the roots of uncertainty in building energy analysis will help energy modellers and energy simulation software developers reach more accurate energy consumption predictions in buildings.

Keywords: building lifecycle, efficiency, energy analysis, energy performance, uncertainty

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Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

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Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality

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Authors: Louis Nwachi

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Urban planning systems in most countries still rely on expert-driven, top-down technocratic plan-making processes rather than a public and people-led process. This paper set out to evaluate the need for public participation in the plan-making process and to highlight the factors that affect public participation in the plan-making process. In doing this, it adopted a qualitative approach based on document review and interviews taken from real-world phenomena. A case study strategy using the Metropolitan Area of Abuja, the capital of Nigeria, as the study sample was used in carrying out the research. The research finds that participation is an important tool in the plan-making process and that public engagement in the process contributes to the identification of key urban issues that are unique to the specific local areas, thereby contributing to the establishment of priorities and, in turn, to the mobilization of resources to meet the identified needs. It also finds that the development of a participation model by city authorities encourages public engagement and helps to develop trust between those in authority and the different key stakeholder groups involved in the plan-making process.

Keywords: plan-making, participation, urban planning, city

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Authors: Aksana N. Popel, Volha A. Sujayeva, Olga V. Kоshlataja, Irеna S. Karpava

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Introduction: It is a known fact that cardiovascular pathology and its complications cause a more severe course and worse prognosis in patients with comorbid kidney pathology. Chronic kidney disease (CKD) is associated with inflammation, endothelial dysfunction, and increased activity of the sympathoadrenal system. This circumstance increases the risk of cardiovascular diseases and the progression of kidney pathology. The above determines the need to identify cardiorenal changes at early stages to reduce the risks of cardiovascular complications and the progression of CKD. Objective: To identify risk factors (RF) for the development of CKD in elderly patients with chronic ischemic heart disease (CIHD). Methods: The study included 64 patients (40 women and 24 men) with a mean age of 74.4±4.5 years with coronary heart disease, without a history of structural kidney pathology and CKD. All patients underwent transthoracic echocardiography (TTE) and kidney ultrasound (KU) using GE Vivid 9 equipment (GE HealthCare, USA), and cardiac computed tomography (CCT) using Siemens Somatom Force equipment (Siemens Healthineers AG, Germany) in 3 months and in 1 year. Data obtained were analyzed using multiple regression analysis and nonparametric Mann-Whitney test. Statistical analysis was performed using the STATISTICA 12.0 program (StatSoft Inc.). Results: Initially, CKD was not diagnosed in all patients. In 3 months, CKD was diagnosed: stage C1 had 11 people (18%), stage C2 had 4 people (6%), stage C3A had 11 people (18%), stage C3B had 2 people (3%). After 1 year, CKD was diagnosed: stage C1 had 22 people (35%), stage C2 had 5 people (8%), stage C3A had 17 people (27%), stage C3B had 10 people (15%). In 3 months, statistically significant (p<0.05) risk factors were: 1) according to TTE: mitral peak E-wave velocity (U=678, p=0.039), mitral E-velocity DT (U=514, p=0.0168), mitral peak A-wave velocity (U=682, p=0.013). In 1 year, statistically significant (p<0.05) risk factors were: according to TTE: left ventricular (LV) end-systolic volume in B-mode (U=134, p=0.006), LV end-diastolic volume in B-mode (U=177, p=0.04), LV ejection fraction in B-mode (U=135, p=0.006), left atrial volume (U=178, p=0.021), LV hypertrophy (U=294, p=0.04), mitral valve (MV) fibrosis (U=328, p=0.01); according CCT: epicardial fat thickness (EFT) on the right ventricle (U=8, p=0.015); according to KU: interlobar renal artery resistance index (RI) (U=224, p=0.02), segmental renal artery RI (U=409, p=0.016). Conclusions: Both TTE and KU are very informative methods to determine the additional risk factors of CKD development and progression. The most informative risk factors were LV global systolic and diastolic functions, LV and LA volumes. LV hypertrophy, MV fibrosis, interlobar renal artery and segmental renal artery RIs, EFT.

