Search results for: association rule mining
Commenced in January 2007
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Paper Count: 4020

Search results for: association rule mining

420 Dividend Policy in Family Controlling Firms from a Governance Perspective: Empirical Evidence in Thailand

Authors: Tanapond S.

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Typically, most of the controlling firms are relate to family firms which are widespread and important for economic growth particularly in Asian Pacific region. The unique characteristics of the controlling families tend to play an important role in determining the corporate policies such as dividend policy. Given the complexity of the family business phenomenon, the empirical evidence has been unclear on how the families behind business groups influence dividend policy in Asian markets with the prevalent existence of cross-shareholdings and pyramidal structure. Dividend policy as one of an important determinant of firm value could also be implemented in order to examine the effect of the controlling families behind business groups on strategic decisions-making in terms of a governance perspective and agency problems. The purpose of this paper is to investigate the impact of ownership structure and concentration which are influential internal corporate governance mechanisms in family firms on dividend decision-making. Using panel data and constructing a unique dataset of family ownership and control through hand-collecting information from the nonfinancial companies listed in Stock Exchange of Thailand (SET) between 2000 and 2015, the study finds that family firms with large stakes distribute higher dividends than family firms with small stakes. Family ownership can mitigate the agency problems and the expropriation of minority investors in family firms. To provide insight into the distinguish between ownership rights and control rights, this study examines specific firm characteristics including the degrees of concentration of controlling shareholders by classifying family ownership in different categories. The results show that controlling families with large deviation between voting rights and cash flow rights have more power and affect lower dividend payment. These situations become worse when second blockholders are families. To the best knowledge of the researcher, this study is the first to examine the association between family firms’ characteristics and dividend policy from the corporate governance perspectives in Thailand with weak investor protection environment and high ownership concentration. This research also underscores the importance of family control especially in a context in which family business groups and pyramidal structure are prevalent. As a result, academics and policy makers can develop markets and corporate policies to eliminate agency problem.

Keywords: agency theory, dividend policy, family control, Thailand

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419 Understanding Different Facets of Chromosome Abnormalities: A 17-year Cytogenetic Study and Indian Perspectives

Authors: Lakshmi Rao Kandukuri, Mamata Deenadayal, Suma Prasad, Bipin Sethi, Srinadh Buragadda, Lalji Singh

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Worldwide; at least 7.6 million children are born annually with severe genetic or congenital malformations and among them 90% of these are born in mid and low-income countries. Precise prevalence data are difficult to collect, especially in developing countries, owing to the great diversity of conditions and also because many cases remain undiagnosed. The genetic and congenital disorder is the second most common cause of infant and childhood mortality and occurs with a prevalence of 25-60 per 1000 births. The higher prevalence of genetic diseases in a particular community may, however, be due to some social or cultural factors. Such factors include the tradition of consanguineous marriage, which results in a higher rate of autosomal recessive conditions including congenital malformations, stillbirths, or mental retardation. Genetic diseases can vary in severity, from being fatal before birth to requiring continuous management; their onset covers all life stages from infancy to old age. Those presenting at birth are particularly burdensome and may cause early death or life-long chronic morbidity. Genetic testing for several genetic diseases identifies changes in chromosomes, genes, or proteins. The results of a genetic test can confirm or rule out a suspected genetic condition or help determine a person's chance of developing or passing on a genetic disorder. Several hundred genetic tests are currently in use and more are being developed. Chromosomal abnormalities are the major cause of human suffering, which are implicated in mental retardation, congenital malformations, dysmorphic features, primary and secondary amenorrhea, reproductive wastage, infertility neoplastic diseases. Cytogenetic evaluation of patients is helpful in the counselling and management of affected individuals and families. We present here especially chromosomal abnormalities which form a major part of genetic disease burden in India. Different programmes on chromosome research and human reproductive genetics primarily relate to infertility since this is a major public health problem in our country, affecting 10-15 percent of couples. Prenatal diagnosis of chromosomal abnormalities in high-risk pregnancies helps in detecting chromosomally abnormal foetuses. Such couples are counselled regarding the continuation of pregnancy. In addition to the basic research, the team is providing chromosome diagnostic services that include conventional and advanced techniques for identifying various genetic defects. Other than routine chromosome diagnosis for infertility, also include patients with short stature, hypogonadism, undescended testis, microcephaly, delayed developmental milestones, familial, and isolated mental retardation, and cerebral palsy. Thus, chromosome diagnostics has found its applicability not only in disease prevention and management but also in guiding the clinicians in certain aspects of treatment. It would be appropriate to affirm that chromosomes are the images of life and they unequivocally mirror the states of human health. The importance of genetic counseling is increasing with the advancement in the field of genetics. The genetic counseling can help families to cope with emotional, psychological, and medical consequences of genetic diseases.

Keywords: India, chromosome abnormalities, genetic disorders, cytogenetic study

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418 Endotracheal Intubation Self-Confidence: Report of a Realistic Simulation Training

Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo

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Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.

Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation

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417 Providing Health Promotion Information by Digital Animation to International Visitors in Japan: A Factorial Design View of Nurses

Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

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Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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416 An Institutional Mapping and Stakeholder Analysis of ASEAN’s Preparedness for Nuclear Power Disaster

Authors: Nur Azha Putra Abdul Azim, Denise Cheong, S. Nivedita

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Currently, there are no nuclear power reactors among the Association of Southeast Asian Nations (ASEAN) member states (AMS) but there are seven operational nuclear research reactors, and Indonesia is about to construct the region’s first experimental power reactor by the end of the decade. If successful, the experimental power reactor will lay the foundation for the country’s and region’s first nuclear power plant. Despite projecting confidence during the period of nuclear power renaissance in the region in the last decade, none of the AMS has committed to a political decision on the use of nuclear energy and this is largely due to the Fukushima nuclear power accident in 2011. Of the ten AMS, Vietnam, Indonesia and Malaysia have demonstrated the most progress in developing nuclear energy based on the nuclear power infrastructure development assessments made by the International Atomic Energy Agency. Of these three states, Vietnam came closest to building its first nuclear power plant but decided to delay construction further due to safety and security concerns. Meanwhile, Vietnam along with Indonesia and Malaysia continue with their nuclear power infrastructure development and the remaining SEA states, with the exception of Brunei and Singapore, continue to build their expertise and capacity for nuclear power energy. At the current rate of progress, Indonesia is expected to make a national decision on the use of nuclear power by 2023 while Malaysia, the Philippines, and Thailand have included the use of nuclear power in their mid to long-term power development plans. Vietnam remains open to nuclear power but has not placed a timeline. The medium to short-term power development projection in the region suggests that the use of nuclear energy in the region is a matter of 'when' rather than 'if'. In lieu of the prospects for nuclear energy in Southeast Asia (SEA), this presentation will review the literature on ASEAN radiological emergency and preparedness response (EPR) plans and examine ASEAN’s disaster management and emergency framework. Through a combination of institutional mapping and stakeholder analysis methods, which we examine in the context of the international EPR, and nuclear safety and security regimes, we will identify the issues and challenges in developing a regional radiological EPR framework in the SEA. We will conclude with the observation that ASEAN faces serious structural, institutional and governance challenges due to the AMS inherent political structures and history of interstate conflicts, and propose that ASEAN should either enlarge the existing scope of its disaster management and response framework or that its radiological EPR framework should exist as a separate entity.

