Search results for: high risk cardiac patients.

Authors: Tahseen A. Jilani, S. M. Aqil Burney, C. Ardil

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In this paper, we have presented a new multivariate fuzzy time series forecasting method. This method assumes mfactors with one main factor of interest. History of past three years is used for making new forecasts. This new method is applied in forecasting total number of car accidents in Belgium using four secondary factors. We also make comparison of our proposed method with existing methods of fuzzy time series forecasting. Experimentally, it is shown that our proposed method perform better than existing fuzzy time series forecasting methods. Practically, actuaries are interested in analysis of the patterns of causalities in road accidents. Thus using fuzzy time series, actuaries can define fuzzy premium and fuzzy underwriting of car insurance and life insurance for car insurance. National Institute of Statistics, Belgium provides region of risk classification for each road. Thus using this risk classification, we can predict premium rate and underwriting of insurance policy holders.

Keywords: Average forecasting error rate (AFER), Fuzziness offuzzy sets Fuzzy, If-Then rules, Multivariate fuzzy time series.

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Authors: Sayed Amir Hamzeh Mirkheshti

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Offshore wind energy as a strategic renewable energy, has been growing rapidly due to availability, abundance and clean nature of it. On the other hand, budget of this project is incredibly higher in comparison with other renewable energies and it takes more duration. Accordingly, precise estimation of time and cost is needed in order to promote awareness in the developers and society and to convince them to develop this kind of energy despite its difficulties. Occurrence risks during on project would cause its duration and cost constantly changed. Therefore, to develop offshore wind power, it is critical to consider all potential risks which impacted project and to simulate their impact. Hence, knowing about these risks could be useful for the selection of most influencing strategies such as avoidance, transition, and act in order to decrease their probability and impact. This paper presents an evaluation of the feasibility of 500 MV offshore wind project in the Persian Gulf and compares its situation with uncertainty resources and risk. The purpose of this study is to evaluate time and cost of offshore wind project under risk circumstances and uncertain resources by using Monte Carlo simulation. We analyzed each risk and activity along with their distribution function and their effect on the project.

Keywords: Wind energy project; uncertain resources; risks; Monte Carlo simulation.

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Authors: Chiao-Chen Chang, Yang-Chieh Chin

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This study examines the issue of recommendation sources from the perspectives of gender and consumers- perceived risk, and validates a model for the antecedents of consumer online purchases. The method of obtaining quantitative data was that of the instrument of a survey questionnaire. Data were collected via questionnaires from 396 undergraduate students aged 18-24, and a multiple regression analysis was conducted to identify causal relationships. Empirical findings established the link between recommendation sources (word-of-mouth, advertising, and recommendation systems) and the likelihood of making online purchases and demonstrated the role of gender and perceived risk as moderators in this context. The results showed that the effects of word-of-mouth on online purchase intentions were stronger than those of advertising and recommendation systems. In addition, female consumers have less experience with online purchases, so they may be more likely than males to refer to recommendations during the decision-making process. The findings of the study will help marketers to address the recommendation factor which influences consumers- intention to purchase and to improve firm performances to meet consumer needs.

Keywords: Recommendation sources, Online purchaseintentions, Gender differences, Perceived risk.

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Authors: Murat Koklu, Yavuz Unal

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Data mining can be called as a technique to extract information from data. It is the process of obtaining hidden information and then turning it into qualified knowledge by statistical and artificial intelligence technique. One of its application areas is medical area to form decision support systems for diagnosis just by inventing meaningful information from given medical data. In this study a decision support system for diagnosis of illness that make use of data mining and three different artificial intelligence classifier algorithms namely Multilayer Perceptron, Naive Bayes Classifier and J.48. Pima Indian dataset of UCI Machine Learning Repository was used. This dataset includes urinary and blood test results of 768 patients. These test results consist of 8 different feature vectors. Obtained classifying results were compared with the previous studies. The suggestions for future studies were presented.

Keywords: Artificial Intelligence, Classifiers, Data Mining, Diabetic Patients.

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Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

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Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of antiaging. They have been given one intravenous infusion of UCMSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: Chronic inflammatory diseases, intravenous infusion, mesenchymal stem cells (MSCs), umbilical cord blood.