Keywords: chronic kidney disease, ischemic heart disease, prognosis, risk factors

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Authors: Doua AlSaad, Ahmed Awaisu, Samah Elsalem, Palli Valapila Abdulrouf, Binny Thomas, Moza AlHail

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Background: It has been suggested that pyridoxine has an anti-lactogenic effect. Studies of the efficacy of pyridoxine in suppressing lactation have reported conflicting results. The aim of this review is to evaluate the effectiveness and safety of high-dose pyridoxine in postpartum lactation inhibition. Methods: This systematic review included published trials that compared the efficacy and/or safety of pyridoxine to placebo or to other pharmacological agents for the inhibition of postpartum lactation. We searched PubMed, Embase, ScienceDirect, CINAHL, AMED, the Cochrane library, and the clinical trials registry to identify relevant literature. No limit was imposed on the year of publication of the studies, and the review included studies published until 15 January 2016. Two reviewers independently extracted data and assessed the risk of bias. Results: Seven studies were included, with a total of 1155 women, of which 471 women received pyridoxine. Three studies were randomized controlled trials, while the remaining four studies were non-randomized controlled trials. All of the included studies were relatively small (n = 18 – 482). The studies compared pyridoxine with placebo, bromocriptine, and/or stilboestrol. Pyridoxine was given orally, with a total daily dose of 450 – 600 mg for 5 to 7 days. Two trials (n = 349 participants) indicated that pyridoxine was effective in inhibiting lactation in approximately 95% of the enrolled patients. All other studies failed to demonstrate pyridoxine efficacy through either clinical assessment or prolactin level measurements. Pyridoxine safety was assessed by two trials in which no serious untoward side-effects were reported. Overall, the risk of bias for most of the studies was low to moderate. Conclusion: Current evidence supporting the effectiveness of high dose pyridoxine in the inhibition of postpartum lactation is inconsistent and insufficient. Larger randomized trials are needed to confirm the efficacy of pyridoxine in postpartum lactation inhibition. Acknowledgment: This review received a grant from the Medical Research Center of Hamad Medical Corporation in Qatar (grant number: 15100/15).

Keywords: pyridoxine, safety, effectiveness, lactation inhibition

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Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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Authors: Nenashev Yaroslav, Russkin Oleg

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The mixing process is one of the most important and critical stages in many industrial sectors, such as chemistry, pharmaceuticals, and the food industry. When designing equipment with mixing impellers, technology developers often encounter working environments with complex physical properties and rheology. In such cases, the use of computational fluid dynamics tools is an excellent solution to mitigate risks and ensure the stable operation of the equipment. The research focuses on one of the designed reactors with mixing impellers intended for polymer synthesis. The study describes an approach to modeling reactors of similar configurations, taking into account the complex properties of the mixed liquids using the computational fluid dynamics (CFD) method. To achieve this goal, a complex 3D model was created, accurately replicating the functionality of chemical equipment. The model allows for the assessment of the hydrodynamic behavior of the reaction mixture inside the reactor, consideration of heat release due to the reaction, and the heat exchange between the reaction mixture and the cooling medium. The results indicate that the choice of the type and size of the mixing device significantly affects the efficiency of the mixing process inside the chemical reactor.

Keywords: CFD, mixing, blending, chemical reactor, non-Newton liquids, polymers

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Authors: Jefrey Pilusa, Tumisang Seodigeng

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This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: autoclave, disposal, fuel, incineration, medical waste

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Authors: Takashi Kaminagayoshi, Shigeyuki Haruyama

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To improve the manufacturing efficiency of biologics, such as antibody drugs, a quality engineering framework was designed. Within this framework, critical steps and parameters in the manufacturing process were studied. Identification of these critical steps and critical parameters allows a deeper understanding of manufacturing capabilities, and suggests to process development department process control standards based on actual manufacturing capabilities as part of a PDCA (plan-do-check-act) cycle. This cycle can be applied to each manufacturing process so that it can be standardized, reducing the time needed to establish each new process.

