Search results for: elastic net regression

Authors: Mequanent Wale Mekonen, Edoardo Otranto, Angela Alibrandi

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Diabetic kidney disease is one of the main microvascular complications caused by diabetes. Several clinical and biochemical variables are reported to be associated with diabetic kidney disease in people with type 2 diabetes. However, their interrelations could distort the effect estimation of these variables for the disease's progression. The objective of the study is to determine how the biochemical and clinical variables in people with type 2 diabetes are interrelated with each other and their effects on kidney disease progression through advanced statistical methods. First, principal component analysis was used to explore how the biochemical and clinical variables intercorrelate with each other, which helped us reduce a set of correlated biochemical variables to a smaller number of uncorrelated variables. Then, ordered logit regression models (cumulative, stage, and adjacent) were employed to assess the effect of biochemical and clinical variables on the order-level response variable (progression of kidney function) by considering the proportionality assumption for more robust effect estimation. This retrospective cross-sectional study retrieved data from a type 2 diabetic cohort in a polyclinic hospital at the University of Messina, Italy. The principal component analysis yielded three uncorrelated components. These are principal component 1, with negative loading of glycosylated haemoglobin, glycemia, and creatinine; principal component 2, with negative loading of total cholesterol and low-density lipoprotein; and principal component 3, with negative loading of high-density lipoprotein and a positive load of triglycerides. The ordered logit models (cumulative, stage, and adjacent) showed that the first component (glycosylated haemoglobin, glycemia, and creatinine) had a significant effect on the progression of kidney disease. For instance, the cumulative odds model indicated that the first principal component (linear combination of glycosylated haemoglobin, glycemia, and creatinine) had a strong and significant effect on the progression of kidney disease, with an effect or odds ratio of 0.423 (P value = 0.000). However, this effect was inconsistent across levels of kidney disease because the first principal component did not meet the proportionality assumption. To address the proportionality problem and provide robust effect estimates, alternative ordered logit models, such as the partial cumulative odds model, the partial adjacent category model, and the partial continuation ratio model, were used. These models suggested that clinical variables such as age, sex, body mass index, medication (metformin), and biochemical variables such as glycosylated haemoglobin, glycemia, and creatinine have a significant effect on the progression of kidney disease.

Keywords: diabetic kidney disease, ordered logit model, principal component analysis, type 2 diabetes

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Authors: M. Aboalazayem, Essam A. Gouda, Ahmed M. Moussa, Amr E. Flifl

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Field data collecting is considered one of the most difficult work due to the difficulty of accessing large zones such as large lakes. Also, it is well known that the cost of obtaining field data is very expensive. Remotely monitoring of lake water quality (WQ) provides an economically feasible approach comparing to field data collection. Researchers have shown that lake WQ can be properly monitored via Remote sensing (RS) analyses. Using satellite images as a method of WQ detection provides a realistic technique to measure quality parameters across huge areas. Landsat (LS) data provides full free access to often occurring and repeating satellite photos. This enables researchers to undertake large-scale temporal comparisons of parameters related to lake WQ. Satellite measurements have been extensively utilized to develop algorithms for predicting critical water quality parameters (WQPs). The goal of this paper is to use RS to derive WQ indicators in Aswan High Dam Reservoir (AHDR), which is considered Egypt's primary and strategic reservoir of freshwater. This study focuses on using Landsat8 (L-8) band surface reflectance (SR) observations to predict water-quality characteristics which are limited to Turbidity (TUR), total suspended solids (TSS), and chlorophyll-a (Chl-a). ArcGIS pro is used to retrieve L-8 SR data for the study region. Multiple linear regression analysis was used to derive new correlations between observed optical water-quality indicators in April and L-8 SR which were atmospherically corrected by values of various bands, band ratios, and or combinations. Field measurements taken in the month of May were used to validate WQP obtained from SR data of L-8 Operational Land Imager (OLI) satellite. The findings demonstrate a strong correlation between indicators of WQ and L-8 .For TUR, the best validation correlation with OLI SR bands blue, green, and red, were derived with high values of Coefficient of correlation (R2) and Root Mean Square Error (RMSE) equal 0.96 and 3.1 NTU, respectively. For TSS, Two equations were strongly correlated and verified with band ratios and combinations. A logarithm of the ratio of blue and green SR was determined to be the best performing model with values of R2 and RMSE equal to 0.9861 and 1.84 mg/l, respectively. For Chl-a, eight methods were presented for calculating its value within the study area. A mix of blue, red, shortwave infrared 1(SWR1) and panchromatic SR yielded the greatest validation results with values of R2 and RMSE equal 0.98 and 1.4 mg/l, respectively.

Keywords: remote sensing, landsat 8, nasser lake, water quality

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Authors: Zülfiye Bıkmaz, Aytolan Yıldırım

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This study was planned as a descriptive regressive study in order to determine the relationship between the competency levels of working nurses, the levels of competency expected by nursing students, the critical thinking disposition of nurses, their perceived autonomy levels, and certain socio demographic characteristics. It is also a methodological study with regard to the intercultural adaptation of the Nursing Competence Scale (NCS) in both working and student samples. The sample of the study group of nurses at a university hospital for at least 6 months working properly and consists of 443 people filled out questionnaires. The student group, consisting of 543 individuals from the 4 public university nursing 3rd and 4th grade students. Data collection tools consisted of a questionnaire prepared in order to define the socio demographic, economic, and personal characteristics of the participants, the ‘Nursing Competency Scale’, the ‘Autonomy Subscale of the Sociotropy – Autonomy Scale’, and the ‘California Critical Thinking Disposition Inventory’. In data evaluation, descriptive statistics, nonparametric tests, Rasch analysis and correlation and regression tests were used. The language validity of the ‘NCS’ was performed by translation and back translation, and the context validity of the scale was performed with expert views. The scale, which was formed into its final structure, was applied in a pilot application from a group consisting of graduate and student nurses. The time constancy of the test was obtained by analysis testing retesting method. In order to reduce the time problems with the two half reliability method was used. The Cronbach Alfa coefficient of the scale was found to be 0.980 for the nurse group and 0.986 for the student group. Statistically meaningful relationships between competence and critical thinking and variables such as age, gender, marital status, family structure, having had critical thinking training, education level, class of the students, service worked in, employment style and position, and employment duration were found. Statistically meaningful relationships between autonomy and certain variables of the student group such as year, employment status, decision making style regarding self, total duration of employment, employment style, and education status were found. As a result, it was determined that the NCS which was adapted interculturally was a valid and reliable measurement tool and was found to be associated with autonomy and critical thinking.

