Search results for: risk score

Authors: Kumari Bandana Bhatt, Navin Bhatt

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Background: Orphans and vulnerable children (OVC) are high risk of physical, mental, sexual and emotional abuse and face social stigma and discrimination which significantly increase the risk of mental and behavioral disorders such as anxiety, depression or emotional problems even they stay in well run child care homes. The objective of this study was to estimate the prevalence of depression and determine the determinants among OVC in child care homes in Nepal. Methods: An institutional-based analytical cross-sectional study was conducted in twenty orphanages of five districts of Nepal. Six hundred two children were recruited into the study. After the informed consent form obtaining, the guardian and assent were interviewed by a semi-structured questionnaire and Beck Depression Inventory-II (BDI-II). Logistic regression was used for detecting the association between variables at the significant level of =0.05. Results: The study revealed that 33.20% of OVC had depression. Among them 66.80% of children experienced minimal depression, 17.40% had mild depression, 11.30% had moderate depression 4.50% had severe depression. Sex, alcohol drinking, congenital problem, social support and bully were the main variables associated with depression among OVC of the child care homes in Nepal. Conclusion: Prevalence of depression was high among the orphans and vulnerable children living in child care homes especially among the female children in Nepal. Therefore, early identification and instituting of preventive measures of depression are essential to reduce this problem in this special group of children living in child care homes.

Keywords: Mental health, Depression, Orphans and vulnerable children, child care homes

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Authors: Ioannis N. Sergentanis, Stavroula Papadodima, Maria Tsellou, Dimitrios Vlachodimitropoulos, Sotirios Athanaselis, Chara Spiliopoulou

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Introduction: The aim of this study is the investigation of characteristics of suicide, as documented in autopsies during a five-year interval in the greater area of Attica, including the city of Athens. This could reveal possible protective or aggravating factors for suicide risk during a period strongly associated with the Greek debt crisis. Materials and Methods: Data was obtained following registration of suicide cases among autopsies performed in the Forensic Medicine and Toxicology Department, School of Medicine, National and Kapodistrian University of Athens, Greece, during the time interval from January 2011 to December 2015. Anonymity and medical secret were respected. A series of demographic and social factors in addition to special characteristics of suicide were entered into a specially established pre-coded database. These factors include social data as well as psychiatric background and certain autopsy characteristics. Data analysis was performed using descriptive statistics and Fisher’s exact test. The software used was STATA/SE 13 (Stata Corp., College Station, TX, USA). Results: A total of 162 cases were studied, 128 men and 34 women. Age ranged from 14 to 97 years old with an average of 53 years, presenting two peaks around 40 and 60 years. A 56% of cases were single/ divorced/ widowed. 25% of cases occurred during the weekend, and 66% of cases occurred in the house. A predominance of hanging as the leading method of suicide (41.4%) followed by jumping from a height (22.8%) and firearms (19.1%) was noted. Statistical analysis showed an association was found between suicide method and gender (P < 0.001, Fisher’s exact test); specifically, no woman used a firearm while only one man used medication overdose (against four women). Discussion: Greece has historically been one of the countries with the lowest suicide rates in Europe. Given a possible change in suicide trends during the financial crisis, further research seems necessary in order to establish risk factors. According to our study, suicide is more frequent in men who are not married, inside their house. Gender seems to be a factor affecting the method of suicide. These results seem in accordance with the international literature. Stronger than expected predominance in male suicide can be associated with failure to live up to social and family expectations for financial reasons.