Keywords: antibody drugs, biologics, manufacturing efficiency, PDCA cycle, quality engineering

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Authors: Seyed Fakhreddin Hejazi, Leili Iranirad, Mohammad Sadeghi, Mohsen Talebizadeh

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Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures. We performed this clinical trial to assess the preventive effect of allopurinol against CIN in high-risk patients undergoing coronary angiography. Methods: In this prospective randomized controlled trial, 140 patients with at least two risk factors for CIN undergoing coronary angiography were randomly assigned to either the allopurinol group or the control group. Patients in the allopurinol group received 300 mg allopurinol 24 hours before a procedure and intravenous hydration for 12 hours before and after coronary angiography, whereas patients in the control group received intravenous hydration. Serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid were measured before contrast exposure and at 48 hours. CIN was defined as an increase of 25% in serum creatinine (SCr) or >0.5 mg/dl 48 hours after contrast administration. Results: CIN occurred in 11 out of 70 (7.9%) patients in the control group and in 8 out of 70 (5.7%) patients in the allopurinol group. There was no significant difference in the incidence of CIN between the two groups at 48 hours after administering the radiocontrast agent (p = 0.459). However, there were significant differences between the two groups in SCr, BUN, uric acid, and eGFR 48 hours after radiocontrast administration (p < 0.05). Conclusion: Our findings revealed that allopurinol had no substantial efficacy over hydration protocol in high-risk patients for the development of CIN.

Keywords: contrast-induced nephropathy, allopurinol, coronary angiography, contrast agent

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Authors: Mehdi Janbaz

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The global financial crisis and the credit crunch that followed magnified the importance of credit risk management and its crucial role in the stability of all financial sectors and the whole of the system. Many believe that risks faced by the sovereign sector are highly interconnected with banking risks and most likely to trigger and reinforce each other. This study aims to examine (1) the impact of banking and interbank risk factors on the sovereign credit risk of Eurozone, and (2) how the EU Credit Default Swaps spreads dynamics are affected by the Crude Oil price fluctuations. The hypothesizes are tested by employing fitting risk measures and through a four-staged linear modeling approach. The sovereign senior 5-year Credit Default Swap spreads are used as a core measure of the credit risk. The monthly time-series data of the variables used in the study are gathered from the DataStream database for a period of 2008-2019. First, a linear model test the impact of regional macroeconomic and market-based factors (STOXX, VSTOXX, Oil, Sovereign Debt, and Slope) on the CDS spreads dynamics. Second, the bank-specific factors, including LIBOR-OIS spread (the difference between the Euro 3-month LIBOR rate and Euro 3-month overnight index swap rates) and Euribor, are added to the most significant factors of the previous model. Third, the global financial factors including EURO to USD Foreign Exchange Volatility, TED spread (the difference between 3-month T-bill and the 3-month LIBOR rate based in US dollars), and Chicago Board Options Exchange (CBOE) Crude Oil Volatility Index are added to the major significant factors of the first two models. Finally, a model is generated by a combination of the major factor of each variable set in addition to the crisis dummy. The findings show that (1) the explanatory power of LIBOR-OIS on the sovereign CDS spread of Eurozone is very significant, and (2) there is a meaningful adverse co-movement between the Crude Oil price and CDS price of Eurozone. Surprisingly, adding TED spread (the difference between the three-month Treasury bill and the three-month LIBOR based in US dollars.) to the analysis and beside the LIBOR-OIS spread (the difference between the Euro 3M LIBOR and Euro 3M OIS) in third and fourth models has been increased the predicting power of LIBOR-OIS. Based on the results, LIBOR-OIS, Stoxx, TED spread, Slope, Oil price, OVX, FX volatility, and Euribor are the determinants of CDS spreads dynamics in Eurozone. Moreover, the positive impact of the crisis period on the creditworthiness of the Eurozone is meaningful.

Keywords: CDS, crude oil, interbank risk, LIBOR-OIS, OVX, sovereign credit risk, TED

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Authors: Mahdi Farajzadeh Ajirlou

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Ordinary fetal brain development can be considered by in vivo attractive reverberation imaging (MRI) from the 18th gestational week (GW) to term and depends fundamentally on T2-weighted and diffusion-weighted (DW) arrangements. The foremost commonly suspected brain pathologies alluded to fetal MRI for assist assessment are ventriculomegaly, lost corpus callosum, and anomalies of the posterior fossa. Brain division could be a crucial to begin with step in neuroimage examination. Within the case of fetal MRI it is especially challenging and critical due to the subjective introduction of the hatchling, organs that encompass the fetal head, and irregular fetal movement. A few promising strategies have been proposed but are constrained in their execution in challenging cases and in realtime division. Fetal MRI is routinely performed on a 1.5-Tesla scanner without maternal or fetal sedation. The mother lies recumbent amid the course of the examination, the length of which is ordinarily 45 to 60 minutes. The accessibility and continuous approval of standardizing fetal brain development directions will give critical devices for early discovery of impeded fetal brain development upon which to oversee high-risk pregnancies.