Keywords: nuclear power, nuclear accident, ASEAN, Southeast Asia

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415 High Cycle Fatigue Analysis of a Lower Hopper Knuckle Connection of a Large Bulk Carrier under Dynamic Loading

Authors: Vaso K. Kapnopoulou, Piero Caridis

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The fatigue of ship structural details is of major concern in the maritime industry as it can generate fracture issues that may compromise structural integrity. In the present study, a fatigue analysis of the lower hopper knuckle connection of a bulk carrier was conducted using the Finite Element Method by means of ABAQUS/CAE software. The fatigue life was calculated using Miner’s Rule and the long-term distribution of stress range by the use of the two-parameter Weibull distribution. The cumulative damage ratio was estimated using the fatigue damage resulting from the stress range occurring at each load condition. For this purpose, a cargo hold model was first generated, which extends over the length of two holds (the mid-hold and half of each of the adjacent holds) and transversely over the full breadth of the hull girder. Following that, a submodel of the area of interest was extracted in order to calculate the hot spot stress of the connection and to estimate the fatigue life of the structural detail. Two hot spot locations were identified; one at the top layer of the inner bottom plate and one at the top layer of the hopper plate. The IACS Common Structural Rules (CSR) require that specific dynamic load cases for each loading condition are assessed. Following this, the dynamic load case that causes the highest stress range at each loading condition should be used in the fatigue analysis for the calculation of the cumulative fatigue damage ratio. Each load case has a different effect on ship hull response. Of main concern, when assessing the fatigue strength of the lower hopper knuckle connection, was the determination of the maximum, i.e. the critical value of the stress range, which acts in a direction normal to the weld toe line. This acts in the transverse direction, that is, perpendicularly to the ship's centerline axis. The load cases were explored both theoretically and numerically in order to establish the one that causes the highest damage to the location examined. The most severe one was identified to be the load case induced by beam sea condition where the encountered wave comes from the starboard. At the level of the cargo hold model, the model was assumed to be simply supported at its ends. A coarse mesh was generated in order to represent the overall stiffness of the structure. The elements employed were quadrilateral shell elements, each having four integration points. A linear elastic analysis was performed because linear elastic material behavior can be presumed, since only localized yielding is allowed by most design codes. At the submodel level, the displacements of the analysis of the cargo hold model to the outer region nodes of the submodel acted as boundary conditions and applied loading for the submodel. In order to calculate the hot spot stress at the hot spot locations, a very fine mesh zone was generated and used. The fatigue life of the detail was found to be 16.4 years which is lower than the design fatigue life of the structure (25 years), making this location vulnerable to fatigue fracture issues. Moreover, the loading conditions that induce the most damage to the location were found to be the various ballasting conditions.

Keywords: dynamic load cases, finite element method, high cycle fatigue, lower hopper knuckle

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414 The Development of Cultural Routes: The Case of Greece

Authors: Elissavet Kosta

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Introduction: In this research, we will propose the methodology, which is required for the planning of the cultural route in order to prepare substantiated proposals for the development and planning of cultural routes in Greece in the near future. Our research has started at 2016. Methodology in our research: Α combination of primary and secondary research will be used as project methodology. Furthermore, this study aims to follow a multidisciplinary approach, using dimensions of qualitative and quantitative data analysis models. Regarding the documentation of the theoretical part of the project, the method of secondary research will be mainly used, yet in combination with bibliographic sources. However, the data collection regarding the research topic will be conducted exclusively through primary research (questionnaires and interviews). Cultural Routes: The cultural route is defined as a brand name touristic product, that is a product of cultural tourism, which is shaped according to a specific connecting element. Given its potential, the cultural route is an important ‘tool’ for the management and development of cultural heritage. Currently, a constant development concerning the cultural routes is observed in an international level during the last decades, as it is widely accepted that cultural tourism has an important role in the world touristic industry. Cultural Routes in Greece: Especially for Greece, we believe, actions have not been taken to the systematic development of the cultural routes yet. The cultural routes that include Greece and have been design in a world scale as well as the cultural routes, which have been design in Greek ground up to this moment are initiations of the Council of Europe, World Tourism Organization UNWTO and ‘Diazoma’ association. Regarding the study of cultural routes in Greece as a multidimensional concept, the following concerns have arisen: Firstly, we are concerned about the general impact of cultural routes at local and national level and specifically in the economic sector. Moreover, we deal with the concerns regarding the natural environment and we delve into the educational aspect of cultural routes in Greece. In addition, the audience we aim at is both specific and broad and we put forward the institutional framework of the study. Finally, we conduct the development and planning of new cultural routes, having in mind the museums as both the starting and ending point of a route. Conclusion: The contribution of our work is twofold and lies firstly on the fact that we attempt to create cultural routes in Greece and secondly on the fact that an interdisciplinary approach is engaged towards realizing our study objective. In particular, our aim is to take advantage of all the ways in which the promotion of a cultural route can have a positive influence on the way of life of society. As a result, we intend to analyze how a cultural route can turn into a well-organized activity that can be used as social intervention to develop tourism, strengthen the economy and improve access to cultural goods in Greece during the economic crisis.

Keywords: cultural heritage, cultural routes, cultural tourism, Greece

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413 Listening to Circles, Playing Lights: A Study of Cross-Modal Perception in Music

Authors: Roni Granot, Erica Polini

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Music is often described in terms of non-auditory adjectives such as a rising melody, a bright sound, or a zigzagged contour. Such cross modal associations have been studied with simple isolated musical parameters, but only rarely in rich musical contexts. The current study probes cross sensory associations with polarity based dimensions by means of pairings of 10 adjectives: blunt-sharp, relaxed-tense, heavy-light, low (in space)-high, low (pitch)-high, big-small, hard-soft, active-passive, bright-dark, sad-happy. 30 participants (randomly assigned to one of two groups) were asked to rate one of 27 short saxophone improvisations on a 1 to 6 scale where 1 and six correspond to the opposite pole of each dimension. The 27 improvisations included three exemplars for each of three dimensions (size, brightness, sharpness), played by three different players. Here we focus on the question of whether ratings of scales corresponding with the musical dimension were consistently rated as such (e.g. music improvised to represent a white circle rated as bright in contrast with music improvised to represent a dark circle rated as dark). Overall the average scores by dimension showed an upward trend in the equivalent verbal scale, with a low rating for small, bright and sharp musical improvisations and higher scores for large, dark and blunt improvisations. Friedman tests indicate a statistically significant difference for brightness (χ2 (2) = 19.704, p = .000) and sharpness dimensions (χ2 (2) = 15.750, p = .000), but not for size (χ2 (2) = 1.444, p = .486). Post hoc analysis with Wilcoxon signed-rank tests within the brightness dimension, show significant differences among all possible parings resulted in significant differences: the rankings of 'bright' and 'dark' (Z = -3.310, p = .001), of 'bright' and 'medium' (Z = -2.438, p = .015) and of 'dark' and 'medium' music (Z = -2.714, p = .007); but only differences between the extreme contrasts within the sharpness dimension : 'sharp' and 'blunt' music (Z = -3.147, p = .002) and between 'sharp' and 'medium' music rated on the sharpness scale (Z = - 3.054, p = .002), but not between 'medium' and 'blunt' music (Z = -.982, p = .326). In summary our study suggests a privileged link between music and the perceptual and semantic domain of brightness. In contrast, size seems to be very difficult to convey in music, whereas sharpness seems to be mapped onto the two extremes (sharp vs. blunt) rather than continuously. This is nicely reflected in the musical literature in titles and texts which stress the association between music and concepts of light or darkness rather than sharpness or size.

