Search results for: stroke risk

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of Covid-19 infection. Understanding novel treatment approaches are important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with virtual reality (VR) included. This game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with covid-19 related CVA. The safety of newly developed instruments for such cases provides new approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: covid-19, stroke, virtual reality, rehabilitation

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Authors: Shumaila Zeb

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The proposed study aims to investigate insolvency risk of commercial banks of Pakistan. Furthermore, it empirically estimates the effect of already implemented financial regulations on the insolvency risk of banks. To carry out the empirical analysis, a balanced bank-level panel data covering the period 2008-2016 is used. The Z-score is used for calculating the insolvency risk of each bank. The panel regression is used to investigate the relationship between financial regulations and insolvency risk of banks. The empirics reveal that the financial regulations enforced by State Bank of Pakistan have significant impacts on the insolvency risk of banks. The results further indicate that loan ratio and reserve ratio are positively and significantly related to the insolvency risk of banks.

Keywords: insolvency risk, Z-score, financial regulations, banks

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Authors: Steffy Maria Joseph, Abdu Rahiman V, Abdul Hameed K. M.

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Online handwritten character recognition is a challenging field in Artificial Intelligence. The classification success rate of current techniques decreases when the dataset involves similarity and complexity in stroke styles, number of strokes and stroke characteristics variations. Malayalam is a complex south indian language spoken by about 35 million people especially in Kerala and Lakshadweep islands. In this paper, we consider the significant feature extraction for the similar stroke styles of Malayalam. This extracted feature set are suitable for the recognition of other handwritten south indian languages like Tamil, Telugu and Kannada. A classification scheme based on support vector machines (SVM) is proposed to improve the accuracy in classification and recognition of online malayalam handwritten characters. SVM Classifiers are the best for real world applications. The contribution of various features towards the accuracy in recognition is analysed. Performance for different kernels of SVM are also studied. A graphical user interface has developed for reading and displaying the character. Different writing styles are taken for each of the 44 alphabets. Various features are extracted and used for classification after the preprocessing of input data samples. Highest recognition accuracy of 97% is obtained experimentally at the best feature combination with polynomial kernel in SVM.

Keywords: SVM, matlab, malayalam, South Indian scripts, onlinehandwritten character recognition

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Authors: Hye Jin Kim, Hwa Sung Shin

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Ischemic stroke means the caused brain damage due to neurological defects, occurring occlusion of cerebral vascular resulting in thrombus or embolism. t-PA (tissue Plasminogen Activator) is the only thrombolytic agent passed the FDA (Food and Drug Administration). However, t-PA directly dissolves the thrombus (direct activity) through fibrinolysis, showing side effects such as re-occlusion. In this study, we evaluated the thrombolytic activities of the serine protease extracted from lugworms inhabiting tidal flats. The new serine protease identified as 38 kDa by SDS-PAGE was not toxic to brain endothelial cells line (hCMEC/D3). Also, the plasmin synthesis inhibition activity (indirect activity) of the new serine protease was confirmed through fibrin zymography assay and fibrin plate assay. It was higher than direct activity as compared to u-PA (urokinase Plasminogen Activator). The activities were found to be maintained at a wide range of temperature (4-70 ℃) and pH 7-10 compared to previous thrombolytic agents from the azocasein assay. In addition, the new serine protease has shown anticoagulant activity from fibrinogenolytic activity assay. In conclusion, the serine protease in lug worms inhabiting the tidal flats could be considered a promising thrombolytic candidate for the treatment of ischemic stroke.

Keywords: alkaline serine protease, bifunctional thrombolytic activity, fibrinolytic activity, ischemic stroke, lug worms

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Authors: Naim Izet Kajtazi

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Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

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Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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Authors: Ahmet Parlak, Celalettin Bilgen

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In order to create an effective early warning system, Identification of the risks, preparation and carrying out risk modeling of risk scenarios, taking into account the shortcomings of the old disaster scenarios should be used to improve the system. In the light of this, the importance of risk modeling in creating an effective early warning system is understood. In the scope of TAFRISK project risk modeling trend analysis report on risk modeling developed and a demonstration was conducted for Risk Modeling for flood and mass movements. For risk modeling R&D, studies have been conducted to determine the information, and source of the information, to be gathered, to develop algorithms and to adapt the current algorithms to Turkey’s conditions for determining the risk score in the high disaster risk areas. For each type of the disaster; Disaster Deficit Index (DDI), Local Disaster Index (LDI), Prevalent Vulnerability Index (PVI), Risk Management Index (RMI) have been developed as disaster indices taking danger, sensitivity, fragility, and vulnerability, the physical and economic damage into account in the appropriate scale of the respective type.