Keywords: nurse, nursing student, competence, autonomy, critical thinking, Rasch analysis

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Authors: Ernest Nweke

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Mongolia has made giant strides in the development of its auditing and accounting system from Soviet-style to a market-oriented system. High levels of domestic and foreign investment desired by the Mongolian government require that better and improved quality of corporate information and disclosure consistent with international standards be made available to investors. However, the Mongolian Certified Public Accountants (CPA) profession is still developing, and the quality of services provided by accounting firms in most cases do not comply with International Financial Reporting Standards (IFRS) framework approved by the government for use in financial reporting. Against this backdrop, Accounting and audit reforms, liberalization and deregulation, establishment of an efficient and effective professional monitoring and supervision regime are policy necessities. These will further enhance the Mongolian business environment, eliminate incompetence in the system, make the economy more attractive to investors and ultimately lift reporting standards and bring about improved accounting, auditing and disclosure practices among Mongolian firms. This paper examines the fundamental issues in the accounting and auditing environment in Mongolia and investigates the relationship between selected characteristics of Mongolian Stock Exchange (MSE) listed firms (profitability, leverage, firm size, firm auditor size, firm listing age, board size and proportion of independent directors) and voluntary accounting disclosures in their annual reports and accounts. The selected sample of firms for the research purpose consists of the top 20 indexes of the MSE, representing over 95% of the market capitalization. An empirical analysis of the hypothesized relationship was carried out using multiple regression in EViews analytical software. Research results lend credence to the fact that only a few of the company attributes positively impact voluntary accounting disclosures in Mongolian Stock Exchange-listed firms. The research is motivated by the absence of empirical evidence on the correlation between the quality of voluntary accounting disclosures made by listed companies in Mongolia and company characteristics and the findings thereof significantly useful to both firms and regulatory authorities. The concluding part of the paper precisely consists of useful research-based recommendations for listed firms and regulatory agencies on measures to put in place in order to enhance the quality of corporate financial reporting and disclosures in Mongolia.

Keywords: accounting, auditing, corporate disclosure, listed firms

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Authors: Yuqing Zou, Chunrui Zou, Yichong Cao

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Previous research has revealed relationships between self-efficacy (SE), engagement, and academic achievement among students in Western countries, but these relationships remain unknown in college math courses among college students in China. In addition, previous research has shown that test anxiety has a direct effect on engagement and academic achievement. However, how test anxiety affects the relationships between SE, engagement, and academic achievement is still unknown. In this study, the authors aimed to explore the mediating roles of behavioral engagement (BE), emotional engagement (EE), and cognitive engagement (CE) in the association between SE and academic achievement and the moderating role of test anxiety in college math courses. Our hypotheses are that the association between SE and academic achievement was mediated by engagement and that test anxiety played a moderating role in the association. To explore the research questions, the authors collected data through self-reported surveys among 147 students at a northwestern university in China. Self-reported surveys were used to collect data. The motivated strategies for learning questionnaire (MSLQ) (Pintrich, 1991), the metacognitive strategies questionnaire (Wolters, 2004), and the engagement versus disaffection with learning scale (Skinner et al., 2008) were used to assess SE, CE, and BE and EE, respectively. R software was used to analyze the data. The main analyses used were reliability and validity analysis of scales, descriptive statistics analysis of measured variables, correlation analysis, regression analysis, and structural equation modeling (SEM) analysis and moderated mediation analysis to look at the structural relationships between variables at the same time. The SEM analysis indicated that student SE was positively related to BE, EE, and CE and academic achievement. BE, EE, and CE were all positively associated with academic achievement. That is, as the authors expected, higher levels of SE led to higher levels of BE, EE, and CE, and greater academic achievement. Higher levels of BE, EE, and CE led to greater academic achievement. In addition, the moderated mediation analysis found that the path of SE to academic achievement in the model was as significant as expected, as was the moderating effect of test anxiety in the SE-Achievement association. Specifically, test anxiety was found to moderate the association between SE and BE, the association between SE and CE, and the association between EE and Achievement. The authors investigated possible mediating effects of BE, EE, and CE in the associations between SE and academic achievement, and all indirect effects were found to be significant. As for the magnitude of mediations, behavioral engagement was the most important mediator in the SE-Achievement association. This study has implications for college teachers, educators, and students in China regarding ways to promote academic achievement in college math courses, including increasing self-efficacy and engagement and lessening test anxiety toward math.

Keywords: academic engagement, self-efficacy, test anxiety, academic achievement, college math courses, behavioral engagement, cognitive engagement, emotional engagement

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Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah

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Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.

Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices

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Authors: Oindrila Nath, S. Sridharan

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Long-term (2002-2012) temperature and ozone measurements by Sounding of Atmosphere by Broadband Emission Radiometry (SABER) instrument onboard Thermosphere, Ionosphere, Mesosphere Energetics and Dynamics (TIMED) satellite zonally averaged over 10°N-15°N are used to study their long-term changes and their responses to solar cycle, quasi-biennial oscillation and El Nino Southern Oscillation. The region is selected to provide more accurate long-term trends and variabilities, which were not possible earlier with lidar measurements over Gadanki (13.5°N, 79.2°E), which are limited to cloud-free nights, whereas continuous data sets of SABER temperature and ozone are available. Regression analysis of temperature shows a cooling trend of 0.5K/decade in the stratosphere and that of 3K/decade in the mesosphere. Ozone shows a statistically significant decreasing trend of 1.3 ppmv per decade in the mesosphere although there is a small positive trend in stratosphere at 25 km. Other than this no significant ozone trend is observed in stratosphere. Negative ozone-QBO response (0.02ppmv/QBO), positive ozone-solar cycle (0.91ppmv/100SFU) and negative response to ENSO (0.51ppmv/SOI) have been found more in mesosphere whereas positive ozone response to ENSO (0.23ppmv/SOI) is pronounced in stratosphere (20-30 km). The temperature response to solar cycle is more positive (3.74K/100SFU) in the upper mesosphere and its response to ENSO is negative around 80 km and positive around 90-100 km and its response to QBO is insignificant at most of the heights. Composite monthly mean of ozone volume mixing ratio shows maximum values during pre-monsoon and post-monsoon season in middle stratosphere (25-30 km) and in upper mesosphere (85-95 km) around 10 ppmv. Composite monthly mean of temperature shows semi-annual variation with large values (~250-260 K) in equinox months and less values in solstice months in upper stratosphere and lower mesosphere (40-55 km) whereas the SAO becomes weaker above 55 km. The semi-annual variation again appears at 80-90 km, with large values in spring equinox and winter months. In the upper mesosphere (90-100 km), less temperature (~170-190 K) prevails in all the months except during September, when the temperature is slightly more. The height profiles of amplitudes of semi-annual and annual oscillations in ozone show maximum values of 6 ppmv and 2.5 ppmv respectively in upper mesosphere (80-100 km), whereas SAO and AO in temperature show maximum values of 5.8 K and 4.6 K in lower and middle mesosphere around 60-85 km. The phase profiles of both SAO and AO show downward progressions. These results are being compared with long-term lidar temperature measurements over Gadanki (13.5°N, 79.2°E) and the results obtained will be presented during the meeting.