Keywords: audiovisual, brightness, cross-modal perception, cross-sensory correspondences, size, visual angularity

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412 The Relationship between the Skill Mix Model and Patient Mortality: A Systematic Review

Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

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411 The Impact of Coronal STIR Imaging in Routine Lumbar MRI: Uncovering Hidden Causes to Enhanced Diagnostic Yield of Back Pain and Sciatica

Authors: Maysoon Nasser Samhan, Somaya Alkiswani, Abdullah Alzibdeh

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Background: Routine lumbar MRIs for back pain may yield normal results despite persistent symptoms, which means the possibility of other causes for this pain, which was not shown on the routine images. Research suggests including coronal STIR imaging to detect additional pathologies like sacroiliitis. Objectives: This study aims to enhance diagnostic accuracy and aid in determining treatment processes for patients with persistent back pain who have normal routine lumbar MRI (T1 and T2 images) by incorporating coronal STIR into the examination. Methods: A prospectively conducted study involving 274 patients, 115 males and 159 females, with an age range of 6–92 years, reviewed their medical records and imaging data following a lumbar spine MRI. This study included patients with back pain and sciatica as their primary complaints, all of whom underwent lumbar spine MRIs at our hospital to identify potential pathologies. Using a GE Signa HD 1.5T MRI System, each patient received a standard MRI protocol that included T1 and T2 sagittal and axial sequences, as well as a coronal STIR sequence. We collected relevant MRI findings, including abnormalities and structural variations, from radiology reports. We classified these findings into tables and documented them as counts and percentages, using Fisher’s exact test to assess differences between categorical variables. We conducted a statistical analysis using Prism GraphPad software version 10.1.2. The study adhered to ethical guidelines, institutional review board approvals, and patient confidentiality regulations. Results: Exclusion of the coronal STIR sequence led to 83 subjects (30.29%) being classified as within normal limits on MRI examination. 36 patients without abnormalities on T1 and T2 sequences showed abnormalities on the coronal STIR sequence, with 26 cases attributed to spinal pathologies and 10 to non-spinal pathologies. In addition to that, Fisher's exact test demonstrated a significant association between sacroiliitis diagnosis and abnormalities identified solely through the coronal STIR sequence (P < 0.0001). Conclusion: Implementing coronal STIR imaging as part of routine lumbar MRI protocols has the potential to improve patient care by facilitating a more comprehensive evaluation and management of persistent back pain.

Keywords: magnetic resonance imaging, lumber MRI, radiology, neurology

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410 Impact of Twin Therapeutic Approaches on Certain Biophysiological Parameters among Breast Cancer Patients after Breast Surgery at Selected Hospital

Authors: Selvia Arokiya Mary

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Introduction: Worldwide, breast cancer comprises 10.4% of all cancer incidence among women. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Many women who undergo breast surgery suffer from ill-defined pain syndromes. STATEMENT OF THE PROBLEM: A study to assess the effectiveness of twin therapeutic approaches on certain bio-physiological parameters in breast cancer patients after breast surgery at selected hospital, Chennai. Objectives: This study is to 1. assess the level of certain biophysiological parameters in women after mastectomy. 2. assess the effectiveness of twin therapeutic approaches on certain biophysiological parameters in women after mastectomy. 3. correlate the practice of twin therapeutic approaches with certain biophysiological parameters. 4. associate the selected demographic variables with certain biophysiological parameters in women after mastectomy Research Design and Method: Pre experimental research design was used. Fifty women were selected by using convenient sampling technique at government general hospital, Chennai. Results: The Level of pain shows, in the study group 49(98%) of them had moderate in the pre test and after the intervention all of them had mild pain in the post test. In relation to level of shoulder function before the intervention shows that in the study group 49(98%) of them had movement towards gravity and after intervention 24 (48%) of them had movement against gravity maximum resistance. There was a significant reduction in pain and shoulder stiffness level at a ‘P’ level of < 0.001. There was a negative correlation between the pranayama practice and the level of pain, there was a positive correlation between the arm exercise practice and the level of shoulder function. There was no significant association between demographic and clinical variables with the level of pain and shoulder function in the study. Hypothesis: There is a significant difference in level of pain and shoulder function among women following breast surgery who receive pranayama & arm exercise programme. The pranayama had effect in terms of reduction of pain, arm exercise programme had effect in prevention of arm stiffness among post operative women following breast surgery. Thus the stated hypothesis was accepted. Conclusion: On the basis of the findings of the present study there was Advancing age related to increasing risk of breast cancer, level of pain also the type of surgery was associated with level of pain and shoulder function, There fore it is to be concluded that the study participants may get benefited by practice of pranayama and arm exercise program.

Keywords: biophysiological parameters breast surgery, lumpectomy , mastectomy, radical mastectomy, twin therapeutic approach, pranayama, arm exercise

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409 Three Foci of Trust as Potential Mediators in the Association Between Job Insecurity and Dynamic Organizational Capability: A Quantitative, Exploratory Study

Authors: Marita Heyns

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Job insecurity is a distressing phenomenon which has far reaching consequences for both employees and their organizations. Previously, much attention has been given to the link between job insecurity and individual level performance outcomes, while less is known about how subjectively perceived job insecurity might transfer beyond the individual level to affect performance of the organization on an aggregated level. Research focusing on how employees’ fear of job loss might affect the organization’s ability to respond proactively to volatility and drastic change through applying its capabilities of sensing, seizing, and reconfiguring, appears to be practically non-existent. Equally little is known about the potential underlying mechanisms through which job insecurity might affect the dynamic capabilities of an organization. This study examines how job insecurity might affect dynamic organizational capability through trust as an underling process. More specifically, it considered the simultaneous roles of trust at an impersonal (organizational) level as well as trust at an interpersonal level (in leaders and co-workers) as potential underlying mechanisms through which job insecurity might affect the organization’s dynamic capability to respond to opportunities and imminent, drastic change. A quantitative research approach and a stratified random sampling technique enabled the collection of data among 314 managers at four different plant sites of a large South African steel manufacturing organization undergoing dramatic changes. To assess the study hypotheses, the following statistical procedures were employed: Structural equation modelling was performed in Mplus to evaluate the measurement and structural models. The Chi-square values test for absolute fit as well as alternative fit indexes such as the Comparative Fit Index and the Tucker-Lewis Index, the Root Mean Square Error of Approximation and the Standardized Root Mean Square Residual were used as indicators of model fit. Composite reliabilities were calculated to evaluate the reliability of the factors. Finally, interaction effects were tested by using PROCESS and the construction of two-sided 95% confidence intervals. The findings indicate that job insecurity had a lower-than-expected detrimental effect on evaluations of the organization’s dynamic capability through the conducive buffering effects of trust in the organization and in its leaders respectively. In contrast, trust in colleagues did not seem to have any noticeable facilitative effect. The study proposes that both job insecurity and dynamic capability can be managed more effectively by also paying attention to factors that could promote trust in the organization and its leaders; some practical recommendations are given in this regard.

Keywords: dynamic organizational capability, impersonal trust, interpersonal trust, job insecurity

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408 The Relationship between Violence against Women in the Family and Common Mental Disorders in Urban Informal Settlements of Mumbai, India: A Cross-Sectional Study

Authors: Abigail Bentley, Audrey Prost, Nayreen Daruwalla, Apoorwa Gupta, David Osrin

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BACKGROUND: Intimate partner violence (IPV) can impact a woman’s physical, reproductive and mental health, including common mental disorders such as anxiety and depression. However, people other than an intimate partner may also perpetrate violence against women in the family, particularly in India. This study aims to investigate the relationship between experiences of violence perpetrated by the husband and other members of the wider household and symptoms of common mental disorders in women residing in informal settlement (slum) areas of Mumbai. METHODS: Experiences of violence were assessed through a detailed cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points in the woman’s life and the main perpetrator of each act. Symptoms of common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were divided into four groups and the relationship between experiences of each type of violence in the last 12 months and GHQ-12 score group was analyzed using ordinal logistic regression, adjusted for the woman’s age and clustering. RESULTS: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 7 years of education and had been married 9 years. 88% were Muslim and 47% lived in joint and 53% in nuclear families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 23% physical, 12% sexual). 7% had a high GHQ-12 score (6 or above). For violence experiences in the last 12 months, the odds of being in the highest GHQ-12 score group versus the lower groups combined were 13.1 for emotional violence, 6.5 for economic, 5.7 for physical and 6.3 for sexual (p<0.001 for all outcomes). DISCUSSION: The high level of violence reported across the lifetime could be due to the detailed assessment of violent acts at multiple time points and the inclusion of perpetrators within the family other than the husband. Each type of violence was associated with greater odds of a higher GHQ-12 score and therefore more symptoms of common mental disorders. Emotional violence was far more strongly associated with symptoms of common mental disorders than physical or sexual violence. However, it is not possible to attribute causal directionality to the association. Further work to investigate the relationship between differing severity of violence experiences and women’s mental health and the components of emotional violence that make it so strongly associated with symptoms of common mental disorders would be beneficial.