Keywords: disaster, hazard, risk modeling, sensor

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Authors: Yuji Fujino, Kazu Amimoto, Kazuhiro Fukata, Masahide Inoue, Hidetoshi Takahashi, Shigeru Makita

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Aim: Pusher behavior (PB) is a disorder in which stroke patients shift their body weight toward the affected side of the body (the hemiparetic side) and push away from the non-hemiparetic side. These patients often use further pushing to resist any attempts to correct their position to upright. It is known that the subcortical white matter lesion (SWML) usually correlates of gait or balance function in stroke patients. However, it is unclear whether the SWML influences PB. The purpose of this study was to investigate if the damage of SWML affects the severity of PB on acute stroke patients. Methods: Fourteen PB patients without thalamic or cortical lesions (mean age 73.4 years, 17.5 days from onset) participated in this study. Evaluation of PB was performed according to the Scale for Contraversive Pushing (SCP) for sitting and/or standing. We used modified criteria wherein the SCP subscale scores in each section of the scale were >0. As a clinical measurement, patients were evaluated by the Stroke Impairment Assessment Set (SIAS). For the depiction of SWML, we used T2-weighted fluid-attenuated inversion-recovery imaging. The degree of damage on SWML was assessed using the Fazekas scale. Patients were divided into two groups in the presence of SWML (SWML+ group; Fazekas scale grade 1-3, SWML- group; Fazekas scale grade 0). The independent t-test was used to compare the SCP and SIAS. This retrospective study was approved by the Ethics Committee. Results: In SWML+ group, the SCP was 3.7±1.0 points (mean±SD), the SIAS was 28.0 points (median). In SWML- group, the SCP was 2.0±0.2 points, and the SIAS was 31.5 points. The SCP was significantly higher in SWML+ group than in SWML- group (p<0.05). The SIAS was not significant in both groups (p>0.05). Discussion: It has been considered that the posterior thalamus is the neural structures that process the afferent sensory signals mediating graviceptive information about upright body orientation in humans. Therefore, many studies reported that PB was typically associated with unilateral lesions of the posterior thalamus. However, the result indicates that these extra-thalamic brain areas also contribute to the network controlling upright body posture. Therefore, SMWL might induce dysfunction through malperfusion in distant thalamic or other structurally intact neural structures. This study had a small sample size. Therefore, future studies should be performed with a large number of PB patients. Conclusion: The present study suggests that SWML can be definitely associated with PB. The patients with SWML may be severely incapacitating.

Keywords: pushing behavior, subcortical white matter lesion, acute phase, stroke

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Authors: Christo Februanto Putra

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This paper presents risk identification that affects investment feasibility on toll road infrastructure in Indonesia using qualitative methods survey based on the expert practitioner in investor, contractor, and state officials. The problems on infrastructure investment in Indonesia, especially on KPBU model contract, is many risk factors in the investment plan is not calculated in detail thoroughly. Risk factor is a value used to provide an overview of the risk level assessment of an event which is a function of the probability of the occurrence and the consequences of the risks that arise. As results of the survey which is to show which risk factors impacts directly to the investment feasibility and rank them by their impacts on the investment.

Keywords: risk identification, indonesia toll road, investment feasibility

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Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

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We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance

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Authors: Janusz K. Grabara, Bartłomiej Okwiet, Sebastian Kot

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The purpose of the article is presentation and analysis of the aspect of job security in small and medium-size enterprises in Poland with reference to other EU countries. We show the theoretical aspects of the risk with reference to managing small and medium enterprises, next risk management in small and medium enterprises in Poland, which were subjected to a detailed analysis. We show in detail the risk associated with the operation of the mentioned above companies, as well as analyses its levels on various stages and for different kinds of conducted activity.