Keywords: trends, QBO, solar cycle, ENSO, ozone, temperature

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Authors: Rania S. Hussein

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Background: This study aims to determine the evolution of service provision by Egyptian travel sites and how these services change in terms of their level of sophistication over the period of the study which is ten years. To the author’s best knowledge, this is the first longitudinal study that focuses on an extended time frame of ten years. Additionally, the study attempts to determine the popularity of these websites through the number of links to these sites. Links maybe viewed as the equivalent of a referral or word of mouth but in an online context. Both popularity and the nature of the services provided by these websites are used to determine the traffic on these sites. In examining the nature of services provided, the website itself is viewed as an overall service offering that is composed of different travel products and services. Method: This study uses content analysis in the form of a small scale survey done on 30 Egyptian travel agents’ websites to examine whether Egyptian travel websites are static or dynamic in terms of the services that they provide and whether they provide simple or sophisticated travel services. To determine the level of sophistication of these travel sites, the nature and composition of products and services offered by these sites were first examined. A framework adapted from Kotler (1997) 'Five levels of a product' was used. The target group for this study consists of companies that do inbound tourism. Four rounds of data collection were conducted over a period of 10 years. Two rounds of data collection were made in 2004 and two rounds were made in 2014. Data from the travel agents’ sites were collected over a two weeks period in each of the four rounds. Besides collecting data on features of websites, data was also collected on the popularity of these websites through a software program called Alexa that showed the traffic rank and number of links of each site. Regression analysis was used to test the effect of links and services on websites as independent variables on traffic as the dependent variable of this study. Findings: Results indicate that as companies moved from having simple websites with basic travel information to being more interactive, the number of visitors illustrated by traffic and the popularity of those sites increase as shown by the number of links. Results also show that travel companies use the web much more for promotion rather than for distribution since most travel agents are using it basically for information provision. The results of this content analysis study taps on an unexplored area and provide useful insights for marketers on how they can generate more traffic to their websites by focusing on developing a distinctive content on these sites and also by focusing on the visibility of their sites thus enhancing the popularity or links to their sites.

Keywords: levels of a product, popularity, travel, website evolution

Procedia PDF Downloads 321

Authors: Haiu-Lan Chin, Yu-Fen Hsiao, Hua-Ying Chuang, Wei Lee

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An adult with intellectual disability generally has insufficient physical activity which is an important factor leading to premature weakness. Studies in recent years on frailty syndrome have accumulated substantial data about indicators of human aging, including unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. Of these indicators, hand-grip strength can be seen as a predictor of mortality, disability, complications, and increased length of hospital stay. Hand-grip strength in fact provides a comprehensive overview of one’s vitality. The research is about the investigation on hand-grip strength of adults with intellectual disabilities in facilities, institutions and workshops. The participants are 197 male adults (M=39.09±12.85 years old), and 114 female ones (M=35.80±8.2 years old) so far. The aim of the study is to figure out the performance of their hand-grip strength, and initiate the setting of training on hand-grip strength in their daily life which will decrease the weakening on their physical condition. Test items include weight, bone density, basal metabolic rate (BMR), static body balance except hand-grip strength. Hand-grip strength was measured by a hand dynamometer and classified as normal group ( ≧ 30 kg for male and ≧ 20 kg for female) and weak group ( < 30 kg for male, < 20 kg for female)The analysis includes descriptive statistics, and the indicators of grip strength fo the adults with intellectual disability. Though the research is still ongoing and the participants are increasing, the data indicates: (1) The correlation between hand-grip strength and degree of the intellectual disability (p ≦. 001), basal metabolic rate (p ≦ .001), and static body balance (p ≦ .01) as well. Nevertheless, there is no significant correlation between grip strength and basal metabolic rate which had been having significant correlation with hand-grip strength. (2) The difference between male and female subjects in hand-grip strength is significant, the hand-grip strength of male subjects (25.70±12.81 Kg) is much higher than female ones (16.30±8.89 Kg). Compared to the female counterparts, male participants indicate greater individual differences. And the proportion of weakness between male and female subjects is also different. (3) The regression indicates the main factors related to grip strength performance include degree of the intellectual disability, height, static body balance, training and weight sequentially. (4) There is significant difference on both hand-grip and static body balance between participants in facilities and workshops. The study supports the truth about the sex and gender differences in health. Nevertheless, the average hand-grip strength of left hand is higher than right hand in both male and female subjects. Moreover, 71.3% of male subjects and 64.2% of female subjects have better performance in their left hand-grip which is distinctive features especially in low degree of the intellectual disability.

Keywords: adult with intellectual disability, frailty syndrome, grip strength, physical condition

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Authors: Uyanga Jadamba

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Globalisation of the world economy has necessitated the development and implementation of a comparable and understandable reporting language suitable for use by all reporting entities. The International Accounting Standard Board (IASB) provides an international reporting language that lets all users understand the financial information of their business and potentially allows them to have access to finance at an international level. The study is based on logistic regression analysis to investigate the factors for the adoption of theInternational Financial Reporting Standard for Small and Medium sized Entities (IFRS for SMEs). The study started with a list of 217 countries from World Bank data. Due to the lack of availability of data, the final sample consisted of 136 countries, including 60 countries that have adopted the IFRS for SMEs and 76 countries that have not adopted it yet. As a result, the study included a period from 2010 to 2020 and obtained 1360 observations. The findings confirm that the adoption of the IFRS for SMEs is significantly related to the existence of national reporting standards, law enforcement quality, common law (legal system), and extent of disclosure. It means that the likelihood of adoption of the IFRS for SMEs decreases if the country already has a national reporting standard for SMEs, which suggests that implementation and transitional costs are relatively high in order to change the reporting standards. The result further suggests that the new standard adoption is easier in countries with constructive law enforcement and effective application of laws. The finding also shows that the adoption increases if countries have a common law system which suggests that efficient reportingregulations are more widespread in these countries. Countries with a high extent of disclosing their financial information are more likely to adopt the standard than others. The findings lastly show that the audit qualityand primary education levelhave no significant impact on the adoption.One possible explanation for this could be that accounting professionalsfrom in developing countries lacked complete knowledge of the international reporting standards even though there was a requirement to comply with them. The study contributes to the literature by providing factors that impact the adoption of the IFRS for SMEs. It helps policymakers to better understand and apply the standard to improve the transparency of financial statements. The benefit of adopting the IFRS for SMEs is significant due to the relaxed and tailored reporting requirements for SMEs, reduced burden on professionals to comply with the standard, and provided transparent financial information to gain access to finance.The results of the study are useful toemerging economies where SMEs are dominant in the economy in informing its evaluation of the adoption of the IFRS for SMEs.