Keywords: common mental disorders, family violence, India, informal settlements, mental health, violence against women

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407 Electric Vehicle Fleet Operators in the Energy Market - Feasibility and Effects on the Electricity Grid

Authors: Benjamin Blat Belmonte, Stephan Rinderknecht

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The transition to electric vehicles (EVs) stands at the forefront of innovative strategies designed to address environmental concerns and reduce fossil fuel dependency. As the number of EVs on the roads increases, so too does the potential for their integration into energy markets. This research dives deep into the transformative possibilities of using electric vehicle fleets, specifically electric bus fleets, not just as consumers but as active participants in the energy market. This paper investigates the feasibility and grid effects of electric vehicle fleet operators in the energy market. Our objective centers around a comprehensive exploration of the sector coupling domain, with an emphasis on the economic potential in both electricity and balancing markets. Methodologically, our approach combines data mining techniques with thorough pre-processing, pulling from a rich repository of electricity and balancing market data. Our findings are grounded in the actual operational realities of the bus fleet operator in Darmstadt, Germany. We employ a Mixed Integer Linear Programming (MILP) approach, with the bulk of the computations being processed on the High-Performance Computing (HPC) platform ‘Lichtenbergcluster’. Our findings underscore the compelling economic potential of EV fleets in the energy market. With electric buses becoming more prevalent, the considerable size of these fleets, paired with their substantial battery capacity, opens up new horizons for energy market participation. Notably, our research reveals that economic viability is not the sole advantage. Participating actively in the energy market also translates into pronounced positive effects on grid stabilization. Essentially, EV fleet operators can serve a dual purpose: facilitating transport while simultaneously playing an instrumental role in enhancing grid reliability and resilience. This research highlights the symbiotic relationship between the growth of EV fleets and the stabilization of the energy grid. Such systems could lead to both commercial and ecological advantages, reinforcing the value of electric bus fleets in the broader landscape of sustainable energy solutions. In conclusion, the electrification of transport offers more than just a means to reduce local greenhouse gas emissions. By positioning electric vehicle fleet operators as active participants in the energy market, there lies a powerful opportunity to drive forward the energy transition. This study serves as a testament to the synergistic potential of EV fleets in bolstering both economic viability and grid stabilization, signaling a promising trajectory for future sector coupling endeavors.

Keywords: electric vehicle fleet, sector coupling, optimization, electricity market, balancing market

Procedia PDF Downloads 76
406 Disconnect between Water, Sanitation and Hygiene Related Behaviours of Children in School and Family

Authors: Rehan Mohammad

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Background: Improved Water, Sanitation and Hygiene (WASH) practices in schools ensure children’s health, well-being and cognitive performance. In India under various WASH interventions in schools, teachers, and other staff make every possible effort to educate children about personal hygiene, sanitation practices and harms of open defecation. However, once children get back to their families, they see other practicing inappropriate WASH behaviors, and they consequently start following them. This show disconnect between school behavior and family behavior, which needs to be bridged to achieve desired WASH outcomes. Aims and Objectives: The aim of this study is to assess the factors causing disconnect of WASH-related behaviors between school and the family of children. It also suggests behavior change interventions to bridge the gap. Methodology: The present study has chosen a mixed- method approach. Both quantitative and qualitative methods of data collection have been used in the present study. The purposive sampling for data collection has been chosen. The data have been collected from 20% children in each age group of 04-08 years and 09-12 years spread over three primary schools and 20% of households to which they belong to which is spread over three slum communities in south district of Delhi. Results: The present study shows that despite of several behavior change interventions at school level, children still practice inappropriate WASH behaviors due to disconnect between school and family behaviors. These behaviors show variation from one age group to another. The inappropriate WASH behaviors being practiced by children include open defecation, wrong disposal of garbage, not keeping personal hygiene, not practicing hand washing practices during critical junctures and not washing fruits and vegetables before eating. The present study has highlighted that 80% of children in the age group of 04-08 years still practice inappropriate WASH behaviors when they go back to their families after school whereas, this percentage has reduced to 40% in case of children in the age group 09-12 years. Present study uncovers association between school and family teaching which creates a huge gap between WASH-related behavioral practices. The study has established that children learn and de-learn the WASH behaviors due to the evident disconnect between behavior change interventions at schools and household level. The study has also made it clear that children understand the significance of appropriate WASH practices but owing to the disconnect the behaviors remain unsettled. The study proposes several behavior change interventions to sync the behaviors of children at school and family level to ensure children’s health, well-being and cognitive performance.

Keywords: behavioral interventions, child health, family behavior, school behavior, WASH

Procedia PDF Downloads 111
405 Development of Risk Index and Corporate Governance Index: An Application on Indian PSUs

Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Public Sector Undertakings (PSUs), being government-owned organizations have commitments for the economic and social wellbeing of the society; this commitment needs to be reflected in their risk-taking, decision-making and governance structures. Therefore, the primary objective of the study is to suggest measures that may lead to improvement in performance of PSUs. To achieve this objective two normative frameworks (one relating to risk levels and other relating to governance structure) are being put forth. The risk index is based on nine risks, such as, solvency risk, liquidity risk, accounting risk, etc. and each of the risks have been scored on a scale of 1 to 5. The governance index is based on eleven variables, such as, board independence, diversity, risk management committee, etc. Each of them are scored on a scale of 1 to five. The sample consists of 39 PSUs that featured in Nifty 500 index and, the study covers a 10 year period from April 1, 2005 to March, 31, 2015. Return on assets (ROA) and return on equity (ROE) have been used as proxies of firm performance. The control variables used in the model include, age of firm, growth rate of firm and size of firm. A dummy variable has also been used to factor in the effects of recession. Given the panel nature of data and possibility of endogeneity, dynamic panel data- generalized method of moments (Diff-GMM) regression has been used. It is worth noting that the corporate governance index is positively related to both ROA and ROE, indicating that with the improvement in governance structure, PSUs tend to perform better. Considering the components of CGI, it may be suggested that (i). PSUs ensure adequate representation of women on Board, (ii). appoint a Chief Risk Officer, and (iii). constitute a risk management committee. The results also indicate that there is a negative association between risk index and returns. These results not only validate the framework used to develop the risk index but also provide a yardstick to PSUs benchmark their risk-taking if they want to maximize their ROA and ROE. While constructing the CGI, certain non-compliances were observed, even in terms of mandatory requirements, such as, proportion of independent directors. Such infringements call for stringent penal provisions and better monitoring of PSUs. Further, if the Securities and Exchange Board of India (SEBI) and Ministry of Corporate Affairs (MCA) bring about such reforms in the PSUs and make mandatory the adherence to the normative frameworks put forth in the study, PSUs may have more effective and efficient decision-making, lower risks and hassle free management; all these ultimately leading to better ROA and ROE.