Keywords: job safety, SME, work risk, risk management

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Authors: Elsa Reethu, S. Karthik Babu, N. Syed

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Background: Studies in the past focused on the additional benefits of action observation in improving upper and lower limb functions and improving activities of daily living when administered along with conventional therapy. Nevertheless, there is a paucity of literature proving the effects of motor imagery of truncal exercise in improving trunk control in patients with stroke. Aims/purpose: To study the effect of motor imagery of truncal exercises on trunk function and balance in early stroke. Methods: A total of 24 patients were included in the study. 12 were included in the experimental group and 12 were included in control group Trunk function was measured using Trunk Control Test (TCT), Trunk Impairment Scale Verheyden (TIS Verheyden) and Trunk Impairment Scale Fujiwara (TIS Fujiwara). The balance was assessed using Brunel Balance Assessment (BBA) and Tinetti POMA. For the experimental group, each session was for 30 minutes of physical exercises and 15 minutes of motor imagery, once a day, six times a week for 3 weeks and prior to the exercise session, patients viewed a video tape of all the trunk exercises to be performed for 15minutes. The control group practiced the trunk exercises alone for the same duration. Measurements were taken before, after and 4 weeks after intervention. Results: The effect of treatment in motor imagery group showed better improvement when compared with control group when measured after 3 weeks on values of static sitting balance, dynamic balance, total TIS (Verheyden) score, BBA, Tinetti balance and gait with a large effect size of 0.86, 1.99, 1.69, 1.06, 1.63 and 0.97 respectively. The moderate effect size was seen in values of TIS Fujiwara (0.58) and small effect size was seen on TCT (0.12) and TIS coordination component (0.13).at the end of 4 weeks after intervention, the large effect size was identified on values of dynamic balance (2.06), total TIS score (1.59) and Tinetti balance (1.24). The moderate effect size was observed on BBA (0.62) and Tinetti gait (0.72). Conclusion: Trunk motor imagery is effective in improving trunk function and balance in patients with stroke and has a carryover effect in the aspects of mobility. The therapy gain that was observed during the time of discharge was seen to be maintained at the follow-up levels.

Keywords: stroke, trunk rehabilitation, trunk function, balance, motor imagery

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Authors: Alexander Marx

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Measuring and mitigating market risk is essential for the stability of enterprises, especially for major banking corporations and investment bank firms. To employ these risk measurement and mitigation processes, the Value at Risk (VaR) is the most commonly used risk metric by practitioners. In the past years, we have seen significant weaknesses in the predictive performance of the VaR in times of financial market crisis. To address this issue, the purpose of this study is to investigate the value-at-risk (VaR) estimation models and their predictive performance by applying a series of backtesting methods on the stock market indices of the G7 countries (Canada, France, Germany, Italy, Japan, UK, US, Europe). The study employs parametric, non-parametric, and semi-parametric VaR estimation models and is conducted during three different periods which cover the most recent financial market crisis: the overall period (2006–2022), the global financial crisis period (2008–2009), and COVID-19 period (2020–2022). Since the regulatory authorities have introduced and mandated the Conditional Value at Risk (Expected Shortfall) as an additional regulatory risk management metric, the study will analyze and compare both risk metrics on their predictive performance.

Keywords: value at risk, financial market risk, banking, quantitative risk management

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Authors: Vahid Mehrabi, Iman Sharifi, H. A. Talebi

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The automation of rehabilitation procedure by the implementation of robotic devices can overcome the limitation in conventional physiotherapy methods by increasing training sessions and duration of process. In this paper, the design of a simple rehabilitation robot for forearm-wrist therapy in stroke and spinal cord injuries is presented. Wrist’s biological joint motion is modeled by a gimbal-like mechanism which resembles the human arm anatomy. Presented device is an exoskeleton robot with rotation axes corresponding to human skeleton anatomy. The mechanical structure, actuator and sensor selection, system kinematics and comparison between our device range of motion and required active daily life values is illustrated.