Keywords: IFRS for SMEs, international financial reporting standard, adoption, institutional factors

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Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

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Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

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Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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Authors: Arlene López-Sampson, Tony Page, Betsy Jackes

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Aquilaria genus produces a highly valuable fragrant oleoresin known as agarwood. Agarwood forms in a few trees in the wild as a response to injure or pathogen attack. The resin is used in perfume and incense industry and medicine. Cultivation of Aquilaria species as a sustainable source of the resin is now a common strategy. Physiological traits are frequently used as a proxy of crop and tree productivity. Aquilaria species growing in Queensland, Australia were studied to investigate relationship between leaf-productivity traits with tree growth. Specifically, 28 trees, representing 12 plus trees and 16 trees from yield plots, were selected to conduct carbon isotope analysis (δ13C) and monitor six leaf attributes. Trees were grouped on four diametric classes (diameter at 150 mm above ground level) ensuring the variability in growth of the whole population was sampled. Model averaging technique based on the Akaike’s information criterion (AIC) was computed to identify whether leaf traits could assist in diameter prediction. Carbon isotope values were correlated with height classes and leaf traits to determine any relationship. In average four leaves per shoot were recorded. Approximately one new leaf per week is produced by a shoot. Rate of leaf expansion was estimated in 1.45 mm day-1. There were no statistical differences between diametric classes and leaf expansion rate and number of new leaves per week (p > 0.05). Range of δ13C values in leaves of Aquilaria species was from -25.5 ‰ to -31 ‰ with an average of -28.4 ‰ (± 1.5 ‰). Only 39% of the variability in height can be explained by δ13C in leaf. Leaf δ13C and nitrogen content values were positively correlated. This relationship implies that leaves with higher photosynthetic capacities also had lower intercellular carbon dioxide concentrations (ci/ca) and less depleted values of 13C. Most of the predictor variables have a weak correlation with diameter (D). However, analysis of the 95% confidence of best-ranked regression models indicated that the predictors that could likely explain growth in Aquilaria species are petiole length (PeLen), values of δ13C (true13C) and δ15N (true15N), leaf area (LA), specific leaf area (SLA) and number of new leaf produced per week (NL.week). The model constructed with PeLen, true13C, true15N, LA, SLA and NL.week could explain 45% (R2 0.4573) of the variability in D. The leaf traits studied gave a better understanding of the leaf attributes that could assist in the selection of high-productivity trees in Aquilaria.

Keywords: 13C, petiole length, specific leaf area, tree growth

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Authors: Sonia Tamanna, Akramul Hassan, Mohammad Shakil Mahmood, Farzana Ansari, Gowhar Rashid, Mir Fahim Faisal, M. Zakir Hossain Howlader

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Background: Preeclampsia (PE), a pregnancy-specific hypertensive disorder, significantly impacts maternal and fetal health. It is particularly prevalent in underdeveloped countries and is linked to preterm delivery and fetal growth. The renin-angiotensin system (RAS) plays a crucial role in ensuring a successful pregnancy outcome, with Angiotensin-Converting Enzyme 2 (ACE2) being a key component. ACE2 converts ANG II to Ang-(1-7), offering protection against ANG II-induced stress and inflammation while regulating blood pressure and osmotic balance during pregnancy. The reduced maternal plasma angiotensin-converting enzyme 2 (ACE2) seen in preeclampsia might contribute to its pathogenesis. However, there has been a dearth of comprehensive research into the association between ACE2 gene polymorphism and preeclampsia. In the South Asian population, hypertension is strongly linked to two SNPs: rs2285666 and rs879922. This genotype was therefore considered, and the possible association of maternal and fetal ACE2 gene polymorphism with preeclampsia within the Bangladeshi population was evaluated. Method: DNA was extracted from peripheral white blood cells (WBCs) using the organic method, and SNP genotyping was done via PCR-RFLP. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using logistic regression to determine relative risk. Result: A comprehensive case-control study was conducted on 51 PE patients and their infants, along with 56 control subjects and their infants. Maternal single nuvleotide polymorphisms (SNP) (rs2285666) analysis revealed a strong association between the TT genotype and preeclampsia, with a four-fold increased risk in mothers (P=0.024, OR=4.00, 95% CI=1.36-11.37) compared to their ancestral genotype CC. However, the CT genotype (rs2285666) showed no significant difference (P=0.46, OR=1.54, 95% CI=0.57-4.14). Notably, no significant correlation was found in infants, regardless of their gender. For rs879922, no significant association was observed in both mothers and infants. This pioneering study suggests that mothers carrying the ACE2 gene variant rs2285666 (TT allele) may be at higher risk for preeclampsia, potentially influencing hypertension characteristics, whereas rs879922 does not appear to be associated with developing preeclampsia. Conclusion: This study sheds light on the role of ACE2 gene polymorphism, particularly the rs2285666 TT allele, in maternal susceptibility to preeclampsia. However, rs879922 does not appear to be linked to the risk of PE. This research contributes to our understanding of the genetic underpinnings of preeclampsia, offering insights into potential avenues for prevention and management.

Keywords: ACE2, PCR-RFLP, preeclampsia, single nuvleotide polymorphisms (SNPs)

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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Authors: I. Ling Tsai, Shu Fen Wu, Chen-Fuh Lam, Chia Yu Chen, Shu Jiuan Chen, Yen Lin Liu