Keywords: PSU, risk governance, diff-GMM, firm performance, the risk index

Procedia PDF Downloads 159
404 Magnitude of Infection and Associated factor in Open Tibial Fractures Treated Operatively at Addis Ababa Burn Emergency and Trauma Center April, 2023

Authors: Tuji Mohammed Sani

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Back ground: An open tibial fracture is an injury where the fractured bone directly communicates with the outside environment. Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. Objective: The main objective of the study was to determine Prevalence of infection and its associated factors in surgically treated open tibial fracture in Addis Ababa Burn Emergency and Trauma (AaBET) center. Method: A facility based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET center from September 2018 to September 2021. The data was collected from patient’s chart using structured data collection form, and Data was entered and analyzed using SPSS version 26. Bivariable and multiple binary logistic regression were fitted. Multicollinearity was checked among candidate variables using variance inflation factor and tolerance, which were less than 5 and greater than 0.2, respectively. Model adequacy were tested using Hosmer-Lemeshow goodness of fitness test (P=0.711). AOR at 95% CI was reported, and P-value < 0.05 was considered statistically significant. Result: This study found that 33.9% of the study participants had an infection. Initial IV antibiotic time (AOR=2.924, 95% CI:1.160- 7.370) and time of wound closure from injury (AOR=3.524, 95% CI: 1.798-6.908), injury to admission time (AOR=2.895, 95% CI: 1.402 – 5.977). and definitive fixation method (AOR=0.244, 95% CI: 0.113 – 0.4508) were the factors found to have a statistically significant association with the occurrence of infection. Conclusion: The rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fracture treated at AaBET center. Time from injury to admission, time from injury to first debridement, wound closure time, and initial Intra Venous antibiotic time from the injury are an important factor that can be readily amended to improve the infection rate. Whether wound closed before seven days or not were more important factor associated with occurrences of infection.

Keywords: infection, open tibia, fracture, magnitude

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403 The Impact of Climate Change on Sustainable Aquaculture Production

Authors: Peyman Mosberian-Tanha, Mona Rezaei

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Aquaculture sector is the fastest growing food sector with annual growth rate of about 10%. The sustainability of aquaculture production, however, has been debated mainly in relation to the feed ingredients used for farmed fish. The industry has been able to decrease its dependency on marine-based ingredients in line with policies for more sustainable production. As a result, plant-based ingredients have increasingly been incorporated in aquaculture feeds, especially in feeds for popular carnivorous species, salmonids. The effect of these ingredients on salmonids’ health and performance has been widely studied. In most cases, plant-based diets are associated with varying degrees of health and performance issues across salmonids, partly depending on inclusion levels of plant ingredients and the species in question. However, aquaculture sector is facing another challenge of concern. Environmental challenges in association with climate change is another issue the aquaculture sector must deal with. Data from trials in salmonids subjected to environmental challenges of various types show adverse physiological responses, partly in relation to stress. To date, there are only a limited number of studies reporting the interactive effects of adverse environmental conditions and dietary regimens on salmonids. These studies have shown that adverse environmental conditions exacerbate the detrimental effect of plant-based diets on digestive function and health in salmonids. This indicates an additional challenge for the aquaculture sector to grow in a sustainable manner. The adverse environmental conditions often studied in farmed fish is the change in certain water quality parameters such as oxygen and/or temperature that are typically altered in response to climate change and, more specifically, global warming. In a challenge study, we observed that the in the fish fed a plant-based diet, the fish’s ability to absorb dietary energy was further reduced when reared under low oxygen level. In addition, gut health in these fish was severely impaired. Some other studies also confirm the adverse effect of environmental challenge on fish’s gut health. These effects on the digestive function and gut health of salmonids may result in less resistance to diseases and weaker performance with significant economic and ethical implications. Overall, various findings indicate the multidimensional negative effects of climate change, as a major environmental issue, in different sectors, including aquaculture production. Therefore, a comprehensive evaluation of different ways to cope with climate change is essential for planning more sustainable strategies in aquaculture sector.

Keywords: aquaculture, climate change, sustainability, salmonids

Procedia PDF Downloads 189
402 Learning from Dendrites: Improving the Point Neuron Model

Authors: Alexander Vandesompele, Joni Dambre

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The diversity in dendritic arborization, as first illustrated by Santiago Ramon y Cajal, has always suggested a role for dendrites in the functionality of neurons. In the past decades, thanks to new recording techniques and optical stimulation methods, it has become clear that dendrites are not merely passive electrical components. They are observed to integrate inputs in a non-linear fashion and actively participate in computations. Regardless, in simulations of neural networks dendritic structure and functionality are often overlooked. Especially in a machine learning context, when designing artificial neural networks, point neuron models such as the leaky-integrate-and-fire (LIF) model are dominant. These models mimic the integration of inputs at the neuron soma, and ignore the existence of dendrites. In this work, the LIF point neuron model is extended with a simple form of dendritic computation. This gives the LIF neuron increased capacity to discriminate spatiotemporal input sequences, a dendritic functionality as observed in another study. Simulations of the spiking neurons are performed using the Bindsnet framework. In the common LIF model, incoming synapses are independent. Here, we introduce a dependency between incoming synapses such that the post-synaptic impact of a spike is not only determined by the weight of the synapse, but also by the activity of other synapses. This is a form of short term plasticity where synapses are potentiated or depressed by the preceding activity of neighbouring synapses. This is a straightforward way to prevent inputs from simply summing linearly at the soma. To implement this, each pair of synapses on a neuron is assigned a variable,representing the synaptic relation. This variable determines the magnitude ofthe short term plasticity. These variables can be chosen randomly or, more interestingly, can be learned using a form of Hebbian learning. We use Spike-Time-Dependent-Plasticity (STDP), commonly used to learn synaptic strength magnitudes. If all neurons in a layer receive the same input, they tend to learn the same through STDP. Adding inhibitory connections between the neurons creates a winner-take-all (WTA) network. This causes the different neurons to learn different input sequences. To illustrate the impact of the proposed dendritic mechanism, even without learning, we attach five input neurons to two output neurons. One output neuron isa regular LIF neuron, the other output neuron is a LIF neuron with dendritic relationships. Then, the five input neurons are allowed to fire in a particular order. The membrane potentials are reset and subsequently the five input neurons are fired in the reversed order. As the regular LIF neuron linearly integrates its inputs at the soma, the membrane potential response to both sequences is similar in magnitude. In the other output neuron, due to the dendritic mechanism, the membrane potential response is different for both sequences. Hence, the dendritic mechanism improves the neuron’s capacity for discriminating spa-tiotemporal sequences. Dendritic computations improve LIF neurons even if the relationships between synapses are established randomly. Ideally however, a learning rule is used to improve the dendritic relationships based on input data. It is possible to learn synaptic strength with STDP, to make a neuron more sensitive to its input. Similarly, it is possible to learn dendritic relationships with STDP, to make the neuron more sensitive to spatiotemporal input sequences. Feeding structured data to a WTA network with dendritic computation leads to a significantly higher number of discriminated input patterns. Without the dendritic computation, output neurons are less specific and may, for instance, be activated by a sequence in reverse order.

Keywords: dendritic computation, spiking neural networks, point neuron model

Procedia PDF Downloads 134
401 Time-Interval between Rectal Cancer Surgery and Reintervention for Anastomotic Leakage and the Effects of a Defunctioning Stoma: A Dutch Population-Based Study

Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

Procedia PDF Downloads 138
400 Analysis of Determinants of Growth of Small and Medium Enterprises in Kwara State, Nigeria