Keywords: autopsy, Greece, risk factors, suicide

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Authors: Ho Sy Nam, Tang Ha Nam Anh

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Background: Rotator cuff tears are a common problem in the aging population. The prevalence of massive rotator cuff tears varies in some studies from 10% to 40%. Of irreparable rotator cuff tears (IRCTs), which are mostly associated with massive tear size, 79% are estimated to have recurrent tears after surgical repair. Recent studies have shown that superior capsule reconstruction (SCR) in massive rotator cuff tears can be an efficient technique with optimistic clinical scores and preservation of stable glenohumeral stability. Superior capsule reconstruction techniques most commonly use either fascia lata autograft or dermal allograft, both of which have their own benefits and drawbacks (such as the potential for donor site issues, allergic reactions, and high cost). We propose a simple technique for superior capsule reconstruction that involves using the long head of the biceps tendon as a local autograft; therefore, the comorbidities related to graft harvesting are eliminated. The long head of the biceps tendon proximal portion is relocated to the footprint and secured as the SCR, serving to both stabilize the glenohumeral joint and maintain vascular supply to aid healing. Objective: The purpose of this study is to assess the clinical outcomes of patients with large to massive RCTs treated by SCR using LHBT. Materials and methods: A study was performed of consecutive patients with large to massive RCTs who were treated by SCR using LHBT between January 2022 and December 2022. We use one double-loaded suture anchor to secure the long head of the biceps to the middle of the footprint. Two more anchors are used to repair the rotator cuff using a single-row technique, which is placed anteriorly and posteriorly on the lateral side of the previously transposed LHBT. Results: The 3 men and 5 women had an average age of 61.25 years (range 48 to 76 years) at the time of surgery. The average follow-up was 8.2 months (6 to 10 months) after surgery. The average preoperative ASES was 45.8, and the average postoperative ASES was 85.83. The average postoperative UCLA score was 29.12. VAS score was improved from 5.9 to 1.12. The mean preoperative ROM of forward flexion and external rotation of the shoulder was 720 ± 160 and 280 ± 80, respectively. The mean postoperative ROM of forward flexion and external rotation were 1310 ± 220 and 630 ± 60, respectively. There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Conclusion: SCR using LHBT is considered a treatment option for patients with large or massive RC tears. It can restore superior glenohumeral stability and function of the shoulder joint and can be an effective procedure for selected patients, helping to avoid progression to cuff tear arthropathy.

Keywords: superior capsule reconstruction, large or massive rotator cuff tears, the long head of the biceps, stabilize the glenohumeral joint

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Authors: Oludare Isaac Abiodun, Esther Omolara Abiodun

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The purpose of this paper is to demonstrate that cyberterrorism is existing and poses a threat to computer security and national security. Nowadays, people have become excitedly dependent upon computers, phones, the Internet, and the Internet of things systems to share information, communicate, conduct a search, etc. However, these network systems are at risk from a different source that is known and unknown. These network systems risk being caused by some malicious individuals, groups, organizations, or governments, they take advantage of vulnerabilities in the computer system to hawk sensitive information from people, organizations, or governments. In doing so, they are engaging themselves in computer threats, crime, and terrorism, thereby making the use of computers insecure for others. The threat of cyberterrorism is of various forms and ranges from one country to another country. These threats include disrupting communications and information, stealing data, destroying data, leaking, and breaching data, interfering with messages and networks, and in some cases, demanding financial rewards for stolen data. Hence, this study identifies many ways that cyberterrorists utilize the Internet as a tool to advance their malicious mission, which negatively affects computer security and safety. One could identify causes for disparate anomaly behaviors and the theoretical, ideological, and current forms of the likelihood of cyberterrorism. Therefore, for a countermeasure, this paper proposes the use of previous and current computer security models as found in the literature to help in countering cyberterrorism

Keywords: cyberterrorism, computer security, information, internet, terrorism, threat, digital forensic solution

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Authors: Cedric Leong, Parth Desai, Parth Patel

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The purpose of this project was to develop a neural network based on qualitative team data to predict alliance scores to determine winners of matches in the FIRST Robotics Competition (FRC). The game for the competition changes every year with different objectives and game objects, however the idea was to create a prediction system which can be reused year by year using some of the statistics that are constant through different games, making our system adaptable to future games as well. Aerial Assist is the FRC game for 2014, and is played in alliances of 3 teams going against one another, namely the Red and Blue alliances. This application takes any 6 teams paired into 2 alliances of 3 teams and generates the prediction for the final score between them.