Keywords: brain, fetal, MRI, imaging

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Authors: Rafał Szmajser, Katarzyna Świetla, Mariusz Andrzejewski

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Robotic process automation (RPA) is a technology of repeatable business processes performed using computer programs, robots that simulate the work of a human being. This approach assumes replacing an existing employee with the use of dedicated software (software robots) to support activities, primarily repeated and uncomplicated, characterized by a low number of exceptions. RPA application is widespread in modern business services, particularly in the areas of Finance, Accounting and Human Resources Management. By utilizing this technology, the effectiveness of operations increases while reducing workload, minimizing possible errors in the process, and as a result, bringing measurable decrease in the cost of providing services. Regardless of how the use of modern information technology is assessed, there are also some doubts as to whether we should replace human activities in the implementation of the automation in business processes. After the initial awe for the new technological concept, a reflection arises: to what extent does the implementation of RPA increase the efficiency of operations or is there a Business Case for implementing it? If the business case is beneficial, in which business processes is the greatest potential for RPA? A closer look at these issues was provided by in this research during which the respondents’ view of the perceived advantages resulting from the use of robotization and automation in financial and accounting processes was verified. As a result of an online survey addressed to over 500 respondents from international companies, 162 complete answers were returned from the most important types of organizations in the modern business services industry, i.e. Business or IT Process Outsourcing (BPO/ITO), Shared Service Centers (SSC), Consulting/Advisory and their customers. Answers were provided by representatives of the positions in their organizations: Members of the Board, Directors, Managers and Experts/Specialists. The structure of the survey allowed the respondents to supplement the survey with additional comments and observations. The results formed the basis for the creation of a business case calculating tangible benefits associated with the implementation of automation in the selected financial processes. The results of the statistical analyses carried out with regard to revenue growth confirmed the correctness of the hypothesis that there is a correlation between job position and the perception of the impact of RPA implementation on individual benefits. Second hypothesis (H2) that: There is a relationship between the kind of company in the business services industry and the reception of the impact of RPA on individual benefits was thus not confirmed. Based results of survey authors performed simulation of business case for implementation of RPA in selected Finance and Accounting Processes. Calculated payback period was diametrically different ranging from 2 months for the Account Payables process with 75% savings and in the extreme case for the process Taxes implementation and maintenance costs exceed the savings resulting from the use of the robot.

Keywords: automation, outsourcing, business process automation, process automation, robotic process automation, RPA, RPA business case, RPA benefits

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Authors: Othman Saleh Al-Razgan

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Obesity establishes an epidemic along with an array of comorbidities and this call for careful clinical assessment, to identify causal factors and comprehensive management. In Kuwait, this epidemic reflects the progressive, socio-economic and age-related issues, along with the shift of nutrition from traditional to modern-style. The current research attempts to narrate the obesity and related health issues in Kuwait, with a special emphasis on the magnitude of the issue in Kuwait, nutrition transition over the past three decades, change in life-style, and possible solution for this issue.

Keywords: clinical assessment, comorbidities, obesity, socio-economic

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Authors: Eylem G. Cengiz, Ersin Çilek, Gözde Başkaya, Havva Nur Taş