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Authors: I. Szer, J. Szer, K. Czarnocki, E. Błazik-Borowa

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People on construction scaffoldings work in dynamically changing, often unfavourable climate. Additionally, this kind of work is performed on low stiffness structures at high altitude, which increases the risk of accidents. It is therefore desirable to define the parameters of the work environment that contribute to increasing the construction worker occupational safety level. The aim of this article is to present how changes in microclimate parameters on scaffolding can impact the development of dangerous situations and accidents. For this purpose, indicators based on the human thermal balance were used. However, use of this model under construction conditions is often burdened by significant errors or even impossible to implement due to the lack of precise data. Thus, in the target model, the modified parameter was used – apparent environmental temperature. Apparent temperature in the proposed Scaffold Use Risk Assessment Model has been a perceived outdoor temperature, caused by the combined effects of air temperature, radiative temperature, relative humidity and wind speed (wind chill index, heat index). In the paper, correlations between component factors and apparent temperature for facade scaffolding with a width of 24.5 m and a height of 42.3 m, located at south-west side of building are presented. The distribution of factors on the scaffolding has been used to evaluate fitting of the microclimate model. The results of the studies indicate that observed ranges of apparent temperature on the scaffolds frequently results in a worker’s inability to adapt. This leads to reduced concentration and increased fatigue, adversely affects health, and consequently increases the risk of dangerous situations and accidental injuries

Keywords: Apparent temperature, health, safety work, scaffoldings.

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Authors: C. A. Gilkeson, C. J. Noakes, P. A. Sleigh, M. A. I. Khan, M. A. Camargo-Valero

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Understanding how airborne pathogens are transported through hospital wards is essential for determining the infection risk to patients and healthcare workers. This study utilizes Computational Fluid Dynamics (CFD) simulations to explore possible pathogen transport within a six-bed partitioned Nightingalestyle hospital ward. Grid independence of a ward model was addressed using the Grid Convergence Index (GCI) from solutions obtained using three fullystructured grids. Pathogens were simulated using source terms in conjunction with a scalar transport equation and a RANS turbulence model. Errors were found to be less than 4% in the calculation of air velocities but an average of 13% was seen in the scalar field. A parametric study of variations in the pathogen release point illustrated that its distribution is strongly influenced by the local velocity field and the degree of air mixing present.

Keywords: Natural, Ventilation, Pathogen, Transport

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Authors: K. Qonono

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Despite the significance and economic benefits of petrol stations in South Africa, these still pose a huge risk of fire and explosion threatening public safety. This research paper examines the extent to which land-use planning in Stellenbosch, South Africa, considers the fire risk posed by petrol stations and the implications for public safety as well as preparedness for large fires or explosions. To achieve this, the research identified the land-use types around petrol stations in Stellenbosch and determined the extent to which their locations comply with the local, national, and international land-use planning regulations. A mixed research method consisting of the collection and analysis of geospatial data and qualitative data was applied, where petrol stations within a six-kilometre radius of Stellenbosch’s town centre were utilised as study sites. The research examined the risk of fires/explosions at these petrol stations. The research investigated Stellenbosch Municipality’s institutional preparedness to respond in the event of a fire/explosion at these petrol stations. The research observed that siting of petrol stations does not comply with local, national, and international good practices, thus exposing the surrounding developments to fires and explosions. Land-use planning practice does not consider hazards created by petrol stations. Despite the potential for major fires at petrol stations, Stellenbosch Municipality’s level of preparedness to respond to petrol station fires appears low due to the prioritisation of more frequent events.

Keywords: Petrol stations, technological hazard, DRR, land-use planning, risk analysis.

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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Authors: Gouda K. Helal, Marwa I. Shabayek, Heba A. El-Ramly, Heba A. Awida

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The adverse effects of Clindamycin (Clind.) / Ibuprofen (Ibu.) combination on liver, kidney, blood elements and the significances of antioxidants (N-acetylcysteine and Zinc) against these effects were evaluated. The study includes: Group I; control n=30, Group II; patients on Clind.300mg/Ibu.400mg twice daily for a week n=30, Group III; patients on Clind.300mg/Ibu.400mg+Nacetylcysteine 200mg twice daily for a week n=15 and Group IV; patients on Clind.300mg/Ibu.400mg+Zinc50mg twice daily for a week n=15. Serum malondialdehyde (MDA), alanine transferase (ALT), aspartate transferase (AST), γ glutamyl transferase (GGT), creatinine, blood urea nitrogen (BUN) were measured. Applying one way ANOVA followed by Tuckey Kramer post test, Group II showed significant increase in ALT, AST, GGT, BUN and decrease in Hb, RBCs, platelets than Group I. Group III showed significant decrease in ALT, AST, GGT, BUN than Group II. Moreover, Group IV showed significant decrease in ALT, AST, GGT and increase in Hb, RBCs, and platelets than Group II. Conclusively, Adding Zinc or Nacetylcysteine buffer the oxidative stress and improve the therapeutic outcome of Clindamycin/Ibuprofen combination.