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Purpose: Following the conduction of the National Health Insurance (NHI) system in Taiwan since 1995, the demand for anesthesia services continues to increase in the operating rooms and other medical units. It has been well recognized that increased work stress not only affects the clinical performance of the medical staff, long-term work load may also result in occupational burnout. Our study aimed to determine the influence of working environment, work stress and job satisfaction on the occupational burnout in nurse anesthetists. The ultimate goal of this research project is to develop a strategy in establishing a friendly, less stressful workplace for the nurse anesthetists to enhance their job satisfaction, thereby reducing occupational burnout and increasing the career life for nurse anesthetists. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator 2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the nurse anesthetists. The relationships between two numeric datasets were analyzed by the Pearson correlation test (SPSS 20.0). Results: A total of 66 completed questionnaires were collected from 75 nurses (response rate 88%). The average scores for the working environment, job satisfaction, and work stress were 69.6%, 61.5%, and 63.9%, respectively. The three perspectives used to assess the occupational burnout, namely emotional exhaustion, depersonalization and sense of personal accomplishment were 26.3, 13.0 and 24.5, suggesting the presence of moderate to high degrees of burnout in our nurse anesthetists. The presence of occupational burnout was closely correlated with the unsatisfactory working environment (r=-0.385, P=0.001) and reduced job satisfaction (r=-0.430, P=0.000). Junior nurse anesthetists (<1-year clinical experience) reported having higher satisfaction in working environment than the seniors (5 to 10-year clinical experience) (P=0.02). Although the average scores for work stress, job satisfaction, and occupational burnout were lower in junior nurses, the differences were not statistically different. The linear regression model, the working environment was the independent factor that predicted occupational burnout in nurse anesthetists up to 19.8%. Conclusions: High occupational burnout is more likely to develop in senior nurse anesthetists who experienced the dissatisfied working environment, work stress and lower job satisfaction. In addition to the regulation of clinical duties, the increased workload in the supervision of the junior nurse anesthetists may result in emotional stress and burnout in senior nurse anesthetists. Therefore, appropriate adjustment of clinical and teaching loading in the senior nurse anesthetists could be helpful to improve the occupational burnout and enhance the retention rate.

Keywords: nurse anesthetists, working environment, work stress, job satisfaction, occupational burnout

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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To develop a machine learning model to predict diabetes (DM) prevalence in the U.S. population using demographic characteristics, physical indicators, and lifestyle habits, and to analyze how these factors contribute to the likelihood of diabetes. We analyzed data from 23,546 participants aged 20 and older, who were non-pregnant, from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). The dataset included key demographic (age, sex, ethnicity), physical (BMI, leg length, total cholesterol [TCHOL], fasting plasma glucose), and lifestyle indicators (smoking habits). A weighted sample was used to account for NHANES survey design features such as stratification and clustering. A classification machine learning model was trained to predict diabetes status. The target variable was binary (diabetes or non-diabetes) based on fasting plasma glucose measurements. The following models were evaluated: Logistic Regression (baseline), Random Forest Classifier, Gradient Boosting Machine (GBM), Support Vector Machine (SVM). Model performance was assessed using accuracy, F1-score, AUC-ROC, and precision-recall metrics. Feature importance was analyzed using SHAP values to interpret the contributions of variables such as age, BMI, ethnicity, and smoking status. The Gradient Boosting Machine (GBM) model outperformed other classifiers with an AUC-ROC score of 0.85. Feature importance analysis revealed the following key predictors: Age: The most significant predictor, with diabetes prevalence increasing with age, peaking around the 60s for males and 70s for females. BMI: Higher BMI was strongly associated with a higher risk of diabetes. Ethnicity: Black participants had the highest predicted prevalence of diabetes (14.6%), followed by Mexican-Americans (13.5%) and Whites (10.6%). TCHOL: Diabetics had lower total cholesterol levels, particularly among White participants (mean decline of 23.6 mg/dL). Smoking: Smoking showed a slight increase in diabetes risk among Whites (0.2%) but had a limited effect in other ethnic groups. Using machine learning models, we identified key demographic, physical, and lifestyle predictors of diabetes in the U.S. population. The results confirm that diabetes prevalence varies significantly across age, BMI, and ethnic groups, with lifestyle factors such as smoking contributing differently by ethnicity. These findings provide a basis for more targeted public health interventions and resource allocation for diabetes management.

Keywords: diabetes, NHANES, random forest, gradient boosting machine, support vector machine

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Authors: Beatriz Garcia-Juan, Ana B. Escrig-Tena, Vicente Roca-Puig

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The aim of this article is to conduct a theoretical and empirical study in order to examine how the goal orientation (GO) of public employees affects the relationship between the structural and psychological empowerment that they experience at their workplaces. In doing so, we follow structural empowerment (SE) and psychological empowerment (PE) conceptualizations, and relate them to the public administration framework. Moreover, we review arguments from GO theories, and previous related contributions. Empowerment has emerged as an important issue in the public sector organization setting in the wake of mainstream New Public Management (NPM), the new orientation in the public sector that aims to provide a better service for citizens. It is closely linked to the drive to improve organizational effectiveness through the wise use of human resources. Nevertheless, it is necessary to combine structural (managerial) and psychological (individual) approaches in an integrative study of empowerment. SE refers to a set of initiatives that aim the transference of power from managerial positions to the rest of employees. PE is defined as psychological state of competence, self-determination, impact, and meaning that an employee feels at work. Linking these two perspectives will lead to arrive at a broader understanding of the empowerment process. Specifically in the public sector, empirical contributions on this relationship are therefore important, particularly as empowerment is a very useful tool with which to face the challenges of the new public context. There is also a need to examine the moderating variables involved in this relationship, as well as to extend research on work motivation in public management. It is proposed the study of the effect of individual orientations, such as GO. GO concept refers to the individual disposition toward developing or confirming one’s capacity in achievement situations. Employees’ GO may be a key factor at work and in workforce selection processes, since it explains the differences in personal work interests, and in receptiveness to and interpretations of professional development activities. SE practices could affect PE feelings in different ways, depending on employees’ GO, since they perceive and respond differently to such practices, which is likely to yield distinct PE results. The model is tested on a sample of 521 Spanish local authority employees. Hierarchical regression analysis was conducted to test the research hypotheses using SPSS 22 computer software. The results do not confirm the direct link between SE and PE, but show that learning goal orientation has considerable moderating power in this relationship, and its interaction with SE affects employees’ PE levels. Therefore, the combination of SE practices and employees’ high levels of LGO are important factors for creating psychologically empowered staff in public organizations.