Keywords: artifical neural network, prediction system, qualitative team data, FIRST Robotics Competition (FRC)

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Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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Authors: Yuchen Chen, Dehong Li, Bin Li, Denis Rodrigue, Xiaodong (Alice) Wang

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When selecting insulation materials, not only should their thermal efficiency be considered, but also their impact on the environment. Compared to conventional insulation materials, bio-based materials not only have comparable thermal performance, but they also have a lower embodied energy. Sheep wool has the advantages of low negative health impact, high fire resistance, eco-friendliness, and high moisture resistance. However, studies on applying sheep wool insulation in cold and humid climates are still insufficient. The purpose of this study is to simulate the hygrothermal performance of sheep wool insulation for the Quebec City climate, as well as analyze the mold growth risks. The results show that a sheep wool wall has better thermal performance than a reference wall and that both meet the minimum requirements of the Quebec Code for the thermal performance of above-ground walls. The total water content indicates that the sheep wool wall can reach dynamic equilibrium in the Quebec climate and can dry out. At the same time, a delay of almost four months in the maximum total water content indicates that the sheep wool wall has high moisture absorption compared to the reference wall. The hygrothermal profiles show that the sheathing-insulation interface of both walls is at the highest risk for condensation. When the interior surface gypsum was replaced by stucco, the mold index significantly dropped.

Keywords: sheep wool, water content, hygrothermal performance, mould growth risk

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Authors: Shreyas Kumar, Mili Shangari

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Integrating artificial intelligence (AI) in the cyber insurance sector represents a significant advancement, offering the potential to revolutionize risk assessment, fraud detection, and claims processing. However, this integration introduces a range of regulatory and economic challenges that must be addressed to ensure responsible and effective deployment of AI technologies. This paper examines the multifaceted regulatory landscape governing AI in cyber insurance and explores the economic implications of compliance, innovation, and market dynamics. AI's capabilities in processing vast amounts of data and identifying patterns make it an invaluable tool for insurers in managing cyber risks. Yet, the application of AI in this domain is subject to stringent regulatory scrutiny aimed at safeguarding data privacy, ensuring algorithmic transparency, and preventing biases. Regulatory bodies, such as the European Union with its General Data Protection Regulation (GDPR), mandate strict compliance requirements that can significantly impact the deployment of AI systems. These regulations necessitate robust data protection measures, ethical AI practices, and clear accountability frameworks, all of which entail substantial compliance costs for insurers. The economic implications of these regulatory requirements are profound. Insurers must invest heavily in upgrading their IT infrastructure, implementing robust data governance frameworks, and training personnel to handle AI systems ethically and effectively. These investments, while essential for regulatory compliance, can strain financial resources, particularly for smaller insurers, potentially leading to market consolidation. Furthermore, the cost of regulatory compliance can translate into higher premiums for policyholders, affecting the overall affordability and accessibility of cyber insurance. Despite these challenges, the potential economic benefits of AI integration in cyber insurance are significant. AI-enhanced risk assessment models can provide more accurate pricing, reduce the incidence of fraudulent claims, and expedite claims processing, leading to overall cost savings and increased efficiency. These efficiencies can improve the competitiveness of insurers and drive innovation in product offerings. However, balancing these benefits with regulatory compliance is crucial to avoid legal penalties and reputational damage. The paper also explores the potential risks associated with AI integration, such as algorithmic biases that could lead to unfair discrimination in policy underwriting and claims adjudication. Regulatory frameworks need to evolve to address these issues, promoting fairness and transparency in AI applications. Policymakers play a critical role in creating a balanced regulatory environment that fosters innovation while protecting consumer rights and ensuring market stability. In conclusion, the integration of AI in cyber insurance presents both regulatory and economic challenges that require a coordinated approach involving regulators, insurers, and other stakeholders. By navigating these challenges effectively, the industry can harness the transformative potential of AI, driving advancements in risk management and enhancing the resilience of the cyber insurance market. This paper provides insights and recommendations for policymakers and industry leaders to achieve a balanced and sustainable integration of AI technologies in cyber insurance.