Keywords: Clindamycin, Ibuprofen, Adverse effects, Antioxidant, Zinc, N-acetylcysteine.

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Authors: Omar Hamdy, Schichen Zhao, Hussein Abd El-Atty, Ayman Ragab, Muhammad Salem

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One of the most risky areas in Aswan is Abouelreesh, which is suffering from flood disasters, as heavy deluge inundates urban areas causing considerable damage to buildings and infrastructure. Moreover, the main problem was the urban sprawl towards this risky area. This paper aims to identify the urban areas located in the risk areas prone to flash floods. Analyzing this phenomenon needs a lot of data to ensure satisfactory results; however, in this case the official data and field data were limited, and therefore, free sources of satellite data were used. This paper used ArcGIS tools to obtain the storm water drains network by analyzing DEM files. Additionally, historical imagery in Google Earth was studied to determine the age of each building. The last step was to overlay the urban area layer and the storm water drains layer to identify the vulnerable areas. The results of this study would be helpful to urban planners and government officials to make the disasters risk estimation and develop primary plans to recover the risky area, especially urban areas located in torrents.

Keywords: Risk area, DEM, storm water drains, GIS.

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Authors: H.B. Nguendo Yongsi

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An epidemiological cross sectional study was undertaken in Yaoundé in 2002 and updated in 2005. Focused on health within the city, the objectives were to measure diarrheal prevalence and to identify the risk factors associated with them. Results of microbiological examinations have revealed an urban average prevalence rate of 14.5%. Access to basic services in the living environment appears to be an important risk factor for diarrheas. Statistical and spatial analyses conducted have revealed that prevalence of diarrheal diseases vary among the two main types of settlement (informal and planned). More importantly, this study shows that, diarrhea prevalence rates (notably bacterial and parasitic diarrheas) vary according to the sub- category of settlements. The study draws a number of theoretical and policy implications for researchers and policy decision makers.

Keywords: Cameroon, diarrheal diseases, health risk factor, planned and spontaneous settlement, urban policy, urbanization.

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Authors: Sujata Upgupta, Prasoon Kumar Singh

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The expansion of large scale coal mining into forest areas is a potential hazard for the local biodiversity and wildlife. The objective of this study is to provide a picture of the threat that coal mining poses to the forests of the East Bokaro landscape. The vulnerable forest areas at risk have been assessed and the priority areas for conservation have been presented. The forested areas at risk in the current scenario have been assessed and compared with the past conditions using classification and buffer based overlay approach. Forest vulnerability has been assessed using an analytical framework based on systematic indicators and composite vulnerability index values. The results indicate that more than 4 km² of forests have been lost from 1973 to 2016. Large patches of forests have been diverted for coal mining projects. Forests in the northern part of the coal field within 1-3 km radius around the coal mines are at immediate risk. The original contiguous forests have been converted into fragmented and degraded forest patches. Most of the collieries are located within or very close to the forests thus threatening the biodiversity and hydrology of the surrounding regions. Based on the vulnerability values estimated, it was concluded that more than 90% of the forested grids in East Bokaro are highly vulnerable to mining. The forests in the sub-districts of Bermo and Chandrapura have been identified as the most vulnerable to coal mining activities. This case study would add to the capacity of the forest managers and mine managers to address the risk and vulnerability of forests at a small landscape level in order to achieve sustainable development.

Keywords: Coal mining, forest, indicators, vulnerability.