Keywords: rehabilitation, robotic devices, physiotherapy, forearm-wrist

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Authors: Mueller Jann, Hoffmann Christian Hugo

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Conventional quantitative risk management in banking is a risk factor of its own, because it rests on assumptions such as independence and availability of data which do not hold when rare events of extreme consequences are involved. There is a growing recognition of the need for alternative risk measures that do not make these assumptions. We propose a novel method for modeling the risk associated with investment products, in particular derivatives, by using a formal language for specifying financial contracts. Expressions in this language are interpreted in the category of values annotated with (a formal representation of) uncertainty. The choice of uncertainty formalism thus becomes a parameter of the model, so it can be adapted to the particular application and it is not constrained to classical probabilities. We demonstrate our approach using a simple logic-based uncertainty model and a case study in which we assess the risk of counter party default in a portfolio of collateralized loans.

Keywords: risk model, uncertainty monad, derivatives, contract algebra

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Authors: Sumitta Sawangtook, Parichart Thano

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The purposes of research were to study the relationship between the awareness of sexual risk behaviors and sexual risk behaviors of adolescent students, and to compare the sexual risk behaviors of adolescent students by gender, education level, sweetheart’s number, achievement, sexual value, and the influence of the friendship group. The research sample of 344 sevenths through twelfth grade students in secondary school for the academic year 2014, Dindang district Bangkok was selected by simple random sampling. The research instruments are: 1) demographic questionnaire 2) evaluation form of the awareness of sexual risk behaviors 3) questionnaire about sexual value 4) questionnaire about the influence of the friendship group and 5) evaluation form of sexual risk behaviors. They were used for data collections which are subsequently analyzed by percentage, mean, standard deviation, t-test, One-way Analysis of Variances. The results of this study were presented as follow: 1) The awareness of sexual risk behaviors was negatively correlated with sexual risk behaviors of adolescent students (r=-.27, p=.000). 2) There was significant difference at .05 level in sexual risk behaviors among adolescent students who had gender difference (t=5.90, p=.000). 3) There was no significant difference at .05 level in sexual risk behaviors among adolescent students who had the different level of education (t=1.41, p=.16). 4) There was significant difference at .05 level in sexual risk behaviors among adolescent students who had the different level of sweetheart’s number (F=13.03, p=.000). 5) There was significant difference at .05 level in sexual risk behaviors among adolescent students who had the different level of achievement (F=4.77, p=.009). 6) There were significant difference at .05 level in sexual risk behaviors among adolescent students who had different level of sexual value (F=50.91, p=.000) 7) There were significant difference at .05 level in sexual risk behaviors among adolescent students who had different level of the influence of the friendship group (F=98.41, p=.000).

Keywords: the awareness of sexual risk behaviors, sexual risk behaviors, adolescent students

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Authors: Alfred Kamate Siviri, Angelus Mafikiri Tsongo, Jean Robert Kala Kamdjoug

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Digitalization and information systems well organized have been selected as relevant measures to mitigate operational risks within organizations. Unfortunately, information system comes with new threats that can cause severe damage and quick organization lockout. This study aims to measure perceived information system risks and their effects on operational risks within the microfinance institution in D.R. Congo. Also, the factors influencing the operational risk are identified, and the link between operational risk with other risks and performance is to be assessed. The study proposes a research model drawn on the combination of Resources-Based-View, dynamic capabilities, the agency theory, the Information System Security Model, and social theories of risk. Therefore, we suggest adopting a mixed methods research with the sole aim of increasing the literature that already exists on perceived operational risk assessment and its link with other risk and performance, a focus on IT risk.

Keywords: Democratic Republic Congo, information system risk, microfinance performance, operational risk

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Authors: Alexander Kelíšek, Denisa Janasová, Veronika Mitašová

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Weak signals using is often associated with early warning. It is possible to find a link between early warning, respectively early problems detection and risk management. The idea of early warning is very important in the context of crisis management because of the risk prevention possibility. Weak signals are likened to risk symptoms. Nowadays, their usefulness as a tool of proactive problems solving is emphasized. Based on it, it is possible to use weak signals not only in strategic planning, project management, or early warning system, but also as a subsidiary element in risk management. The main question is how to effectively integrate weak signals into risk management. The main aim of the paper is to point out the possibilities of weak signals using in small and medium enterprises risk management.