Authors: Hussaini Tunde Subairu

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Small and Medium Enterprises (SMEs) sectors serve as catalyst for employment generation, national growth, poverty reduction and economic development in developing and developed countries. However, in Nigeria despite copious and plethora of government policies and stimulus schemes directed at SMEs, the sector is still characterized by high rate of failure and discontinuities. This study therefore investigated owners/managers profile, firms characteristics and external factors as possible determinants of SMEs growth from selected SMEs in Kwara State. Primary data were sourced from 200 SMEs respondents registered with the National Association of Small and Medium Enterprises (NASMES) in Kwara State Central Senatorial District. Multiple Regressions Analysis (MRA) was used to analyze the relationship between dependent and independent variables, and pair wise correlation was employed to examine the relationship among independent variables. The Analysis of Variable (ANOVA) was employed to indicate the overall significant of the model The findings revealed that Analysis of variance (ANOVA) put the value of F-statistics at 420.45 and p-value at 0.000 was significant. The values of R2 and Adjusted R2 of 0.9643 and 0.9620 respectively suggested that 96 percent of variations in employment growth were explained by the explanatory variables. The level of technical and managerial education has t- value of 24.14 and p-value of 0.001, length of managers/owners experience in similar trade with t- value of 21.37 and p-value of 0.001, age of managers/owners with t- value of 42.98 and p-value of 0.001, firm age with t- value of 25.91 and p-value of 0.001, numbers of firms in a cluster with t- value of 7.20 and p-value of 0.001, access to formal finance with t-value of 5.56 and p-value of 0.001, firm technology innovation with t- value of 25.32 and p-value of 0.01, institutional support with t- value of 18.89 and p-value of 0.01, globalization with t- value of 9.78 and p-value of 0.01, and infrastructure with t-value of 10.75 and p-value of 0.01. The result also indicated that initial size has t-value of -1.71 and p-value of 0.090 which is consistent with Gibrat’s Law. The study concluded that owners/managers profile, firm specific characteristics and external factors substantially influenced employment growths of SMEs in the study area. Therefore, policy implication should enhance human capital development of SMEs owners/managers, and strengthen fiscal policy thrust through imposition on tariff regime to minimize effect of globalization. Governments at all level must support SMEs growth radically and enhance institutional support for SMEs growth and radically and significantly upgrading key infrastructure as rail/roads, rail, telecommunications, water and power.

Keywords: external factors, firm specific characteristics, owners / manager profile, small and medium enterprises

Procedia PDF Downloads 246
399 Oral Microbiota as a Novel Predictive Biomarker of Response To Immune Checkpoint Inhibitors in Advanced Non-small Cell Lung Cancer Patients

Authors: Francesco Pantano, Marta Fogolari, Michele Iuliani, Sonia Simonetti, Silvia Cavaliere, Marco Russano, Fabrizio Citarella, Bruno Vincenzi, Silvia Angeletti, Giuseppe Tonini

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Background: Although immune checkpoint inhibitors (ICIs) have changed the treatment paradigm of non–small cell lung cancer (NSCLC), these drugs fail to elicit durable responses in the majority of NSCLC patients. The gut microbiota, able to regulate immune responsiveness, is emerging as a promising, modifiable target to improve ICIs response rates. Since the oral microbiome has been demonstrated to be the primary source of bacterial microbiota in the lungs, we investigated its composition as a potential predictive biomarker to identify and select patients who could benefit from immunotherapy. Methods: Thirty-five patients with stage IV squamous and non-squamous cell NSCLC eligible for an anti-PD-1/PD-L1 as monotherapy were enrolled. Saliva samples were collected from patients prior to the start of treatment, bacterial DNA was extracted using the QIAamp® DNA Microbiome Kit (QIAGEN) and the 16S rRNA gene was sequenced on a MiSeq sequencing instrument (Illumina). Results: NSCLC patients were dichotomized as “Responders” (partial or complete response) and “Non-Responders” (progressive disease), after 12 weeks of treatment, based on RECIST criteria. A prevalence of the phylum Candidatus Saccharibacteria was found in the 10 responders compared to non-responders (abundance 5% vs 1% respectively; p-value = 1.46 x 10-7; False Discovery Rate (FDR) = 1.02 x 10-6). Moreover, a higher prevalence of Saccharibacteria Genera Incertae Sedis genus (belonging to the Candidatus Saccharibacteria phylum) was observed in "responders" (p-value = 6.01 x 10-7 and FDR = 2.46 x 10-5). Finally, the patients who benefit from immunotherapy showed a significant abundance of TM7 Phylum Sp Oral Clone FR058 strain, member of Saccharibacteria Genera Incertae Sedis genus (p-value = 6.13 x 10-7 and FDR=7.66 x 10-5). Conclusions: These preliminary results showed a significant association between oral microbiota and ICIs response in NSCLC patients. In particular, the higher prevalence of Candidatus Saccharibacteria phylum and TM7 Phylum Sp Oral Clone FR058 strain in responders suggests their potential immunomodulatory role. The study is still ongoing and updated data will be presented at the congress.

Keywords: oral microbiota, immune checkpoint inhibitors, non-small cell lung cancer, predictive biomarker

Procedia PDF Downloads 100
398 Poly(Acrylamide-Co-Itaconic Acid) Nanocomposite Hydrogels and Its Use in the Removal of Lead in Aqueous Solution

Authors: Majid Farsadrouh Rashti, Alireza Mohammadinejad, Amir Shafiee Kisomi

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Lead (Pb²⁺), a cation, is a prime constituent of the majority of the industrial effluents such as mining, smelting and coal combustion, Pb-based painting and Pb containing pipes in water supply systems, paper and pulp refineries, printing, paints and pigments, explosive manufacturing, storage batteries, alloy and steel industries. The maximum permissible limit of lead in the water used for drinking and domesticating purpose is 0.01 mg/L as advised by Bureau of Indian Standards, BIS. This becomes the acceptable 'safe' level of lead(II) ions in water beyond which, the water becomes unfit for human use and consumption, and is potential enough to lead health problems and epidemics leading to kidney failure, neuronal disorders, and reproductive infertility. Superabsorbent hydrogels are loosely crosslinked hydrophilic polymers that in contact with aqueous solution can easily water and swell to several times to their initial volume without dissolving in aqueous medium. Superabsorbents are kind of hydrogels capable to swell and absorb a large amount of water in their three-dimensional networks. While the shapes of hydrogels do not change extensively during swelling, because of tremendously swelling capacity of superabsorbent, their shape will broadly change.Because of their superb response to changing environmental conditions including temperature pH, and solvent composition, superabsorbents have been attracting in numerous industrial applications. For instance, water retention property and subsequently. Natural-based superabsorbent hydrogels have attracted much attention in medical pharmaceutical, baby diapers, agriculture, and horticulture because of their non-toxicity, biocompatibility, and biodegradability. Novel superabsorbent hydrogel nanocomposites were prepared by graft copolymerization of acrylamide and itaconic acid in the presence of nanoclay (laponite), using methylene bisacrylamide (MBA) and potassium persulfate, former as a crosslinking agent and the second as an initiator. The superabsorbent hydrogel nanocomposites structure was characterized by FTIR spectroscopy, SEM and TGA Spectroscopy adsorption of metal ions on poly (AAm-co-IA). The equilibrium swelling values of copolymer was determined by gravimetric method. During the adsorption of metal ions on polymer, residual metal ion concentration in the solution and the solution pH were measured. The effects of the clay content of the hydrogel on its metal ions uptake behavior were studied. The NC hydrogels may be considered as a good candidate for environmental applications to retain more water and to remove heavy metals.

Keywords: adsorption, hydrogel, nanocomposite, super adsorbent

Procedia PDF Downloads 189
397 Mild Auditory Perception and Cognitive Impairment in mid-Trimester Pregnancy

Authors: Tahamina Begum, Wan Nor Azlen Wan Mohamad, Faruque Reza, Wan Rosilawati Wan Rosli

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To assess auditory perception and cognitive function during pregnancy is necessary as the pregnant women need extra effort for attention mainly for their executive function to maintain their quality of life. This study aimed to investigate neural correlates of cognitive and behavioral processing during mid trimester pregnancy. Event-Related Potentials (ERPs) were studied by using 128-sensor net and PAS or COWA (controlled Oral Word Association), WCST (Wisconsin Card Sorting Test), RAVLTIM (Rey Auditory Verbal and Learning Test: immediate or interference recall, delayed recall (RAVLT DR) and total score (RAVLT TS) were tested for neuropsychology assessment. In total 18 subjects were recruited (n= 9 in each group; control and pregnant group). All participants of the pregnant group were within 16-27 (mid trimester) weeks gestation. Age and education matched control healthy subjects were recruited in the control group. Participants were given a standardized test of auditory cognitive function as auditory oddball paradigm during ERP study. In this paradigm, two different auditory stimuli (standard and target stimuli) were used where subjects counted silently only target stimuli with giving attention by ignoring standard stimuli. Mean differences between target and standard stimuli were compared across groups. N100 (auditory sensory ERP component) and P300 (auditory cognitive ERP component) were recorded at T3, T4, T5, T6, Cz and Pz electrode sites. An equal number of electrodes showed non-significantly shorter amplitude of N100 component (except significantly shorter at T3, P= 0.05) and non-significant longer latencies (except significantly longer latency at T5, P= 0.008) of N100 component in pregnant group comparing control. In case of P300 component, maximum electrode sites showed non-significantly higher amplitudes and equal number of sites showed non-significant shorter latencies in pregnant group comparing control. Neuropsychology results revealed the non-significant higher score of PAS, lower score of WCST, lower score of RAVLTIM and RAVLTDR in pregnant group comparing control. The results of N100 component and RAVLT scores concluded that auditory perception is mildly impaired and P300 component proved very mild cognitive dysfunction with good executive functions in second trimester of pregnancy.