Keywords: artificial intelligence (AI), cyber insurance, regulatory compliance, economic impact, risk assessment, fraud detection, cyber liability insurance, risk management, ransomware

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Authors: Tochukwu Timothy Okoli, Devi Datt Tewari

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The high rate of Fintech adoption has not transmitted to greater financial inclusion and development in Africa. This problem is attributed to poor Fintech diversification and usefulness in the continent. This concept is referred to as the Fintech depth of penetration in this study. The study, therefore, assessed its determinants and growth process in a panel of three emergings, twenty-four frontiers and five fragile African economies disaggregated with dummies over the period 2004-2018 to allow for heterogeneity between groups. The System Generalized Method of Moments (GMM) technique reveals that the average depth of Mobile banking and automated teller machine (ATM) is a dynamic heterogeneity process. Moreover, users' previous experiences/compatibility, trial-ability/income, and financial development were the major factors that raise its usefulness, whereas perceived risk, financial openness, and inflation rate significantly limit its usefulness. The growth rate of Mobile banking, ATM, and Internet banking in 2018 is, on average 41.82, 0.4, and 20.8 per cent respectively greater than its average rates in 2004. These greater averages after the 2009 financial crisis suggest that countries resort to Fintech as a risk-mitigating tool. This study, therefore, recommends greater Fintech diversification through improved literacy, institutional development, financial liberalization, and continuous innovation.

Keywords: depth of fintech, emerging Africa, financial technology, internet banking, mobile banking

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Authors: Jihen Bennaceur, Wissem Zouaghi, Ali Mabrouk

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The major aim of cyber threat intelligence (CTI) is to provide sophisticated knowledge about cybersecurity threats to ensure internal and external safeguards against modern cyberattacks. Inaccurate, incomplete, outdated, and invaluable threat intelligence is the main problem. Therefore, data analysis based on AI algorithms is one of the emergent solutions to overcome the threat of information-sharing issues. In this paper, we propose a supervised machine learning-based algorithm to improve threat information sharing by providing a sophisticated classification of cyber threats and data. Extensive simulations investigate the accuracy, precision, recall, f1-score, and support overall to validate the designed algorithm and to compare it with several supervised machine learning algorithms.

Keywords: threat information sharing, supervised learning, data classification, performance evaluation

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Authors: Yifu Ding, Vijay Avinash, Malcolm McCulloch

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As the proliferation of decentralized energy systems, the UK power system allows small-scale entities such as microgrids (MGs) to tender multiple energy services including energy arbitrage and frequency responses (FRs). However, its operation requires the balance between the uncertain renewable generations and loads in real-time and has to fulfill their provision requirements of contract services continuously during the time window agreed, otherwise it will be penalized for the under-delivered provision. To hedge against risks due to uncertainties and maximize the economic benefits, we propose a stochastic model predictive control (SMPC) framework to optimize its operation for the multi-service provision. Distinguished from previous works, we include a detailed economic-degradation model of the lithium-ion battery to quantify the costs of different service provisions, as well as accurately describe the changing dynamics of the battery. Considering a branch of load and generation scenarios and the battery aging, we formulate a risk-averse cost function using conditional value at risk (CVaR). It aims to achieve the maximum expected net revenue and avoids severe losses. The framework will be performed on a case study of a PV-battery grid-tied microgrid in the UK with real-life data. To highlight its performance, the framework will be compared with the case without the degradation model and the deterministic formulation.

Keywords: model predictive control (MPC), battery degradation, frequency response, microgrids

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Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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Authors: Marzieh Amiri, Zahra Iranpour Mobarakeh, Fatemeh Mehrbakhsh, Mehran Amiri