Keywords: early warning system, weak signals, risk management, small and medium enterprises (SMEs)

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Authors: Berrin Şentürk

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In this study, due to the recurrence of bovine tuberculosis, in the same areas, the risk factors for the disease were determined and evaluated at the local level. This study was carried out in 32 farms where the disease was detected in the district and center of Samsun province in 2014. Predetermined risk factors, such as farm, environmental and economic risks, were investigated with the survey method. It was predetermined that risks in the three groups are similar to the risk variables of the disease on the global scale. These risk factors that increase the susceptibility of the infection must be understood by the herd owners. The risk-based contagious disease management system approach should be applied for bovine tuberculosis by farmers, animal health professionals and public and private sector decision makers.

Keywords: bovine tuberculosis, disease management, control, outbreak, risk analysis

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Authors: Wei-Po Wu, Wen-Yu Liu, Wei−Ting Lin, Hen-Yu Lien

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Introduction: Improving balance function for individuals after stroke is a crucial target in physiotherapy. Aquatic therapy which challenges individual’s postural control in an unstable fluid environment may be beneficial in enhancing balance functions. The purposes of the systematic review with meta-analyses were to validate the effects of aquatic therapy in improving balance functions for individuals with strokes in contrast to conventional physiotherapy. Method: Available studies were explored from three electronic databases: PubMed, Scopus, and Web of Science. During literature search, the published date of studies was not limited. The study design of the included studies should be randomized controlled trials (RCTs) and the studies should contain at least one outcome measurement of balance function. The PEDro scale was adopted to assess the quality of included studies, while the 'Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence' was used to evaluate the level of evidence. After the data extraction, studies with same outcome measures were pooled together for meta-analysis. Result: Ten studies with 282 participants were included in analyses. The research qualities of the studies were ranged from fair to good (4 to 8 points). Levels of evidence of the included studies were graded as level 2 and 3. Finally, scores of Berg Balance Scale (BBS), Eye closed force plate center of pressure velocity (anterior-posterior, medial-lateral axis) and Timed up and Go test were pooled and analyzed separately. The pooled results shown improvement in balance function (BBS mean difference (MD): 1.39 points; 95% confidence interval (CI): 0.05-2.29; p=0.002) (Eye closed force plate center of pressure velocity (anterior-posterior axis) MD: 1.39 mm/s; 95% confidence interval (CI): 0.93-1.86; p<0.001) (Eye closed force plate center of pressure velocity (medial-lateral) MD: 1.48 mm/s; 95% confidence interval (CI): 0.15-2.82; p=0.03) and mobility (MD: 0.9 seconds; 95% CI: 0.07-1.73; p=0.03) of stroke individuals after aquatic therapy compared to conventional therapy. Although there were significant differences between two treatment groups, the differences in improvement were relatively small. Conclusion: The aquatic therapy improved general balance function and mobility in the individuals with stroke better than conventional physiotherapy.

Keywords: aquatic therapy, balance function, meta-analysis, stroke, systematic review

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Authors: Rajish Shil, Amal Alduhoori, Vipin Thomachan, Jamal Teir, Radhakrishnan Renganathan

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Background: Antiphospholipid antibody syndrome (APS) has a broad spectrum of thrombotic and non-thrombotic clinical manifestations. We present a case of APS presenting with seizure, stroke, and atrial mass. Case Description: A 38-year-old male presented with headache of 10 days duration and tonic-clonic seizure. The neurological examination was normal. Magnetic resonance imaging of brain showed small acute right cerebellar infarct. Magnetic resonance angiography of brain and neck showed a focal narrowing in the origin of the internal carotid artery bilaterally. Electroencephalogram was normal. He was started on aspirin, atorvastatin, and carbamazepine. Transthoracic and trans-esophageal echocardiography showed a pedunculated and lobular atrial mass, measuring 1 X 1.5 cm, which was freely mobile across mitral valve opening across the left ventricular inflow. Autoimmune screening showed positive Antiphospholipid antibodies in high titer (Cardiolipin IgG > 120 units/ml, B2 glycoprotein IgG 90 units/mL). Anti-nuclear antibody was negative. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Platelet count was low (111 x 109/L). The patient underwent successful surgical removal of the mass, which looked like a thrombotic clot, and Histopathological analysis confirmed it as a fibrinous clot, with no evidence of tumor cells. The patient was started on full anticoagulation treatment and was followed up regularly in the clinic, where our patient did not have any further complications from the disease. Discussion: Our patient was diagnosed to have APS based on the features of high positive anticardiolipin antibody IgG and B2 glycoprotein IgG levels, Stroke, thrombocytopenia, and abnormal echo findings. Thrombotic vegetation can mimic an atrial myxoma on echo. Conclusion: APS can present with neurological and cardiac manifestations, and therefore a high index of suspicion is necessary for a diagnosis of the disease as it can affect both short and long term treatment plans and prognosis. Therefore, in patients presenting with neurological symptoms like seizures, weakness and radiological diagnosis of stroke in a young patient, where atrial masses could be thought to be the cause of stroke, they should be screened for any concomitant findings of thrombocytopenia and/or activated partial thromboplastin time prolongation, which should raise the suspicion of vasculitis, specifically APS to be the primary cause of the clinical presentation.