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It is possible to define the abuse and neglect of the child as a social problem. Such adverse experiences of the child are witnessed by wider social circles as well as his or her immediate environment. The most effective institution among these social circles is the school. The awareness of teachers, administrators, and even auxiliary personnel on this issue can act as a protective and preventive buffer because teachers have the opportunity to be with children every day and constantly observe them; therefore, they can notice the physical and mental changes in students. Furthermore, school administrators have an undeniable role in recognizing and responding to the risk of neglect and abuse. This study aims to evaluate the awareness of school administrators on the risk factors, clues, and ways of intervention towards abuse and neglect through the scenarios given to them. Data were collected from 37 primary, secondary, and high school administrators working in various provinces of Turkey through descriptive and scenario-based questions to determine their general knowledge of the concepts of neglect and abuse and their general tendencies towards practice. Descriptive questions were evaluated with content analysis, and scenario-based questions were evaluated with numerical qualitative data analysis. Concepts and themes were tried to be reached by content analysis from the descriptive data collected. When the results are evaluated in general, it is striking that the concept of child abuse means only sexual abuse for some school administrators. There is an important uncertainty for school administrators in the content of the idea of neglect. When the views on the causes of neglect and abuse are examined, the family factor was seen as the primary source of both neglect and abuse. In addition, among the prevention strategies applied by school administrators, intervention for the family -interviewing and informing- was recommended by only 9 (29%) out of 31 administrators. When the responses to the physical, emotional, and sexual abuse scenarios are examined, it is revealed that the administrators generally realize the abuse but fail to develop an appropriate/whole intervention method. The research results show that school administrators' awareness should be increased. Although administrators have sensitivity towards children, they should be empowered to recognize all types of neglect and abuse and develop appropriate intervention tools.

Keywords: assessment child abuse and neglect, child abuse, child neglect, school administrators

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Authors: Farwa Rizvi, Joanne Williams, Humaira Maheen, Elizabeth Hoban

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There is an increase in risky sexual behavior and unsafe sex in adolescent girls and young women aged 15 to 24 years in Cambodia, which negatively affects their reproductive health by increasing the risk of contracting sexually transmitted infections and unintended pregnancies. Risky sexual behavior includes ‘having sex at an early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs, and unprotected sexual behaviors’. A systematic review of quantitative research conducted in Cambodia was undertaken, using the theoretical framework of the Social Ecological Model to identify the personal, social and cultural factors associated with risky sexual behavior and unsafe sex in young Cambodian women. PRISMA guidelines were used to search databases including Medline Complete, PsycINFO, CINAHL Complete, Academic Search Complete, Global Health, and Social Work Abstracts. Additional searches were conducted in Science Direct, Google Scholar and in the grey literature sources. A risk-of-bias tool developed explicitly for the systematic review of cross-sectional studies was used. Summary item on the overall risk of study bias after the inter-rater response showed that the risk-of-bias was high in two studies, moderate in one study and low in one study. The search strategy included a combination of subject terms and free text terms. The medical subject headings (MeSH) terms included were; contracept* or ‘birth control’ or ‘family planning’ or pregnan* or ‘safe sex’ or ‘protected intercourse’ or ‘unprotected intercourse’ or ‘protected sex’ or ‘unprotected sex’ or ‘risky sexual behaviour*’ or ‘abort*’ or ‘planned parenthood’ or ‘unplanned pregnancy’ AND ( barrier* or obstacle* or challenge* or knowledge or attitude* or factor* or determinant* or choic* or uptake or discontinu* or acceptance or satisfaction or ‘needs assessment’ or ‘non-use’ or ‘unmet need’ or ‘decision making’ ) AND Cambodia*. Initially, 300 studies were identified by using key words and finally, four quantitative studies were selected based on the inclusion criteria. The four studies were published between 2010 and 2016. The study participants ranged in age from 10-24 years, single or married, with 3 to 10 completed years of education. The mean age at sexual debut was reported to be 18 years. Using the perspective of the Social Ecological Model, risky sexual behavior was associated with individual-level factors including young age at sexual debut, low education, unsafe sex under the influence of alcohol and substance abuse, multiple sexual partners or transactional sex. Family level factors included living away from parents, orphan status and low levels of family support. Peer and partner level factors included peer delinquency and lack of condom use. Low socioeconomic status at the society level was also associated with risky sexual behaviour. There is scant research on sexual and reproductive health of adolescent girls and young women in Cambodia. Individual, family and social factors were significantly associated with risky sexual behaviour. More research is required to inform potential preventive strategies and policies that address young women’s sexual and reproductive health.