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Introduction: Early diagnosis and intervention of congenital hearing loss is necessary to minimize the adverse effects of hearing loss. The aim of the present study was to report the results of newborn hearing screening in a centerin the south part of Iran, Fasa. Material and methods: In this study, the data related to 6,144 newbornsduring September 2018 up to September2021, was analyzed. Hearing screening was performed using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) tests. Results: From all 6144 newborns,3752 and 2392referred to the center from urban and rural part of Fasa, respectively. There were 2958 female and 3186 male in this study. Of 6144 newborns, 6098 ones passed the screening tests, and 46 neonates were referred to a diagnostic audiology clinic. Finally, nine neonates were diagnosed with congenital hearing loss (seven with sensorineural hearing loss and two with conductive hearing loss). The severity of all the hearing impaired neonates was moderate and above. The most important risk factors were family history of hearing loss, low gestational age, NICU hospitalization, and hyperbilirubinemia. Conclusion: Our results showed that the prevalence of hearing loss was 1.46 per 1000 infants. Boosting public knowledge by providing families with proper education appears to be helpful in preventing the negative effects of delayed implementation of health screening programs.

Keywords: newborn hearing screening, hearing loss, risk factor, prevalence

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Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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Authors: Saidu I. R., Shittu S. S.

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As the trend of personal devices accessing corporate data continues to rise through Bring Your Own Device (BYOD) practices, organizations recognize the potential cost reduction and productivity gains. However, the associated security risks pose a significant threat to these benefits. Often, organizations adopt BYOD environments without fully considering the vulnerabilities introduced by human factors in this context. This study presents an enhanced assessment model that evaluates the security posture of employees in BYOD environments using cyber hygiene principles. The framework assesses users' adherence to best practices and guidelines for maintaining a secure computing environment, employing scales and the Euclidean distance formula. By utilizing this algorithm, the study measures the distance between users' security practices and the organization's optimal security policies. To facilitate user evaluation, a simple and intuitive interface for automated assessment is developed. To validate the effectiveness of the proposed framework, design science research methods are employed, and empirical assessments are conducted using five artifacts to analyze user suitability in BYOD environments. By addressing the human factor vulnerabilities through the assessment of cyber hygiene practices, this study aims to enhance the overall security of BYOD environments and enable organizations to leverage the advantages of this evolving trend while mitigating potential risks.

Keywords: security, BYOD, vulnerability, risk, cyber hygiene

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Authors: Agajie Likie Bogale, Tilahun Teklehaymanot, Getnet Mitike Kassie, Girmay Medhin, Jemal Haidar Ali, Nega Berhe Belay

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Objectives: The aim of this study is to evaluate the performance of visual inspection using acetic acid compared with HPV DNA testing among women living with HIV in Ethiopia. Methods: Acomparative cross-sectional study was conducted to address the aforementioned objective. Data were collected from January to October 2021 to compare the performance of these two screening modalities. Trained clinicians collected cervical specimens and immediately applied acetic acid for visual inspection. The HPV DNA testing was done using Abbott m2000rt/SP by trained laboratory professionals in accredited laboratories. A total of 578 HIV positive women with age 25-49 years were included. Results: Test positivity was 8.9% using VIA and 23.3% using HPV DNA test. The sensitivity and specificity of the VIA test were 19.2% and 95.1%, respectively, while the positive and negative predictive values of the VIA test were 54.4% and 79.4%, respectively. The strength of agreement between the two screening methods was poor (k=0.184), and the area under the curve was 0.572. The burden of genetic distribution of high risk HPV16 was 3.8%, and mixed HPV16& other HR HPV was 1.9%. Other high risk HPV types were predominant in this study (15.7%). Conclusion: The high positivity result using HPV DNA testing compared with VIA, and low sensitivity of VIA are indicating that the implementation of HPV DNA testing as the primary screening strategy is likely to reduce cervical cancer cases and deaths of women in the country.

Keywords: cervical cancer screening, HPV DNA, VIA, Ethiopia

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Authors: Kamelia Hamza

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Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.

Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders

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Authors: Abebayehu Yohannes, Hsiu-Ling Chen, Chiu-Chen Chang

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Mathematics reading and spatial ability are important learning components in mathematics education. However, many students struggle to understand real-world problems and lack the spatial ability to form internal imagery. To cope with this problem, in this study, an interactive e-book was developed. The result indicated that both groups had a significant increase in the mathematics reading ability test, and a significant difference was observed in the overall mathematics reading score in favor of the experimental group. In addition, the interactive e-book learning mode had significant impacts on students’ spatial ability. It was also found that the richness of content with visual and interactive elements provided in the interactive e-book enhanced students’ satisfaction with the teaching material.