Keywords: antiphospholipid syndrome, seizures, atrial mass, stroke

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Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

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This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: physical rehabilitation, mirror neuron, virtual reality, stroke therapy

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Authors: Gerhard Grebe, Johan Marx

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The aim of the study is to assess the state of operational risk management and the adoption of an appropriate risk culture in Ghanaian banks. The Bank of Ghana (BoG) joined the Basel Consultative Group (BCG) of the Basel Committee on Bank Supervision (BCBS) in 2021 and is proceeding with the implementation of the Basel III international regulatory framework for banks. The BoG’s Directive about risk management encourages, inter alia, the creation of an appropriate risk culture by Ghanaian banks. However, it is not evident how the risk management staff of Ghanaian banks experience the risk culture and the implementation of operational risk management in the banks where they are employed. Ghana is a developing economy, and it is addressing challenges with its organisational culture. According to Transparency International, successive Ghanaian governments claim to be fighting corruption, but little success has been achieved so far. This points to a possible lack of accountability, transparency, and integrity in the environment in which Ghanaian banks operate and which could influence their risk culture negatively. Purposive sampling was used for the survey, and the questionnaire was completed byGhanaian bank personnel who specializesin operational risk management, risk governance, and compliance, bank supervision, risk analyses, as well as the implementation of the operational risk management requirements of the Basel regulatory frameworks. The respondents indicated that they are fostering a risk culture and implementing monitoring and reporting procedures; the three lines of defence (3LOD); compliance; internal auditing; disclosure of operational risk information; and receiving guidance from the bank supervisor in an attempt to improve their operational risk management practices. However, the respondents reported the following challenges with staff members who are not inside the risk management departments(in order of priority), namelydemonstrating a risk culture, training and development; communication; reporting and disclosure; roles and responsibilities; performance appraisal; and technological and environmental barriers. Recommendations to address these challenges are provided

Keywords: ghana, operational risk, risk culture, risk management

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Authors: Masoud Ghahvechi Pour

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Risk management is a systematic and regular process of identifying, analyzing and responding to risks throughout the project's life cycle in order to achieve the optimal level of elimination, reduction or control of risk. The purpose of project risk management is to increase the probability and effect of positive events and reduce the probability and effect of unpleasant events on the project. Risk management is one of the most fundamental parts of project management, so that unmanaged or untransmitted risks can be one of the primary factors of failure in a project. Effective risk management does not apply to risk regression, which is apparently the cheapest option of the activity. However, the main problem with this option is the economic sensitivity, because what is potentially profitable is by definition risky, and what does not pose a risk is economically interesting and does not bring tangible benefits. Therefore, in relation to the implemented project, effective risk management is finding a "middle ground" in its management, which includes, on the one hand, protection against risk from a negative direction by means of accurate identification and classification of risk, which leads to analysis And it becomes a comprehensive analysis. On the other hand, management using all mathematical and analytical tools should be based on checking the maximum benefits of these decisions. Detailed analysis, taking into account all aspects of the company, including stakeholder analysis, will allow us to add what will become tangible benefits for our project in the future to effective risk management. Identifying the risk of the project is based on the theory that which type of risk may affect the project, and also refers to specific parameters and estimating the probability of their occurrence in the project. These conditions can be divided into three groups: certainty, uncertainty, and risk, which in turn support three types of investment: risk preference, risk neutrality, specific risk deviation, and its measurement. The result of risk identification and project analysis is a list of events that indicate the cause and probability of an event, and a final assessment of its impact on the environment.