Keywords: auditory perception, pregnancy, stimuli, trimester

Procedia PDF Downloads 385
396 The Effect of Aerobic Training and Consumption of Apple Vinegar on Cardiovascular Risk Factor in Older Women

Authors: S. Fazelifar, M. Ghasemi

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Aim: Recent studies on cardiovascular risk factors have been focused on the new markers of inflammatory diseases such as C-reactive protein (CRP). Research evidence shows that physical activity along with other factors such as reduced smoking, controlling blood pressure, control blood lipids TC, LDL-c, HDL-c and having a healthy weight can reduce the risk of chronic heart disease (CHD) .Therefore, the aim of this study was to determine the effect of twelve weeks aerobic exercise and consumption of apple vinegar on cardiovascular risk factor in older women. Methodology: 28 inactive women (mean body weight 72.13 ± 8.6 kg, height 157 ± 7.4cm, age 48.06 ± 5.18 years and BMI 28.2 ± 3.2 kg/m2) by recall and notice of investigation, among of the eligible voters recruited and randomly divided in 4 groups: control, apple vinegar, exercise, exercise + apple vinegar. The training program includes a 20-minute warm-up and stretching, running for 15 minutes in the first session with an intensity of 80% of maximum heart rate and an increase in one-minute run time in next training session. Also, subjects in experimental groups received daily specified amount of 50 ml apple vinegar. Blood samples were collected from the brachial vein in before and after training to measure CRP and blood lipids (cholesterol, HDL, VLDL, LDL). The levels of CRP were measured by ELISA way. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p < 0/05 accepted. Results: The results indicated that individual characteristics including height, weight, age, and body mass index were not significantly different among the four groups. The results showed that levels of CRP and LDL cholesterol were significantly reduced in all groups at post-test compared to the pre-test. The HDL levels increased significantly in all groups in post-test compared to the pre-test. Analysis of the data indicates that levels of CRP, TC, and LDL were significantly reduced in all groups compared to the control group, while the changes in the other groups were not significant relative to each other. Conclusion: Results of this study showed that twelve weeks of aerobic exercise with apple vinegar cause a significant decrease in CRP, cholesterol, LDL, and significantly increased HDL levels. According to the results of this study, it is possible that aerobic exercise with apple vinegar can inhibit CRP and undesirable fats. Considering the strong association between the inflammatory indices and the prevalence of cardiovascular diseases, every factor that decreases these indices can reduce the cardiovascular complications.

Keywords: aerobic exercise, apple vinegar, CRP, older women

Procedia PDF Downloads 473
395 Applying Sociometer Theory to Different Age Groups and Groups Differences regarding State Self-Esteem Sensitivity

Authors: Yun Yu Stephanie Law

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Sociometer Theory is well tested among young adults in western population, however, limited research is found for other age groups, like adolescent and middle-adulthood in Asia population. Thus, one of the main purposes of this study is to verify the validity of Sociometer Theory in different age groups among Asian. To be specific, we hypothesized that an increase in one’s perceived social rejection is associated to a decrease in his/her state self-esteem among all age groups in Asian population. And we expected that this association can be found among all age groups including adolescent, young adults and middle-adults group in our first study. In this way, we can verify the validity of Sociometer Theory across different age groups as well as its significance in Asian population. Furthermore, those participants who received rejection about ‘mate-role’ would also receive some negative feedbacks regarding their current/future capacity of being a good mate. Results suggested that participants’ state self-esteem sensitivity for mating-capacity rejection is higher when comparing to that of friend-capacity rejection, i.e. greater drop in state self-esteem when receiving mating-capacity feedbacks then receiving friend-capacity feedbacks. These results, however, is just applicable on young adults. Thus, the main purpose of study two would be testing the state self-esteem sensitivity towards social rejection in different domains among three age groups. We hypothesized that group differences would be found for three age groups regarding state self-esteem sensitivity. Research question 1: perceived social rejection is associated to decrease in state self-esteem, is applicable among different age groups in Asia population. Research question 2: there are significant group differences for three age groups regarding state self-esteem sensitivity. Methods: 300 subjects are divided into three age groups, adolescents group, young adult group and middle-adult group, with 100 subjects in each group. Two questionnaires were used in testing this fundamental concept. Subjects were then asked to rate themselves on questionnaire in measuring their current state self-esteem in order to obtain the baseline measurements for later comparison. In order to avoid demand characteristics from subjects, other unrelated tasks like word matching were also given after the first test. Results: A positive correlation between scores in questionnaire 1 and questionnaire 2 among all age groups. Conclusion: State self-esteem decrease to both imagined social rejection (study1) and experienced social rejection (study2). Moreover, level of decrease in state self-esteem vary when receiving different domains of social rejection. Implications: a better understanding of self-esteem development for various age group might bring insights for education systems and policies for teaching approaches and learning methods among different age groups.

Keywords: state self-esteem, social rejection, stage theory, self-feelings

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394 A Lower Dose of Topiramate with Enough Antiseizure Effect: A Realistic Therapeutic Range of Topiramate

Authors: Seolah Lee, Yoohyk Jang, Soyoung Lee, Kon Chu, Sang Kun Lee

Abstract:

Objective: The International League Against Epilepsy (ILAE) currently suggests a topiramate serum level range of 5-20 mg/L. However, numerous institutions have observed substantial drug response at lower levels. This study aims to investigate the correlation between topiramate serum levels, drug responsiveness, and adverse events to establish a more accurate and tailored therapeutic range. Methods: We retrospectively analyzed topiramate serum samples collected between January 2017 and January 2022 at Seoul National University Hospital. Clinical data, including serum levels, antiseizure regimens, seizure frequency, and adverse events, were collected. Patient responses were categorized as "insufficient" (reduction in seizure frequency <50%) or "sufficient" (reduction ≥ 50%). Within the "sufficient" group, further subdivisions included seizure-free and tolerable seizure subgroups. A population pharmacokinetic model estimated serum levels from spot measurements. ROC curve analysis determined the optimal serum level cut-off. Results: A total of 389 epilepsy patients, with 555 samples, were reviewed, having a mean dose of 178.4±117.9 mg/day and a serum level of 3.9±2.8 mg/L. Out of the samples, only 5.6% (n=31) exhibited insufficient response, with a mean serum level of 3.6±2.5 mg/L. In contrast, 94.4% (n=524) of samples demonstrated sufficient response, with a mean serum level of 4.0±2.8 mg/L. This difference was not statistically significant (p = 0.45). Among the 78 reported adverse events, logistic regression analysis identified a significant association between ataxia and serum concentration (p = 0.04), with an optimal cut-off value of 6.5 mg/L. In the subgroup of patients receiving monotherapy, those in the tolerable seizure group exhibited a significantly higher serum level compared to the seizure-free group (4.8±2.0 mg/L vs 3.4±2.3 mg/L, p < 0.01). Notably, patients in the tolerable seizure group displayed a higher likelihood of progressing into drug-resistant epilepsy during follow-up visits compared to the seizure-free group. Significance: This study proposed an optimal therapeutic concentration for topiramate based on the patient's responsiveness to the drug and the incidence of adverse effects. We employed a population pharmacokinetic model and analyzed topiramate serum levels to recommend a serum level below 6.5 mg/L to mitigate the risk of ataxia-related side effects. Our findings also indicated that topiramate dose elevation is unnecessary for suboptimal responders, as the drug's effectiveness plateaus at minimal doses.