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Authors: D. E. Gourgoulis, C. G. Yakinthos, M. G. Vassiliadou

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With high speed vessels getting ever more sophisti-cated, travelling at higher and higher speeds and operating in With high speed vessels getting ever more sophisticated, travelling at higher and higher speeds and operating in areas of high maritime traffic density, training becomes of the highest priority to ensure that safety levels are maintained, and risks are adequately mitigated. Training onboard the actual craft on the actual route still remains the most effective way for crews to gain experience. However, operational experience and incidents during the last 10 years demonstrate the need for supplementary training whether in the area of simulation or man to man, man/ machine interaction. Training and familiarisation of the crew is the most important aspect in preventing incidents. The use of simulator, computer and web based training systems in conjunction with onboard training focusing on critical situations will improve the man machine interaction and thereby reduce the risk of accidents. Today, both ship simulator and bridge teamwork courses are now becoming the norm in order to improve further emergency response and crisis management skills. One of the main causes of accidents is the human factor. An efficient way to reduce human errors is to provide high-quality training to the personnel and to select the navigators carefully.areas of high maritime traffic density, training becomes of the highest priority to ensure that safety levels are maintained, and risks are adequately mitigated. Training onboard the actual craft on the actual route still remains the most effective way for crews to gain experience. How-ever, operational experience and incidents during the last 10 years demonstrate the need for supplementary training whether in the area of simulation or man to man, man/ machine interaction. Training and familiarisation of the crew is the most important aspect in preventing incidents. The use of simulator, computer and web based training systems in conjunction with onboard training focusing on critical situations will improve the man machine interaction and thereby reduce the risk of accidents. Today, both ship simulator and bridge teamwork courses are now becoming the norm in order to improve further emergency response and crisis management skills. One of the main causes of accidents is the human factor. An efficient way to reduce human errors is to provide high-quality training to the person-nel and to select the navigators carefully. KeywordsCBT - WBT systems, Human factors.

Keywords: CBT - WBT systems, Human factors.

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Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

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Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as physiological vital signs, images and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful to influence the judgement of clinical sentiment in ICU clinical notes. This paper presents two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of a clinical transformer model that can reliably predict clinical sentiment for notes of COVID patients in ICU. We train the model on clinical notes for COVID-19 patients, ones not previously seen by Bio_ClinicalBERT or Bio_Discharge_Summary_BERT. The model which was based on Bio_ClinicalBERT achieves higher predictive accuracy than the one based on Bio_Discharge_Summary_BERT (Acc 93.33%, AUC 0.98, and Precision 0.96). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and Precision 0.92).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation.

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Authors: Bill D. Geis, Frederick Newman

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Suicide and wrongful death forensic cases are the fastest rising tort in mental health law. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from US state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. But suicide ideation, in the matter of suicide risk determination, may be a necessary but insufficient target of lethal suicide risk assessment. Assessment of near-term suicide risk—assessment that goes beyond verbalized suicide ideation and relates to acute crisis variables—is likely needed. Specifically, such other or additional suicide risk variable assessment may be required in the context of lethal suicide risk situations, as opposed to the discernment of general, nonlethal suicide behavior as a standard of practice (whether a patient is having suicidal thoughts or exhibiting an ambivalent suicide attempt potential). In the current study, verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The Lethal Suicide Risk Assessment, Acute Model, and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training and become the legal standard of care for expected clinical behavior. Without this expanded clinical assessment perspective, the standard of care for suicide assessment is out of sync with current knowledge—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: Forensic evaluation, standard of care, suicide, suicide assessment, wrongful death.

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: Cardio-pulmonary disease, bipolar disorder, Steven Johnson Syndrome, therapy.

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: Sickle cell disease, quality of life, anxiety, depression, socio-demographic characteristics, Ghana.

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Authors: Amany A. Ragheb, Ghada Ragheb, Abd ElRahman A.

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Egypt has a countless heritage of mansions, castles, cities, towns, villages, industrial and manufacturing sites. This richness of heritage provides endless and matchless prospects for culture. Despite being famous worldwide, Egypt’s heritage still is in constant need of protection. Political conflicts and religious revolutions form a direct threat to buildings in various areas, historic, archaeological sites, and religious monuments. Egypt has witnessed two revolutions in less than 60 years; both had an impact on its architectural heritage. In this paper, the authors aim to review legal and policy framework to protect the cultural heritage and present the risk management strategy for cultural heritage in conflict. Through a review of selected international models of devastated architectural heritage in conflict zones and highlighting some of their changes, we can learn from the experiences of other countries to assist towards the development of a methodology to halt the plundering of architectural heritage. Finally, the paper makes an effort to enhance the formulation of a risk management strategy for protection and conservation of cultural heritage, through which to end the plundering of Egypt’s architectural legacy in the Egyptian community (revolutions, 1952 and 2011); and by presenting to its surrounding community the benefits derived from maintaining it.