Keywords: adolescents, high-risk sex, sexual activity, unplanned pregnancies

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Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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Authors: Mohammad Ruhul Amin, Nusrat Jahan

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Natural gas is a cleaner fuel compared to the others. But it needs some treatment before it is in a state to be used. So natural gas purification is an integral part of any process where natural gas is used as raw material or fuel. There are several impurities in natural gas that have to be removed before use. CO2 is one of the major contaminants. In this project we have removed CO2 by amine process by using MEA solution. We have built up the whole amine process for removing CO2 in Aspen Hysys and simulated the process. At the end of simulation we have got very satisfactory results by using MEA solution for the removal of CO2. Simulation result shows that amine absorption process enables to reduce CO2 content from NG by 58%. HYSYS optimizer allowed us to get a perfect optimized plant. After optimization the profit of existing plant is increased by 2.34 %.Simulation and optimization by Aspen-HYSYS simulator makes available us to enormous information which will help us to further research in future.

Keywords: Aspen–Hysys, CO2 removal, flowsheet development, MEA solution, natural gas optimization

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Authors: Yiannis Koumpouros, Effie Papageorgiou, Alexandra Karavasili, Foteini Koureta

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The objective of the present study was to develop a scale called PYTHEIA. The PYTHEIA is a self-reported measure for the assessment of rehabilitation and assistive robotics and other assistive technology devices. The development of PYTHEIA faced the absence of a valid instrument that can be used to evaluate the assistive robotic devices both as a whole, as well as any of their individual components or functionalities implemented. According to the results presented, PYTHEIA is a valid and reliable scale able to be applied to different target groups for the subjective evaluation of various assistive technology devices.

Keywords: rehabilitation, assistive technology, assistive robots, rehabilitation robots, scale, psychometric test, assessment, validation, user satisfaction

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Authors: Kamalendu Pal

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This paper describes the main features of a knowledge-based system evaluation method. System evaluation is placed in the context of a hybrid legal decision-support system, Advisory Support for Home Settlement in Divorce (ASHSD). Legal knowledge for ASHSD is represented in two forms, as rules and previously decided cases. Besides distinguishing the two different forms of knowledge representation, the paper outlines the actual use of these forms in a computational framework that is designed to generate a plausible solution for a given case, by using rule-based reasoning (RBR) and case-based reasoning (CBR) in an integrated environment. The nature of suitability assessment of a solution has been considered as a multiple criteria decision making process in ASHAD evaluation. The evaluation was performed by a combination of discussions and questionnaires with different user groups. The answers to questionnaires used in this evaluations method have been measured as a combination of linguistic variables, fuzzy numbers, and by using defuzzification process. The results show that the designed evaluation method creates suitable mechanism in order to improve the performance of the knowledge-based system.

Keywords: case-based reasoning, fuzzy number, legal decision-support system, linguistic variable, rule-based reasoning, system evaluation

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Authors: Steven Walker

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This paper assesses recent data on the prevalence of poverty among children and young people diagnosed with mental health problems. The paper will demonstrate that the current hierarchy of risk factors for developing mental health problems needs adjusting to place poverty among the highest risk factors. Globally poverty is calculated to keep rising especially among less developed countries, and the post-Covid 19 economic recession in developed countries is set to rise. The experience of young people enduring Pandemic isolation is already being quantified and is expected to increase referrals for specialist intervention. Searches on several medical/psychological/social databases using keywords: poverty, children, mental illness were undertaken between 2018 and 2021. Worldwide, 700 million people still live in extreme poverty, half of whom are children. Children are physically and mentally disproportionately affected. Children who grow up impoverished lack the basic necessities they need to survive and thrive. 150 million children have been plunged into multidimensional poverty due to COVID-19. The poorest children are twice as likely to die in childhood than their wealthier peers. For those growing up in humanitarian crises such as Ukraine, the risks of deprivation and exclusion are magnified. In the world’s richest countries, one in seven children still live in poverty. Currently, one in four children in the European Union are at risk of falling into poverty. In Europe the impact of Brexit on the UK economy is predicted to reduce GDP by 5% in 2021 with a corresponding rise in poverty. According to the global charity Oxfam wealth inequality impacts levels of child abuse and affects women and girls worse and is a contributory factor in the risk of developing childhood mental illness. In the UK 2000 Foodbanks have opened since 2010, handing out 2 million food parcels annually, where there are currently 4 million children officially living in poverty. This research demonstrates that there is a strong association between families’ socio-economic circumstances and the chances that their children will experience mental illness. Evidence of this association is found repeatedly across developed countries. The paper will conclude by arguing that psychologists, psychiatrists, psychotherapists, social workers and CAMHS specialists need to place more importance on this critical socio-economic variable when assessing referred children and also advocate for political priorities in governments to reduce poverty and lower the risk of childhood mental illness.