Keywords: interactive e-books, spatial ability, mathematics reading, satisfaction, three view

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Authors: Malgorzata Schwab, Ashis Kumer Biswas

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In this concept paper, we explore the topic of Reversibility in Neural Networks leveraged for Network Integrity Verification and crafted the term ''Trusted Neural Network'' (TNN), paired with the API abstraction around it, to embrace the idea formally. This newly proposed high-level generalizable TNN model builds upon the Invertible Neural Network architecture, trained simultaneously in both forward and reverse directions. This allows for the original system inputs to be compared with the ones reconstructed from the outputs in the reversed flow to assess the integrity of the end-to-end inference flow. The outcome of that assessment is captured as an Integrity Score. Concrete implementation reflecting the needs of specific problem domains can be derived from this general approach and is demonstrated in the experiments. The model aspires to become a useful practice in drafting high-level systems architectures which incorporate AI capabilities.

Keywords: trusted, neural, invertible, API

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Authors: Hoda Rahmani, Gary Weckman

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The body of research examining the integration of drones into various industries is expanding rapidly. Despite progress made in addressing the cybersecurity concerns for commercial drones, knowledge deficits remain in determining potential occupational hazards and risks of drone use to employees’ well-being and health in the workplace. This creates difficulty in identifying key approaches to risk mitigation strategies and thus reflects the need for raising awareness among employers, safety professionals, and policymakers about workplace drone-related accidents. The purpose of this study is to investigate the prevalence of and possible risk factors for drone-related mishaps by comparing the application of drones in construction with manufacturing industries. The chief reason for considering these specific sectors is to ascertain whether there exists any significant difference between indoor and outdoor flights since most construction sites use drones outside and vice versa. Therefore, the current research seeks to examine the causes and patterns of workplace drone-related mishaps and suggest possible ergonomic interventions through data collection. Potential ergonomic practices to mitigate hazards associated with flying drones could include providing operators with professional pieces of training, conducting a risk analysis, and promoting the use of personal protective equipment. For the purpose of data analysis, two data mining techniques, the random forest and association rule mining algorithms, will be performed to find meaningful associations and trends in data as well as influential features that have an impact on the occurrence of drone-related accidents in construction and manufacturing sectors. In addition, Spearman’s correlation and chi-square tests will be used to measure the possible correlation between different variables. Indeed, by recognizing risks and hazards, occupational safety stakeholders will be able to pursue data-driven and evidence-based policy change with the aim of reducing drone mishaps, increasing productivity, creating a safer work environment, and extending human performance in safe and fulfilling ways. This research study was supported by the National Institute for Occupational Safety and Health through the Pilot Research Project Training Program of the University of Cincinnati Education and Research Center Grant #T42OH008432.

Keywords: commercial drones, ergonomic interventions, occupational safety, pattern recognition

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Authors: Benkouiten Imene, Chabli Ouerdia, Boutoutaou Hamid, Kadri Nesrine, Bouledroua Omar

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Algeria is actively enhancing gas productivity by augmenting the supply flow. However, this effort has led to increased internal pressure, posing a potential risk to the pipeline's integrity, particularly in the presence of corrosion defects. Sonatrach relies on a vast network of pipelines spanning 24,000 kilometers for the transportation of gas and oil. The aging of these pipelines raises the likelihood of corrosion both internally and externally, heightening the risk of ruptures. To address this issue, a comprehensive inspection is imperative, utilizing specialized scraping tools. These advanced tools furnish a detailed assessment of all pipeline defects. It is essential to recalculate the pressure parameters to safeguard the corroded pipeline's integrity while ensuring the continuity of production. In this context, Sonatrach employs symbolic pressure limit calculations, such as ASME B31G (2009) and the modified ASME B31G (2012). The aim of this study is to perform a comparative analysis of various limit pressure calculation methods documented in the literature, namely DNV RP F-101, SHELL, P-CORRC, NETTO, and CSA Z662. This comparative assessment will be based on a dataset comprising 329 burst tests published in the literature. Ultimately, we intend to introduce a novel approach grounded in the finite element method, employing ANSYS software.