Keywords: Cultural heritage, legal regulation, risk management, preservation.

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Authors: M. Izvercianu, L. Ivascu

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This paper presents an innovative computer system that contributes to sustainable development of the enterprise. The research refers to a rethinking of traditional systems of collaboration and risk assessment, present in any organization, leading to a sustainable enterprise. This concept integrates emerging tools that allow the implementation and exploitation of the collective intelligence of the enterprise, allowing the exchange of contextual, agile and simplified information, and collaboration with networks of customers and partners in an environment where risks are controlled. Risk assessment is done in a systemic way: the enterprise as the system compared to the contained departments and the enterprise as a subsystem compared to: families of international standards and sustainability-s responsibilities. The enterprise, in this systemic vision, responds to the requirements that any existing system to operate continuously in an indefinite future without reaching key resource depletion. The research is done by integrating collaborative science, engineering, management, psychology, obtaining thus a cornerstone of sustainable development of the enterprise.

Keywords: Enterprise 2.0, ISO, Risk management, Sustainable development

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Authors: Carolyn J. Ortega, Stephen E. Berger

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The role of the custody evaluator is perhaps one of the most controversial and risky endeavors in clinical practice. Complaints filed with licensing boards regarding a child-custody evaluation constitute the second most common reason for such an event. Although the evaluator is expected to answer for the family-law court what is in the “best interest of the child,” there is a lack of clarity on how to establish this in any empirically validated manner. Hence, practitioners must contend with a nebulous framework in formulating their methodological procedures that inherently places them at risk in an already litigious context. This study sought to qualitatively investigate patterns of practice among doctoral practitioners conducting child custody evaluations in the area of Southern California. Ten psychologists were interviewed who devoted between 25 and 100% of their California private practice to custody work. All held Ph.D. degrees with a range of eight to 36 years of experience in custody work. Semi-structured interviews were used to investigate assessment practices, ensure adherence to guidelines, risk management, and qualities of evaluators. Forty-three Specific Themes were identified using Interpretive Phenomenological Analysis (IPA). Seven Higher Order Themes clustered on salient factors such as use of Ethics, Law, Guidelines; Parent Variables; Child Variables; Psychologist Variables; Testing; Literature; and Trends. Evaluators were aware of the ever-present reality of a licensure complaint and thus presented idiosyncratic descriptions of risk management considerations. Ambiguity about quantifying and validly tapping parenting abilities was also reviewed. Findings from this study suggested a high reliance on unstructured and observational methods in child custody practices.

Keywords: Forensic psychology, psychological testing, assessment methodology, child custody.

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Authors: Shima Nabinejad, Holger Schüttrumpf

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Farmers who are living in flood-prone areas such as coasts are exposed to storm surges increased due to climate change. Crop cultivation is the most important economic activity of farmers, and in the time of flooding, agricultural lands are subject to inundation. Additionally, overflow saline water causes more severe damage outcomes than riverine flooding. Agricultural crops are more vulnerable to salinity than other land uses for which the economic damages may continue for a number of years even after flooding and affect farmers’ decision-making for the following year. Therefore, it is essential to assess what extent the agricultural areas are flooded and how much the associated flood damage to each individual farmer is. To address these questions, we integrated farmers’ decision-making at farm-scale with flood risk management. The integrated model includes identification of hazard scenarios, failure analysis of structural measures, derivation of hydraulic parameters for the inundated areas and analysis of the economic damages experienced by each farmer. The present study has two aims; firstly, it attempts to investigate the flooded cropland and potential crop damages for the whole area. Secondly, it compares them among farmers’ field for three flood scenarios, which differ in breach locations of the flood protection structure. To achieve its goal, the spatial distribution of fields and cultivated crops of farmers were fed into the flood risk model, and a 100-year storm surge hydrograph was selected as the flood event. The study area was Pellworm Island that is located in the German Wadden Sea National Park and surrounded by North Sea. Due to high salt content in seawater of North Sea, crops cultivated in the agricultural areas of Pellworm Island are 100% destroyed by storm surges which were taken into account in developing of depth-damage curve for analysis of consequences. As a result, inundated croplands and economic damages to crops were estimated in the whole Island which was further compared for six selected farmers under three flood scenarios. The results demonstrate the significance and the flexibility of the proposed model in flood risk assessment of flood-prone areas by integrating flood risk management and decision-making.