Keywords: topiramate, therapeutic range, low dos, antiseizure effect

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393 A (Morpho) Phonological Typology of Demonstratives: A Case Study in Sound Symbolism

Authors: Seppo Kittilä, Sonja Dahlgren

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In this paper, a (morpho)phonological typology of proximal and distal demonstratives is proposed. Only the most basic proximal (‘this’) and distal (‘that’) forms have been considered, potential more fine-grained distinctions based on proximity are not relevant to our discussion, nor are the other functions the discussed demonstratives may have. The sample comprises 82 languages that represent the linguistic diversity of the world’s languages, although the study is not based on a systematic sample. Four different major types are distinguished; (1) Vowel type: front vs. back; high vs. low vowel (2) Consonant type: front-back consonants (3) Additional element –type (4) Varia. The proposed types can further be subdivided according to whether the attested difference concern only, e.g., vowels, or whether there are also other changes. For example, the first type comprises both languages such as Betta Kurumba, where only the vowel changes (i ‘this’, a ‘that’) and languages like Alyawarra (nhinha vs. nhaka), where there are also other changes. In the second type, demonstratives are distinguished based on whether the consonants are front or back; typically front consonants (e.g., labial and dental) appear on proximal demonstratives and back consonants on distal demonstratives (such as velar or uvular consonants). An example is provided by Bunaq, where bari marks ‘this’ and baqi ‘that’. In the third type, distal demonstratives typically have an additional element, making it longer in form than the proximal one (e.g., Òko òne ‘this’, ònébé ‘that’), but the type also comprises languages where the distal demonstrative is simply phonologically longer (e.g., Ngalakan nu-gaʔye vs. nu-gunʔbiri). Finally, the last type comprises cases that do not fit into the three other types, but a number of strategies are used by the languages of this group. The two first types can be explained by iconicity; front or high phonemes appear on the proximal demonstratives, while back/low phonemes are related to distal demonstratives. This means that proximal demonstratives are pronounced at the front and/or high part of the oral cavity, while distal demonstratives are pronounced lower and more back, which reflects the proximal/distal nature of their referents in the physical world. The first type is clearly the most common in our data (40/82 languages), which suggests a clear association with iconicity. Our findings support earlier findings that proximal and distal demonstratives have an iconic phonemic manifestation. For example, it has been argued that /i/ is related to smallness (small distance). Consonants, however, have not been considered before, or no systematic correspondences have been discovered. The third type, in turn, can be explained by markedness; the distal element is more marked than the proximal demonstrative. Moreover, iconicity is relevant also here: some languages clearly use less linguistic substance for referring to entities close to the speaker, which is manifested in the longer (morpho)phonological form of the distal demonstratives. The fourth type contains different kinds of cases, and systematic generalizations are hard to make.

Keywords: demonstratives, iconicity, language typology, phonology

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392 Accessibility of Social Justice through Social Security in Indian Organisations: Analysis Based on Workforce

Authors: Neelima Rashmi Lakra

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India was among one of the highly developed economy up to 1850 due to its cottage industries. During the end of the 18th century, modern industrial enterprises began with the first cotton mill in Bombay, the jute mill near Calcutta and the coal mine in Raniganj. This was counted as the real beginning of industry in 1854 in India. Prior to this period people concentrated only to agriculture, menial service or handicraft, and the introduction of industries exposed them to the disciplines of factory which was very tedious for them. With increasing number of factories been setup adding on to mining and introduction of railway, World War Period (1914-19), Second World War Period (1939-45) and the Great Depression (1929-33) there were visible change in the nature of work for the people, which resulted in outburst of strike for various reasons in these factories. Here, with India’s independence there was emergence of public sector industries and labour legislations were introduced. Meanwhile, trade unions came to notice to the rescue of the oppressed but failed to continue till long. Soon after, with the New Economic Policy organisations came across to face challenges to perform their best, where social justice for the workmen was in question. On these backdrops, studies were found discussing the central human capabilities which could be addressed through Social Security schemes. Therefore, this study was taken up to look at the reforms and legislations mainly meant for the welfare of the labour. This paper will contribute to the large number of Indian population who are serving in public sectors in India since the introduction of industries and will complement the issue of social justice through social security measures among this huge crowd serving the nation. The objectives of the study include; to find out what labour Legislations have already been existing in India, the role of Trade Union Movement, to look at the effects of New Economic Policy on these reforms and its effects and measures taken for the workforce employed in the public sectors and finally, if these measures fulfil the social justice aspects for the larger society on whole. The methodology followed collection of data from books, journal articles, reports, company reports and manuals focusing mainly on Indian studies and the data was analysed following content analysis method. The findings showed the measures taken for Social Security, but there were also reflections of very few particular additions or amendments to these Acts and provisions with the onset of New Liberalisation Policy. Therefore, the study concluded examining the social justice aspects in the context of a developing economy and discussing the recommendations.

Keywords: public sectors, social justice, social security schemes, trade union movement

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391 Clinical Features, Diagnosis and Treatment Outcomes in Necrotising Autoimmune Myopathy: A Rare Entity in the Spectrum of Inflammatory Myopathies

Authors: Tamphasana Wairokpam

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Inflammatory myopathies (IMs) have long been recognised as a heterogenous family of myopathies with acute, subacute, and sometimes chronic presentation and are potentially treatable. Necrotizing autoimmune myopathies (NAM) are a relatively new subset of myopathies. Patients generally present with subacute onset of proximal myopathy and significantly elevated creatinine kinase (CK) levels. It is being increasingly recognised that there are limitations to the independent diagnostic utility of muscle biopsy. Immunohistochemistry tests may reveal important information in these cases. The traditional classification of IMs failed to recognise NAM as a separate entity and did not adequately emphasize the diversity of IMs. This review and case report on NAM aims to highlight the heterogeneity of this entity and focus on the distinct clinical presentation, biopsy findings, specific auto-antibodies implicated, and available treatment options with prognosis. This article is a meta-analysis of literatures on NAM and a case report illustrating the clinical course, investigation and biopsy findings, antibodies implicated, and management of a patient with NAM. The main databases used for the search were Pubmed, Google Scholar, and Cochrane Library. Altogether, 67 publications have been taken as references. Two biomarkers, anti-signal recognition protein (SRP) and anti- hydroxyl methylglutaryl-coenzyme A reductase (HMGCR) Abs, have been found to have an association with NAM in about 2/3rd of cases. Interestingly, anti-SRP associated NAM appears to be more aggressive in its clinical course when compared to its anti-HMGCR associated counterpart. Biopsy shows muscle fibre necrosis without inflammation. There are reports of statin-induced NAM where progression of myopathy has been seen even after discontinuation of statins, pointing towards an underlying immune mechanism. Diagnosisng NAM is essential as it requires more aggressive immunotherapy than other types of IMs. Most cases are refractory to corticosteroid monotherapy. Immunosuppressive therapy with other immunotherapeutic agents such as IVIg, rituximab, mycophenolate mofetil, azathioprine has been explored and found to have a role in the treatment of NAM. In conclusion,given the heterogeneity of NAM, it appears that NAM is not just a single entity but consists of many different forms, despite the similarities in presentation and its classification remains an evolving field. A thorough understanding of underlying mechanism and the clinical correlation with antibodies associated with NAM is essential for efficacious management and disease prognostication.

Keywords: inflammatory myopathies, necrotising autoimmune myopathies, anti-SRP antibody, anti-HMGCR antibody, statin induced myopathy

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