Keywords: goal orientation, moderating effect, psychological empowerment, structural empowerment

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Authors: Dial Tassadit Rania, Figueiredo De Oliveira Gabriel

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In this paper, we investigate the relationship between ports and their hinterland and foreland environments and the competitive relationship between the ports themselves. These two environments are changing, evolving and introducing new challenges for commercial and economic development at the regional, national and international levels. Because of the rise of the containerization phenomenon, shipping costs and port handling costs have considerably decreased due to economies of scale. The volume of maritime trade has increased substantially and the markets served by the ports have expanded. On these bases, overlapping hinterlands can give rise to the phenomenon of competition between ports. Our main contribution comparing to the existing literature on this issue, is to build a set of hinterland, foreland and competition indicators. Using these indicators? we investigate the effect of hinterland accessibility, foreland connectivity and inter-ports competition on containerized traffic of Europeans ports. For this, we have a 10-year panel database from 2004 to 2014. Our hinterland indicators are given by two indicators of accessibility; they describe the market potential of a port and are calculated using information on population and wealth (GDP). We then calculate population and wealth for different neighborhoods within a distance from a port ranging from 100 to 1000km. For the foreland, we produce two indicators: port connectivity and number of partners for each port. Finally, we compute the two indicators of inter-port competition and a market concentration indicator (Hirshmann-Herfindhal) for different neighborhood-distances around the port. We then apply a fixed-effect model to test the relationship above. Again, with a fixed effects model, we do a sensitivity analysis for each of these indicators to support the results obtained. The econometric results of the general model given by the regression of the accessibility indicators, the LSCI for port i, and the inter-port competition indicator on the containerized traffic of European ports show a positive and significant effect for accessibility to wealth and not to the population. The results are positive and significant for the two indicators of connectivity and competition as well. One of the main results of this research is that the port development given here by the increase of its containerized traffic is strongly related to the development of its hinterland and foreland environment. In addition, it is the market potential, given by the wealth of the hinterland that has an impact on the containerized traffic of a port. However, accessibility to a large population pool is not important for understanding the dynamics of containerized port traffic. Furthermore, in order to continue to develop, a port must penetrate its hinterland at a deep level exceeding 100 km around the port and seek markets beyond this perimeter. The port authorities could focus their marketing efforts on the immediate hinterland, which can, as the results shows, not be captive and thus engage new approaches of port governance to make it more attractive.

Keywords: accessibility, connectivity, European containerization, European hinterland and foreland, inter-port competition

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Authors: Priyanka Mazumdar, Ananya Mukhopadhyay

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A lot of progress has been achieved in the research of turbidites during the last decades. However, their relationship to delta systems still deserves further attention. This paper addresses example of fine grained turbidite from a pro-deltaic deposit of a Proterozoic mixed energy delta system exposed along Chaossa-Baliana river section of the Chaossa Formation of the Simla Basin. Lithostratigraphic analysis of the Chaossa Formation reveals three major facies associations (prodelta deposit-FA1, delta slope deposit-FA2 and delta front deposit-FA3) based on lithofacies types, petrography and sedimentary structures. Detailed process-based facies and paleoenvironmental analysis of the study area have led to identification of more than150 m thick coarsening-upwards deltaic successions composed of fine grained turbidites overlain by delta slope deposits. Erosional features are locally common at the base of turbidite beds and still more widespread at the top. The complete sequence has eight sub-divisions that are here termed T1 to T8. The basal subdivision (T1) comprises a massive graded unit with a sharp, scoured base, internal parallel-lamination and cross-lamination. The overlying sequence shows textural and compositional grading through alternating silt and mud laminae (T2). T2 is overlying by T3 which is characterized by climbing ripple and cross lamination. Parallel laminae are the predominant facies attributes of T4 which caps the T3 unit. T5 has a loaded scour base and is mainly characterized laminated silt. The topmost three divisions, graded mud (T6), ungraded mud (T7) and laminated mud (T8). The proposed sequence is analogous to the Bouma (1962) structural scheme for sandy turbidites. Repetition of partial sequences represents deposition from different stages of evolution of a large, muddy, turbidity flow. Detailed facies analysis of the study area reveals that the sediments of the turbidites developed during normal regression at the stage of stable or marginally rising sea level. Thin-bedded turbidites were deposited predominantly by turbidity currents in the relatively shallower part of the Simla basin. The fine-grained turbidites are developed by resedimentation of delta-front sands and slumping of upper pro-delta muds.

Keywords: turbidites, prodelta, proterozoic, Simla Basin, Bouma sequence

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Authors: Keith T. S. Tung, Frederick K. Ho, Rosa S. Wong, Camilla K. M. Lo, Wilfred H. S. Wong, C. B. Chow, Patrick Ip

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Objectives: Underage drinking is an important public health problem both locally and globally. Conventional prevention/intervention relies on unidirectional knowledge transfer such as mail leaflets or health talks which showed mixed results in changing the target behaviour. Previously, we conducted a school internet-based intervention which was found to be effective in reducing alcohol use among adolescents, yet the underlying mechanisms have not been properly investigated. This study, therefore, examined the mechanisms that explain how the intervention produced a change in alcohol drinking behaviours among Chinese adolescent as observed in our previous clustered randomised controlled trial (RCT) study. Methods: This is a cluster randomised controlled trial with parallel group design. Participating schools were randomised to the Internet intervention or the conventional health education group (control) with a 1:1 allocation ratio. Secondary 1–3 students of the participating schools were enrolled in this study. The Internet intervention was a web-based quiz game competition, in which participating students would answer 1,000 alcohol-related multiple-choice quiz questions. Conventional health education group received a promotional package on equivalent alcohol-related knowledge. The participants’ alcohol-related attitude, knowledge, and perceived behavioural control were self-reported before the intervention (baseline) and one month and three months after the intervention. Results: Our RCT results showed that participants in the Internet group were less likely to drink (risk ratio [RR] 0.79, p < 0.01) as well as in lesser amount (β -0.06, p < 0.05) compared to those in the control group at both post-intervention follow-ups. Within the intervention group, regression analyses showed that high quiz scorer had greater improvement in alcohol-related knowledge (β 0.28, p < 0.01) and attitude (β -0.26, p < 0.01) at 1 month after intervention, which in turn increased their perceived behavioural control against alcohol use (β 0.10 and -0.26, both p < 0.01). Attitude, compared to knowledge, was found to be a stronger contributor to the intervention effect on perceived behavioural control. Conclusions: Our internet-based intervention has demonstrated effectiveness in reducing the risk of underage drinking when compared with conventional health education. Our study results further showed an attitude to be a more important factor than knowledge in changing health-related behaviour. This has an important implication for future prevention/intervention on an underage drinking problem.