Keywords: Crop damages, flood risk analysis, individual farmer, inundated cropland, Pellworm Island, storm surges.

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Authors: Somayeh Negahdari, Mohsen Ghanbarzadeh, Masoud Nikbakht, Heshmatolah Tavakol

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Asthma, obesity and overweight are the main factors causing change within the heart and respiratory airways. Asthma symptoms are normally observed during exercising. Epidemiological studies have indicated asthma symptoms occurring due to certain lifestyle habits; for example, a sedentary lifestyle. In this study, eight weeks of aerobic exercises resulted in a positive effect overall in overweight women experiencing mild chronic asthma. The quasi-experimental applied research has been done based on experimental and control groups. The experimental group (seven patients) and control group (n = 7) were graded before and after the test. According to the Borg dyspnea and fatigue Perception Index, the training intensity has determined. Participants in the study performed a sub-maximal aerobic activity schedule (45% to 80% of maximum heart rate) for two months, while the control group (n = 7) stayed away from aerobic exercise. Data evaluation and analysis of covariance compared both the pre-test and post-test with paired t-test at significance level of P≤ 0.05. After eight weeks of exercise, the results of the experimental group show a significant decrease in resting heart rate, systolic blood pressure, minute ventilation, while a significant increase in maximal oxygen uptake and tolerance activity (P ≤ 0.05). In the control group, there was no significant difference in these parameters ((P ≤ 0.05). The results indicate the aerobic activity can strengthen the respiratory muscles, while other physiological factors could result in breathing and heart recovery. Aerobic activity also resulted in favorable changes in cardiovascular parameters, and exercise tolerance of overweight women with chronic asthma.

Keywords: Asthma, respiratory cardiac index, exercise tolerance, aerobic, overweight.

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Authors: A.C. Duarte, C.I.L. Justino, K. Duarte, A.C. Freitas, R. Pereira, P. Chaves, P. Bettencourt, S. Cardoso, T.A.P. Rocha-Santos

Abstract:

This paper aims at overviewing the topics of a research project (CARDIOSENSOR) on the field of health sciences (biomaterials and biomedical engineering). The project has focused on the development of a nanosensor for the assessment of the risk of cardiovascular diseases by the monitoring of C-reactive protein (CRP), which has been currently considered as the best validated inflammatory biomarker associated to cardiovascular diseases. The project involves tasks such as: 1) the development of sensor devices based on field effect transistors (FET): assembly, optimization and validation; 2) application of sensors to the detection of CRP in standard solutions and comparison with enzyme-linked immunosorbent assay (ELISA); and 3) application of sensors to real samples such as blood and saliva and evaluation of their ability to predict the risk of cardiovascular disease.

Keywords: Carbon nanotubes field effect transistors, cardiovascular diseases, C-reactive protein, sensor.

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Authors: A. Faro, D. Giordano, M. Pennisi, G. Scarciofalo, C. Spampinato, F. Tramontana

Abstract:

The paper proposes a methodology to process the signals coming from the Transcranial Magnetic Stimulation (TMS) in order to identify the pathology and evaluate the therapy to treat the patients affected by demency diseases. In particular, a fuzzy model is developed to identify the demency of the patients affected by Subcortical Ischemic Vascular Dementia (SIVD) and to measure the effect of a repetitive TMS on their motor performances. A tool is also presented to support the mentioned analysis.

Keywords: TMS, EMG, fuzzy logic, transcranial magnetic stimulation.

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Authors: Margaret F. Shipley

Abstract:

Fuzzy logic can be used when knowledge is incomplete or when ambiguity of data exists. The purpose of this paper is to propose a proactive fuzzy set- based model for reacting to the risk inherent in investment activities relative to a complete view of portfolio management. Fuzzy rules are given where, depending on the antecedents, the portfolio size may be slightly or significantly decreased or increased. The decision maker considers acceptable bounds on the proportion of acceptable risk and return. The Fuzzy Controller model allows learning to be achieved as 1) the firing strength of each rule is measured, 2) fuzzy output allows rules to be updated, and 3) new actions are recommended as the system continues to loop. An extension is given to the fuzzy controller that evaluates potential financial loss before adjusting the portfolio. An application is presented that illustrates the algorithm and extension developed in the paper.