Keywords: pipeline burst pressure, burst test, corrosion defect, corroded pipeline, finite element method

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Authors: Kali Prasad Sarma

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Indiscriminate disposal of municipal solid waste (MSW) in open dumping site is a common scenario in developing countries like India which poses a risk to the environment as well as human health. The objective of the present investigation was to find out the concentration of heavy metals (Pb, Cr, Ni, Mn, Zn, Cu, and Cd) and other physicochemical parameters of leachate and soil collected from an open dumping site of Tezpur town, Assam, India and its associated potential ecological risk. Tezpur is an urban agglomeration coming under the category of Class I UAs/Towns with a population of 105,377 as per data released by Government of India for Census 2011. Impact of the leachate on the groundwater was also addressed in our study. The concentrations of heavy metals were determined using ICP-OES. Energy dispersive X-Ray (SEM-EDS) microanalysis was also conducted to see the presence of the studied metals in the soil. X-Ray diffraction analysis (XRD) and Fourier Transform Infrared (FTIR) spectroscopy were also used to identify dominant minerals present in the soil samples. The trend of measured heavy metals in the soil samples was found in the following order: Mn > Pb > Cu > Zn > Cr > Ni > Cd. The assessment of heavy metal contamination in the soil was carried out by calculating enrichment factor (EF), geo-accumulation index (Igeo), contamination factor (Cfi), degree of contamination (Cd), pollution load index (PLI) and ecological risk factor (Eri). The study showed that the concentrations of Pb, Cu, and Cd were much higher than their respective average shale value and the EF of the soil samples depicted very severe enrichment for Pb, Cu, and Cd; moderate enrichment for Cr and Zn. Calculated Igeo values indicated that the soil is moderate to strongly contaminated with Pb and uncontaminated to moderately contaminated with Cd and Cu. The Cfi value for Pb indicates a very strong contamination level of the metal in the soil. The Cfi values for Cu and Cd were 2.37 and 1.65 respectively indicating moderate contamination level. To apportion the possible sources of heavy metal contamination in soil, principal components analysis (PCA) has been adopted. From the leachate, heavy metals are accumulated at the dumping site soil which could easily percolate through the soil and reach the groundwater. The possible relation of groundwater contamination due to leachate percolation was examined by analyzing the heavy metal concentrations in groundwater with respect to distance from the dumping site. The concentrations of Cd and Pb in groundwater (at a distance of 20m from dumping site) exceeded the permissible limit for drinking water as set by WHO. Occurrence of elevated concentration of potentially toxic heavy metals such as Pb and Cd in groundwater and soil are much environmental concern as it is detrimental to human health and ecosystem.

Keywords: groundwater, heavy metal contamination, leachate, open dumping site

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Authors: Akintunde O. Osibamowo, Abdulrasaq O. Olusanya

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The present study was designed to examine the effect of problem-solving approach as a medium of instruction in teaching and learning of mathematics to improve the achievement of the student. One Hundred (100) students were randomly chosen from five (5) Junior Secondary School in Ijebu-Ode Local Government Area of Ogun State, Nigeria. The data was collected through Mathematics Achievement Test (MAT) on the two groups (experimental and control group). The study confirmed that there is a significant different in the achievement of students exposed to problem-solving approach than those not exposed. The result also indicated that male students, however, had a greater mean-score than the female with no significant difference in their achievement. The result of the study supports the use of problem-solving approach in the teaching and learning of mathematics in secondary schools.