Keywords: poverty, resilience, risk factor, socio economic, susceptibility

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Authors: Jorn Meyer, Stefan Sturmer

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The assessment of attachment patterns in toddlers and adults has been well researched, and valid diagnostic methods (e.g., Strange Situation Test, Adult Attachment Interview) are applicable. For middle and late childhood, on the other hand, there are only few validated methods available so far. For the Child Attachment Interview (CAI) promising validation studies from English-speaking countries are available, but so far a comprehensive study on the validity of a German sample is lacking. Within the scope of a longitudinal project, the results of the first point of measurement are reported in this study. A German-language version of the CAI was carried out with 111 primary school children (56% female; age: M = 8.34, SD = 0.49). In relation to psychometric quality criteria, parameters on interrater reliability, construct validity and discriminant, and convergent validity are reported. Analyses of the correlations between attachment patterns and internalizing and externalizing behavior problems from parent and teacher reports are presented. The implications for the German-language assessment of attachment in middle and late childhood in research and individual case diagnostics, e.g., in the context of conducting expert evaluation reports for family courts, are discussed.

Keywords: attachment, attachment assessment, developmental psychology, longitudinal study

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Authors: Ali Kassem, Mohamed Alsenbasy, Ahmed Nagaah

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Background: Diabetic foot is one of the often neglected complications of diabetes mellitus It was reported that patients of diabetic foot ulcer (DFU) have considerable morbidity and mortality. Due to arterial abnormalities, diabetic neuropathy, as well as the tendency to delayed wound healing, foot infection and or gangrene is relatively common in diabetic patients. Foot related problems are responsible for up to 50% of diabetic related hospital admissions. Aim of work: The aim of the present study is to assess the risk factors for DFU in diabetic patients attending Sohag University Hospitals (Upper Egypt) Material and methods: The present study includes 100 diabetic foot patients attending the diabetic outpatient clinic of Sohag University Hospitals. For all of the studied patients the following were done: Full medical history and clinical examination; thorough foot examination; Laboratory tests including: Blood glucose level, HBA1c, serum lipids and renal function tests, ECG and Echocardiography, Doppler study on the lower limbs. Results: Sixty eight percent of the affected patients were males versus 32 % female patients. All male patients and none of the female were smoker. Seventy nine percent of patients were living in rural areas versus 14 % in urban areas. Duration of diabetes was more than 12 years in 74%, less than 12 years in 26% of patients. Fifty percent of patients have associated hypertension, 46% have dyslipidemia, 18% have ischemic heart disease or old myocardial infarction and 8% have impaired renal function. History of previous foot ulcers was reported in 11 % and foot amputation in 2% of patients. Conclusion: Male gender, low socioeconomic status, smoking, long duration of diabetes, other cardiovascular risk factors particularly hypertension and previous history of foot ulceration are the major risk factors for diabetic foot in our locality.

Keywords: diabetic foot, diabetic neuropathy, foot gangrene, risk factors for diabetic complications

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Authors: H. Al-Jabli

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Using the freeze-melting process for the disposing of high saline brines was the aim of the paper by confirming the performance estimation of the treatment system. A laboratory bench scale freezing technique test unit was designed, constructed, and tested at Doha Research Plant (DRP) in Kuwait. The principal unit operations that have been considered for the laboratory study are: ice crystallization, separation, washing, and melting. The applied process is characterized as “the secondary-refrigerant indirect freezing”, which is utilizing normal freezing concept. The high saline brine was used as definite feed water, i.e. average TDS of 250,000 ppm. Kuwait desalination plants were carried out in the experimental study to measure the performance of the proposed treatment system. Experimental analysis shows that the freeze-melting process is capable of dropping the TDS of the feed water from 249,482 ppm to 56,880 ppm of the freeze-melting process in the two-phase’s course, whereas overall recovery results of the salt passage and salt rejection are 31.11%, 19.05%, and 80.95%, correspondingly. Therefore, the freeze-melting process is encouraging for the proposed application, as it shows on the results, which approves the process capability of reducing a major amount of the dissolved salts of the high saline brine with reasonable sensible recovery. This process might be reasonable with other brine disposal processes.