Keywords: risk, management, knowledge, risk management

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Authors: Dianne Williams

Abstract:

This study examined the peer/individual domain of the Risk Factor Prevention Paradigm (RFPP) to assess the risk and protective factors that impact criminal gang involvement among at-risk males residing in a juvenile home in Trinidad and Tobago. The RFPP allows for the identification of both risk and protective factors in a single, holistic framework to identify the relationship between risk factors, protective factors, and criminal gang involvement among at-risk male adolescents. Findings showed that having anti-social peers was the most significant risk factor associated with criminal gang involvement, while the most significant protective factor was having a positive social attitude. Moreover, while 65% of the boys reported never having been in a gang, 70% reported having hit, struck or used a weapon against someone, while 52% reported being involved in other violent incidents on more than two occasions. This suggests that while involvement with criminal gangs may not be common among this population, predisposing behavioral patterns are present. Results are expected to assist in the development of targeted strategies to reduce the attractiveness of gang membership.

Keywords: risk factor prevention paradigm, risk factors, protective factors, peer/individual domain, gang involvement, at-risk youth, trinidad and tobago, juvenile home

Procedia PDF Downloads 563

Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

Abstract:

Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic blood pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2. and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population, we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Our study even with some limitations might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: hypertension, age, exercise, obesity and gender

Procedia PDF Downloads 518

Authors: Ulas Cinar, Omer Faruk Ugurlu, Selcuk Cebi

Abstract:

Occupational safety risk management is the most important element of a safe working environment. Effective risk management can only be possible with accurate analysis and evaluations. Scoring-based risk assessment methods offer considerable ease of application as they convert linguistic expressions into numerical results. It can also be easily adapted to any field. Contrary to all these advantages, important problems in scoring-based methods are frequently discussed. Effective measurability is one of the most critical problems. Existing methods allow experts to choose a score equivalent to each parameter. Therefore, experts prefer the score of the most likely outcome for risk. However, all other possible consequences are neglected. Assessments of the existing methods express the most probable level of risk, not the real risk of the enterprises. In this study, it is aimed to develop a method that will present a more comprehensive evaluation compared to the existing methods by evaluating the probability and severity scores, all sub-parameters, and potential results, and a new scoring-based method is proposed in the literature.

Keywords: occupational health and safety, risk assessment, scoring based risk assessment method, underground mining, weighted risk scores

Procedia PDF Downloads 116

Authors: Lenka Jesonkova, Frantisek Bozek

Abstract:

Trihalogenmethanes (THMs) are disinfection byproducts with non-carcinogenic and genotoxic effects. The contamination of 6 sites close to the water treatment plant has been monitored in second largest city of the Czech Republic. Health risk assessment including both non-carcinogenic and genotoxic risk for long term exposition was realized using the critical concentrations. Concentrations of trihalogenmethanes met national standards in all samples. Risk assessment proved that health risks from trihalogenmethanes are acceptable on each site.

Keywords: drinking water, health risk assessment, trihalogenmethanes, water pollution

Procedia PDF Downloads 491

Authors: Preeda Sansakorn, Min An

Abstract:

In order to be capable of dealing with uncertainties, subjectivities, including vagueness arising in building construction projects, the application of fuzzy reasoning technique based on fuzzy set theory is proposed. This study contributes significantly to the development of a fuzzy reasoning safety risk assessment model for building construction projects that could be employed to assess the risk magnitude of each hazardous event identified during construction, and a third parameter of probability of consequence is incorporated in the model. By using the proposed safety risk analysis methodology, more reliable and less ambiguities, which provide the safety risk management project team for decision-making purposes.

Keywords: safety risk assessment, building construction safety, fuzzy reasoning, construction risk assessment model, building construction projects

Procedia PDF Downloads 455

Authors: Mohammad Hadi Khorashadi Zadeh, Amin Karkon, Seyd Mohammad Reza Mashhoori

Abstract:

The technology of computer audit played a major role in the progress and prospects of a proper application to improve the quality and efficiency of audit work. But due to the technical complexity and the specific risks of computer audit, it should be shown effective in audit and preventive action. Mainly through research in this paper, we propose the causes of audit risk in a computer environment and the risk of further proposals for measures to control, to some extent reduce the risk of computer audit and improve the audit quality.

Keywords: computer auditing, risk, measures to prevent, information management

Procedia PDF Downloads 484