Keywords: problem, achievement, teaching phases, experimental control

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Authors: Ziyu Zhang, Xuanyu Ren, Fei Wu, Qinfei Lu, Yongmei Li, Xinyue Zhi

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Introduction: Adolescents experience a critical period of physical and psychological growth. Few studies focus on the influence of sleep hygiene on psychological health from the high school period to freshmen year. Also, the influence of the COVID-19 pandemic has public health significance. Methods: Totally 698 students from high school and college were included in the manuscript, and a cross-sectional procedure was conducted; the objective was to make the epidemiological comparison of the social phobia/depression prevalence and discuss the effects of potential determinants. Results: Psychological problems, including social phobia and depression, are prevalent, especially among high school students, with gender differences. The current results indicated that the association between sleep status and social phobia is most obvious among high school students, while the higher MMR risk was found both for high school social phobia students and college depressive freshmen. Moreover, the interaction between social phobia and depression was also obvious for both populations. Conclusions: Psychological problems, including social phobia and depression, are more prevalent among high school girls when compared with their male and freshmen peers. Important influenced factors for the risk of psychological problems among the two populations were different, but media multitasking status should be paid attention to for both.

Keywords: adolescence, psychological health, epidemiology, social culture

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Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

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Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

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Authors: Ruth Muturi Wanjiku

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HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.

Keywords: AIDS, HIV, children, pregnant

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Authors: Yogita Tulsian, R. S. Gupta, K. F. Laserson

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Background: Delays in the diagnosis and treatment of TB facilitates disease transmission in the community, so we conducted a study to evaluate the burden of and risk factors for delay in TB diagnosis and initiation of TB treatment among patients in the private and public sectors in Udaipur district, Rajasthan, India. Methods: A retrospective cohort study was conducted among 100 new sputum-positive TB. Patients were interviewed in the intensive phase of treatment September 2013-November 2013 Long total diagnosis delay (TDD) was defined as a time interval between first symptom to confirmed diagnosis > 30 days. Long health treatment delay (HTD) was defined as a time interval between confirmed diagnosis to treatment initiation > 7 days. Results: We observed a median TDD of 55 days (range: 7-136 days) in the public sector and of 92 days (11-380 days) in the private sector. Long TDD in the private sector was significantly associated with middle-higher socio-economic status (Risk Ratio (RR): 2;95% CI: 1.3-3). The reasons reported from the private sector for long TDD were suspect TB patients not advised for sputum examination (RR: 42; 95% CI:2.6-660), practise of self-medication (RR: 17.4; 95% CI: 1.1-267), or lack of awareness (RR: 9.7;95% CI: 0.6-145). The median HTD in the public sector was 3 days (range: 0-14 days), and in the private sector, 2 days (range: 0-11 days) (non-significant difference). Conclusions: Long TDD in private sector may be improved through sputum referral for all suspect TB cases and better education to all regarding TB.

Keywords: diagnosis delay, treatment delay, privatesector, public sector

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Authors: Iin Mayasari

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This study aims at exploring the influence of aspects of entrepreneurial marketing on a firm’s performance. Entrepreneurs are not only supported by resources control to obtain sustainable competitive advantage, but it should also be supported by intangible resources. Entrepreneurial marketing provides the opportunity for entrepreneurs to proactively find better ways to create value for desired customers, to create innovation, and to build customer equity. Entrepreneurial marketing has the medium between entrepreneurship and marketing, and serves as an umbrella for many of the emergent perspectives on marketing. It has eight underlying dimensions. They are proactiveness, calculated risk-taking, innovativeness, an opportunity focus, entrepreneurial orientation, resource leveraging, customer intensity, and value creating. The research method of the study was a qualitative study by having an interview with 8 small companies in Kudus Region, the Central Java, Indonesia. The interviewees were the owner and the manager of the company that had the scope work of small business enterprise in wood crafting industry. The interview was related to the implementation of the elements of the entrepreneurial marketing. The result showed that the small business enterprises had implemented the elements of entrepreneurial marketing in supporting their daily activities. The understanding based on the theoretical implementation was well executed by the owner and managers. The problems in managing small business enterprises were related to the full support by the government and the branding management. Furthermore, the innovation process should be improved especially the use of internet to promote the product, to expand the market and to increase the firm’s performance.

Keywords: entrepreneurial marketing, innovativeness, risk taking, opportunity focus

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Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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