Keywords: adolescents, internet-based intervention, randomized controlled trial, underage drinking

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

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

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

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Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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Authors: Man Fung Ho, Lap So, Jiaqi Zhang, Yuheng Zhao, Huiyang Lu, Tat Shing Choi, K. Y. Michael Wong

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Nowadays, a tremendous amount of data is available in the transportation system, enabling the development of various machine learning approaches to make short-term latency predictions. A natural question is then the choice of relevant information to enable accurate predictions. Using traffic data collected from the Taiwan Freeway System, we consider the prediction of short-term latency of a freeway segment with a length of 17 km covering 5 measurement points, each collecting vehicle-by-vehicle data through the electronic toll collection system. The processed data include the past latencies of the freeway segment with different time lags, the traffic conditions of the individual segments (the accumulations, the traffic fluxes, the entrance and exit rates), the total accumulations, and the weekday latency profiles obtained by Gaussian process regression of past data. We arrive at several important conclusions about how data should be refined to obtain accurate predictions, which have implications for future system-wide latency predictions. (1) We find that the prediction of median latency is much more accurate and meaningful than the prediction of average latency, as the latter is plagued by outliers. This is verified by machine-learning prediction using XGBoost that yields a 35% improvement in the mean square error of the 5-minute averaged latencies. (2) We find that the median latency of the segment 15 minutes ago is a very good baseline for performance comparison, and we have evidence that further improvement is achieved by machine learning approaches such as XGBoost and Long Short-Term Memory (LSTM). (3) By analyzing the feature importance score in XGBoost and calculating the mutual information between the inputs and the latencies to be predicted, we identify a sequence of inputs ranked in importance. It confirms that the past latencies are most informative of the predicted latencies, followed by the total accumulation, whereas inputs such as the entrance and exit rates are uninformative. It also confirms that the inputs are much less informative of the average latencies than the median latencies. (4) For predicting the latencies of segments composed of two or three sub-segments, summing up the predicted latencies of each sub-segment is more accurate than the one-step prediction of the whole segment, especially with the latency prediction of the downstream sub-segments trained to anticipate latencies several minutes ahead. The duration of the anticipation time is an increasing function of the traveling time of the upstream segment. The above findings have important implications to predicting the full set of latencies among the various locations in the freeway system.

Keywords: data refinement, machine learning, mutual information, short-term latency prediction

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Authors: Chia-Ching Sun, Li-Yin Chien, Chun-Ting Hsiao

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Background: Appropriate gestation weight gain benefits pregnant women and their children; however, excessive weight gain could raise the risk of adverse health outcomes and chronicle diseases. Nevertheless, there is currently limited evidence on the effect of physical activities on pregnant women’s gestational weight gain. Purpose: This study aimed to explore the correlation between the level of physical activity and gestation weight gain during the second and third trimester of pregnancy. Methods: This longitudinal study enrolled 800 healthy pregnant women aged over 20 from six hospitals in northern Taiwan. Structured questionnaires were used to collect data twice for each participant during 14-27 and 28-40 weeks of gestation. Variables included demographic data, maternal health history, and lifestyle. The International Physical Activity Questionnaire-short form was used to measure the level of physical activity from walking and of moderate-intensity and vigorous-intensity before and during pregnancy. Weight recorded at prenatal checkups were used to calculate average weight gain in each trimester of pregnancy. T-tests, ANOVA, chi-squared tests, and multivariable logistic regression models were applied to determine the predicting factors for weight gain during the second and third trimester. Result: Participants who had achieved recommended physical activity level (150 minutes of moderate physical activity or 75 minutes of vigorous physical activity a week) before pregnancy (aOR=1.85, 95% CI=1.27-2.67) or who achieved recommended walking level (150 minutes a week) during the second trimester of pregnancy (aOR=1.43, 95% CI= 1.00-2.04) gained significantly more weight during the second trimester. Compared with those who did not reach recommended level of moderate-intensity physical activity (150 minutes a week), women who had reached that during the second trimester were more likely to be in the less than recommended weight gain group than in the recommended weight gain group (aOR=2.06, CI=1.06-4.00). However, there was no significant correlation between physical activity level and weight gain in the third trimester. Other predicting factors of excessive weight gain included education level which showed a negative correlation (aOR=0.38, CI=0.17-0.88), whereas overweight and obesity before pregnancy showed a positive correlation (OR=3.97, CI=1.23-12.78). Conclusions/implications for practice: Participants who had achieved recommended physical activity level before pregnancy significantly reduced exercise during pregnancy and gained excessive weight during the second trimester. However, women who engaged in the practice of physical activity as recommended could effectively control weight gain in the third trimester. Healthcare professionals could suggest that pregnant women who exercise maintain their pre-pregnancy level of physical activity, given activities requiring physical contact or causing falls are avoided. For those who do not exercise, health professionals should encourage them to gradually increase the level of physical activity. Health promotion strategies related to weight control and physical activity level achievement should be given to women before pregnancy.

Keywords: pregnant woman, physical activity, gestation weight gain, obesity, overweight

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Authors: Gabriela Silva-Maceda, Silvia Romero-Contreras

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Spanish is a more transparent language than English given that it has more direct correspondences between sounds and letters. It has become important to understand how decoding and linguistic comprehension contribute to reading comprehension in the framework of the widely known Simple View Model. This study aimed to identify the level of prediction by these two components in a sample of 1st to 4th grade children attending two schools in central Mexico (one public and one private). Within each school, ten children were randomly selected in each grade level, and their parents were asked about reading habits and socioeconomic information. In total, 79 children completed three standardized tests measuring decoding (pseudo-word reading), linguistic comprehension (understanding of paragraphs) and reading comprehension using subtests from the Clinical Evaluation of Language Fundamentals-Spanish, Fourth Edition, and the Test de Lectura y Escritura en Español (LEE). The data were analyzed using hierarchical regression, with decoding as a first step and linguistic comprehension as a second step. Results showed that decoding accounted for 19.2% of the variance in reading comprehension, while linguistic comprehension accounted for an additional 10%, adding up to 29.2% of variance explained: F (2, 75)= 15.45, p <.001. Socioeconomic status derived from parental questionnaires showed a statistically significant association with the type of school attended, X2 (3, N= 79) = 14.33, p =.002. Nonetheless when analyzing the Simple View components, only decoding differences were statistically significant (t = -6.92, df = 76.81, p < .001, two-tailed); reading comprehension differences were also significant (t = -3.44, df = 76, p = .001, two-tailed). When socioeconomic status was included in the model, it predicted a 5.9% unique variance, even when already accounting for Simple View components, adding to a 35.1% total variance explained. This three-predictor model was also significant: F (3, 72)= 12.99, p <.001. In addition, socioeconomic status was significantly correlated with the amount of non-textbook books parents reported to have at home for both adults (rho = .61, p<.001) and children (rho= .47, p<.001). Results converge with a large body of literature finding socioeconomic differences in reading comprehension; in addition this study suggests that these differences were also present in decoding skills. Although linguistic comprehension differences between schools were expected, it is argued that the test used to collect this variable was not sensitive to linguistic differences, since it came from a test to diagnose clinical language disabilities. Even with this caveat, results show that the components of the Simple View Model can predict less than a third of the variance in reading comprehension in Spanish. However, the results also suggest that a fuller model of reading comprehension is obtained when considering the family’s socioeconomic status, given the potential differences shown by the socioeconomic status association with books at home, factors that are particularly important in countries where inequality gaps are relatively large.