Keywords: Portfolio Management, Financial Market Monitoring, Fuzzy Controller, Fuzzy Logic,

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Authors: Petr V. Vasilev, Eduard V. Volkov, Alexej N. Godok, Alexej A, Grischschuk, Vitalij A. Rybalchenko

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Laser Doppler flowmetry is a modern method of noninvasive microcirculation investigation. The aim of our study was to use this method in the examination of patients with secondary lymphedema of the lower extremities and obliterating atherosclerosis of lower extremities. In the analysis of the amplitude-frequency spectrum of secondary lymphedema patients we have identified remarkable changes. To describe the changes we used a special amplitude rate. In both of patients groups this rate was significally (p<0.05) different with the control group. So the marker phenomena of the amplitude-frequency spectrum of the LDF signal were identified. It is suggested that there is a limfodynamics contribution to the formation of the output signal of laser Doppler flowmetry. These data have fundamental meaning and are interesting for practical medicine, as they give an opportunity to further developments for the use of laser Doppler flowmetry in the diagnostics and monitoring the effectiveness of the treatment.

Keywords: laser Doppler flowmetry, secondary lymphedema of the lower extremities, obliterating atherosclerosis, non-invasive diagnostics.

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Authors: Amer A. Hasan, Mehri Igci, Ersin Borazan, Rozhgar A. Khailany, Emine Bayraktar, Ahmet Arslan

Abstract:

Gastric Cancer (GC) has high morbidity and fatality rate in various countries. It is still one of the most frequent and deadly diseases. Gastrokine1 (GKN1) and gastrokine2 (GKN2) genes are highly expressed in the normal stomach epithelium and play important roles in maintaining the integrity and homeostasis of stomach mucosal epithelial cells. In this study, 47 paired samples that were grouped according to the types of gastric cancer and the clinical characteristics of the patients, including gender and average of age. They were investigated with gene expression analysis and mutation screening by monitoring RT-PCR, SSCP and nucleotide sequencing techniques. Both GKN1 and GKN2 genes were observed significantly reduced found by (Wilcoxon signed rank test; p<0.05). As a result of gene screening, no mutation (no different genotype) was detected. It is considered that gene mutations are not the cause of gastrokines inactivation. In conclusion, the mRNA expression level of GKN1 and GKN2 genes statistically was decreased regardless the gender, age, or cancer type of patients. Reduced of gastrokine genes seem to occur at the initial steps of gastric cancer development.

Keywords: Diagnostic biomarker, gastric cancer, nucleotide sequencing, semi-quantitative RT-PCR.

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Authors: T. Delval, C. Sauvage, Q. Jullien, R. Viano, T. Diallo, B. Collignan, G. Picinbono

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In the context of the international spread of COVID-19, the Centre Scientifique et Technique du Bâtiment (CSTB) has led a joint research with the French government authorities Hauts-de-Seine department, to analyse the risk in school spaces according to their configuration, ventilation system and spatial segmentation strategy. This paper describes the main results of this joint research. A multidisciplinary team involving experts in indoor air quality/ventilation, pedestrian movements and IT domains was established to develop a COVID risk analysis tool based on Building Information Model. The work started with specific analysis on two pilot schools in order to provide for the local administration specifications to minimize the spread of the virus. Different recommendations were published to optimize/validate the use of ventilation systems and the strategy of student occupancy and student flow segmentation within the building. This COVID expertise has been digitized in order to manage a quick risk analysis on the entire building that could be used by the public administration through an easy user interface implemented in a free BIM Management software. One of the most interesting results is to enable a dynamic comparison of different ventilation system scenarios and space occupation strategy inside the BIM model. This concurrent engineering approach provides users with the optimal solution according to both ventilation and pedestrian flow expertise.

Keywords: BIM, knowledge management, system expert, risk management, indoor ventilation, pedestrian movement, integrated design.

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Authors: Karim Abouelmehdi, Loubna Dali, Elmoutaoukkil Abdelmajid, Hoda Elsayed Eladnani Fatiha, Benihssane Abderahim

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The security of cloud services is the concern of cloud service providers. In this paper, we will mention different classifications of cloud attacks referred by specialized organizations. Each agency has its classification of well-defined properties. The purpose is to present a high-level classification of current research in cloud computing security. This classification is organized around attack strategies and corresponding defenses.

Keywords: Cloud computing, security, classification, risk.

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