Keywords: high saline brine, freeze-melting process, ice crystallization, brine disposal process

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Authors: Siyao Zhu, Yifang Xu

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After natural and man-made disasters, robots can bypass the danger, expedite the search, and acquire unprecedented situational awareness to design rescue plans. The hands-free requirement from the first responders excludes the use of tedious manual control and operation. In unknown, unstructured, and obstructed environments, natural-language-based supervision is not amenable for first responders to formulate, and is difficult for robots to understand. Brain-computer interface is a promising option to overcome the limitations. This study aims to test the feasibility of using electroencephalography (EEG) signals to decode human intentions and detect the level of consensus on robot-provided information. EEG signals were classified using machine-learning and deep-learning methods to discriminate search intentions and agreement perceptions. The results show that the average classification accuracy for intention recognition and consensus assessment is 67% and 72%, respectively, proving the potential of incorporating recognizable users’ bioelectrical responses into advanced robot-assisted systems for emergency response.

Keywords: consensus assessment, electroencephalogram, emergency response, human-robot collaboration, intention recognition, search and rescue

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Authors: N. Cihan KayaçEtin, Stijn Verdoodt, Alexis Versele

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The construction industry is accounted for one-third of all waste generated in the European Union (EU) countries. The Circular Economy Action Plan of the EU aims to tackle this issue and aspires to enhance the sustainability of the construction industry by adopting more circular principles and bio-based material use. The Interreg Circular Bio-Based Construction Industry (CBCI) project was conceived to research how this adoption can be facilitated. For this purpose, an approach is developed that integrates technical, legal and social aspects and provides business models for circular designing and building with bio-based materials. In the scope of the project, the research outputs are to be displayed in a real-life setting by constructing a demo terraced single-family house, the living lab (LL) located in Ghent (Belgium). The realization of the LL is conducted in a step-wise approach that includes iterative processes for design, description, criteria definition and multi-criteria assessment of building components. The essence of the research lies within the exploratory approach to the state-of-art building envelope and technical systems options for achieving an optimum combination for a circular and bio-based construction. For this purpose, nine preliminary designs (PD) for building envelope are generated, which consist of three basic construction methods: masonry, lightweight steel construction and wood framing construction supplemented with bio-based construction methods like cross-laminated timber (CLT) and massive wood framing. A comparative analysis on the PDs was conducted by utilizing several complementary tools to assess the circularity. This paper focuses on the life cycle assessment (LCA) approach for evaluating the environmental impact of the LL Ghent. The adoption of an LCA methodology was considered critical for providing a comprehensive set of environmental indicators. The PDs were developed at the component level, in particular for the (i) inclined roof, (ii-iii) front and side façade, (iv) internal walls and (v-vi) floors. The assessment was conducted on two levels; component and building level. The options for each component were compared at the first iteration and then, the PDs as an assembly of components were further analyzed. The LCA was based on a functional unit of one square meter of each component and CEN indicators were utilized for impact assessment for a reference study period of 60 years. A total of 54 building components that are composed of 31 distinct materials were evaluated in the study. The results indicate that wood framing construction supplemented with bio-based construction methods performs environmentally better than the masonry or steel-construction options. An analysis on the correlation between the total weight of components and environmental impact was also conducted. It was seen that masonry structures display a high environmental impact and weight, steel structures display low weight but relatively high environmental impact and wooden framing construction display low weight and environmental impact. The study provided valuable outputs in two levels: (i) several improvement options at component level with substitution of materials with critical weight and/or impact per unit, (ii) feedback on environmental performance for the decision-making process during the design phase of a circular single family house.

Keywords: circular and bio-based materials, comparative analysis, life cycle assessment (LCA), living lab

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