Keywords: decoding, linguistic comprehension, reading comprehension, simple view model, socioeconomic status, Spanish

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Authors: Siti Badriyah Rushayati, Resti Meilani, Rachmad Hermawan

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A biosphere reserve is developed to create harmony amongst economic development, community development, and environmental protection, through partnership between human and nature. Giam Siak Kecil Bukit Batu Biosphere Reserve (GSKBB BR) in Riau Province, Indonesia, is unique in that it has peat soil dominating the area, many springs essential for human livelihood, high biodiversity. Furthermore, it is the only biosphere reserve covering privately managed production forest areas. The annual occurrences of deforestation and forest fire pose a threat toward such unique biosphere reserve. Forest fire produced smokes that along with mass airflow reached neighboring countries, particularly Singapore and Malaysia. In this research, we aimed at analyzing the threat of deforestation and forest fire, and the potential of CO2 emission at GSKBB BR. We used Landsat image, arcView software, and ERDAS IMAGINE 8.5 Software to conduct spatial analysis of land cover and land use changes, calculated CO2 emission based on emission potential from each land cover and land use type, and exercised simple linear regression to demonstrate the relation between CO2 emission potential and deforestation. The result showed that, beside in the buffer zone and transition area, deforestation also occurred in the core area. Spatial analysis of land cover and land use changes from years 2010, 2012, and 2014 revealed that there were changes of land cover and land use from natural forest and industrial plantation forest to other land use types, such as garden, mixed garden, settlement, paddy fields, burnt areas, and dry agricultural land. Deforestation in core area, particularly at the Giam Siak Kecil Wildlife Reserve and Bukit Batu Wildlife Reserve, occurred in the form of changes from natural forest in to garden, mixed garden, shrubs, swamp shrubs, dry agricultural land, open area, and burnt area. In the buffer zone and transition area, changes also happened, what once swamp forest changed into garden, mixed garden, open area, shrubs, swamp shrubs, and dry agricultural land. Spatial analysis on land cover and land use changes indicated that deforestation rate in the biosphere reserve from 2010 to 2014 had reached 16 119 ha/year. Beside deforestation, threat toward the biosphere reserve area also came from forest fire. The occurrence of forest fire in 2014 had burned 101 723 ha of the area, in which 9 355 ha of core area, and 92 368 ha of buffer zone and transition area. Deforestation and forest fire had increased CO2 emission as much as 24 903 855 ton/year.

Keywords: biosphere reserve, CO2 emission, deforestation, forest fire

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Authors: Stephanie Watson, Fabrice Stephenson, Conrad Pilditch, Carolyn Lundquist

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Spatial data detailing both the distribution and density of functionally important marine species are needed to inform management decisions. Species distribution models (SDMs) have proven helpful in this regard; however, models often focus only on species occurrences derived from spatially expansive datasets and lack the resolution and detail required to inform regional management decisions. Boosted regression trees (BRT) were used to produce high-resolution SDMs (250 m) at two spatial scales predicting probability of occurrence, abundance (count per sample unit), density (count per km2) and uncertainty for seven coastal seafloor taxa that vary in habitat usage and distribution to examine prediction differences and implications for coastal management. We investigated if small scale regionally focussed models (82,000 km2) can provide improved predictions compared to data-rich national scale models (4.2 million km2). We explored the variability in predictions across model type (occurrence vs abundance) and model scale to determine if specific taxa models or model types are more robust to geographical variability. National scale occurrence models correlated well with broad-scale environmental predictors, resulting in higher AUC (Area under the receiver operating curve) and deviance explained scores; however, they tended to overpredict in the coastal environment and lacked spatially differentiated detail for some taxa. Regional models had lower overall performance, but for some taxa, spatial predictions were more differentiated at a localised ecological scale. National density models were often spatially refined and highlighted areas of ecological relevance producing more useful outputs than regional-scale models. The utility of a two-scale approach aids the selection of the most optimal combination of models to create a spatially informative density model, as results contrasted for specific taxa between model type and scale. However, it is vital that robust predictions of occurrence and abundance are generated as inputs for the combined density model as areas that do not spatially align between models can be discarded. This study demonstrates the variability in SDM outputs created over different geographical scales and highlights implications and opportunities for managers utilising these tools for regional conservation, particularly in data-limited environments.

Keywords: Benthic ecology, spatial modelling, multi-scalar modelling, marine conservation.

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Authors: Rudainah Alkhazam, Özlem Yaşar Uğurlu

Abstract:

Immigrant entrepreneurship arises from the start of entrepreneurial activity by immigrants in the country they relocate to. The future prosperity and stability of the refugee-hosting countries depends on the mutual social and economic benefits between the residents and the refugees. Syrian refugees and workers in host countries necessitate efforts to assist their residents and refugees in meeting their daily needs, contributing lawfully to local and possibly regional economies through trade, and instilling hope in their future. This study investigates the effects of Syrian refugee entrepreneurs on host communities' business sectors, focusing on Turkey. Specifically, we examine entrepreneurship in general and its role in the country's economy. Because Turkey is the most popular resettlement destination for Syrian refugees, this study will shed light on the challenges of successful migrant entrepreneurship in Turkey and their role in the business sector. The research relies on a mixed-method approach which helps identify recurring themes, favorable results, and conflicting results across methods, allowing us to draw accurate conclusions. The study will adopt a quantitative method in collecting numerical data from Syrian refugees in Turkey. The self-administered survey would be translated into Arabic to ensure that the respondents understood the questions and possible replies. The research will use survey questionnaires to gather the majority of the data. These surveys would have closed-ended questions with nominal ratio and Likert scales. The data will be analyzed using linear regression and the Statistical Package for Social Sciences (SPSS) to ascertain the role of Syrian entrepreneurs in the business sectors of Turkey. The research will use the findings to make future recommendations. Syrian entrepreneurs, among the migrant entrepreneurs, contribute to the labor market, the majority of whom are young people. This research noted the significant participation of Syrian immigrant women in the entrepreneurship sector. The previous experience of Syrians in the field of trade and running their own business plays a vital role in the success of their business in the host countries. The study shows that Syrian entrepreneurs could integrate effectively into the various Turkish business sectors and could rely on themselves, open and manage their projects, and market them in the Turkish market. Syrian entrepreneurs consider that the investment and labor laws, commercial arrangements, and facilities for obtaining financial resources in Turkey need to be more flexible and available to immigrant entrepreneurs.

Keywords: entrepreneurship, immigration, Syrian, Turkey, refugees, investors, socio-economic benefits, unemployment

Procedia PDF Downloads 65