Search results for: robust penalized regression

Authors: Natalia V. Beloglazova, Pieterjan Lenain, Martin Hedstrom, Dietmar Knopp, Sarah De Saeger

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In recent years polycyclic aromatic hydrocarbons (PAHs), which represent a hazard to humans and entire ecosystem, have been receiving an increased interest due to their mutagenic, carcinogenic and endocrine disrupting properties. They are formed in all incomplete combustion processes of organic matter and, as a consequence, ubiquitous in the environment. Benzo(a)pyrene (BaP) is on the priority list published by the Environmental Agency (US EPA) as the first PAH to be identified as a carcinogen and has often been used as a marker for PAHs contamination in general. It can be found in different types of water samples, therefore, the European Commission set up a limit value of 10 ng L–1 (10 ppt) for BAP in water intended for human consumption. Generally, different chromatographic techniques are used for PAHs determination, but these assays require pre-concentration of analyte, create large amounts of solvent waste, and are relatively time consuming and difficult to perform on-site. An alternative robust, stand-alone, and preferably cheap solution is needed. For example, a sensing unit which can be submerged in a river to monitor and continuously sample BaP. An affinity sensor based on capacitive transduction was developed. Natural antibodies or their synthetic analogues can be used as ligands. Ideally the sensor should operate independently over a longer period of time, e.g. several weeks or months, therefore the use of molecularly imprinted polymers (MIPs) was discussed. MIPs are synthetic antibodies which are selective for a chosen target molecule. Their robustness allows application in environments for which biological recognition elements are unsuitable or denature. They can be reused multiple times, which is essential to meet the stand-alone requirement. BaP is a highly lipophilic compound and does not contain any functional groups in its structure, thus excluding non-covalent imprinting methods based on ionic interactions. Instead, the MIPs syntheses were based on non-covalent hydrophobic and π-π interactions. Different polymerization strategies were compared and the best results were demonstrated by the MIPs produced using electropolymerization. 4-vinylpyridin (VP) and divinylbenzene (DVB) were used as monomer and cross-linker in the polymerization reaction. The selectivity and recovery of the MIP were compared to a non-imprinted polymer (NIP). Electrodes were functionalized with natural receptor (monoclonal anti-BaP antibody) and with MIPs selective towards BaP. Different sets of electrodes were evaluated and their properties such as sensitivity, selectivity and linear range were determined and compared. It was found that both receptor can reach the cut-off level comparable to the established ML, and despite the fact that the antibody showed the better cross-reactivity and affinity, MIPs were more convenient receptor due to their ability to regenerate and stability in river till 7 days.

Keywords: antibody, benzo(a)pyrene, capacitive sensor, MIPs, river water

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Authors: Luna Degife, Desalegn Belay, Yoseph Worku, Tigist Tesfaye, Assefa Tufa, Abyot Bekele, Zegeye Hailemariam, Abay Hagos

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Half of the world’s population is at risk of Dengue Fever (DF), a highly under-recognized and underreported mosquito-borne viral disease with high prevalence in the tropical and subtropical regions. Globally, an estimated 50 to 200 million cases and 20, 000 DF deaths occur annually as per the world health organization report. In Ethiopia, the first outbreak occurred in 2013 in Diredawa administration city. Afterward, three outbreaks have been reported from the eastern part of the country. We received a report of the fifth DF outbreak for Ethiopia and the second for Diredawa city on October 4, 2015. We conducted the investigation to confirm the outbreak, identify the risk factors for the repeatedly occurrence of the disease and implement control measures. We conducted un- matched case-control study and defined a suspected DF case as any person with fever of 2-7 days and 2 or more of the following: a headache, arthralgia, myalgia, rash, or bleeding from any part of the body. Controls were residents of Diredawa city without DF symptoms. We interviewed 70 Cases and 140 controls from all health facilities in Diredawa city from October 7 to 15; 2015. Epi Info version 7.1.5.0 was used to analyze the data and multivariable logistic regression was conducted to assess risk factors for DF. Sixty-nine blood samples were collected for Laboratory confirmation.The mean age for cases was 23.7±9.5 standard deviation (SD) and for controls 31.2±13 SD. Close contact with DF patient (Adjusted odds ratio (AOR)=5.36, 95% confidence interval(CI): 2.75-10.44), nonuse of long-lasting insecticidal nets (AOR=2.74, 95% CI: 1.06-7.08) and availability of stagnant water in the village (AOR=3.61, 95% CI:1.31-9.93) were independent risk factors associated with higher rates of the disease. Forty-two samples were tested positive. Endemicity of DF is becoming a concern for Diredawa city after the first outbreak. Therefore, effective vector control activities need to be part of long-term preventive measures.

Keywords: dengue fever, Diredawa, outbreak, risk factors, second

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Authors: Phatu William Mashela, Pontsho Edmund Tseke, Kgabo Martha Pofu

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‘Inconsistent results’ in nematode suppression post-application of botanical-based products created credibility concerns. Relative to untreated control, sampling for nematodes post-application of botanical-based products suggested significant increases in nematode population densities. ‘Inconsistent results’ were confirmed in Tylenchulus semipenetrans on Citrus jambhiri seedlings when sampling was carried out at 120 days post-application of a granular Nemarioc-AG phytonematicide. The objective of this study was to determine post-application effects of untreated control, Nemarioc-AG phytonematicide and aldicarb to T. semipenetrans population densities on C. jambhiri seedlings. Two hundred and ten seedlings were each inoculated with 10000 T. semipenetrans eggs and second-stage juveniles (J2) in plastic pots containing 2700 ml growing mixture. A week after inoculation, seedlings were equally split and subjected to once-off treatment of 2 g aldicarb, 2 g Nemarioc-AG phytonematicide and untreated control. Five seedlings from each group were randomly placed on greenhouse benches to serve as a sampling block, with a total of 14 blocks. The entire block was sampled weekly and assessed for final nematode population density (Pf). After the final assessment, post-regression of untreated Pf to increasing sampling intervals exhibited positive quadratic relations, with the model explaining 90% associations, with optimum Pf of 13804 eggs and J2 at six weeks post-application. In contrast, treated Pf and increasing sampling interval exhibited negative quadratic relations, with the model explaining 95% and 92% associations in phytonematicide and aldicarb, respectively. In the phytonematicide, Pf was 974 eggs and J2, whereas that in aldicarb was 2205 eggs and J2 at six weeks. In conclusion, temporal cyclic nematode population growth provided an empirically-based explanation of ‘inconsistent results’ in nematode suppression post-application of the two nematode management strategies.

Keywords: nematode management, residual effect, slow decline of citrus, the citrus nematode

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Authors: Akram Sadat Jafari Roodbandi, Farzaneh Akbari, Vafa Feyzi, Zahra Zare, Zohreh Foroozanfar

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Introduction: Circadian rhythm or sleep-awake cycle in 24 hours is one of the important factors affecting the physiological and psychological characteristics in humans that contribute to biochemical, physiological and behavioral processes and helps people to set up brain and body for sleep or active awakening during certain hours. The purpose of this study was to investigate the relationship between the characteristics of circadian rhythms on the sleep quality and sleepiness according to their demographic characteristics such as age. Methods: This cross-sectional descriptive-analytic study was carried out among the general population of Kerman, aged 15-84 years. After dividing the age groups into 10-year demographic characteristics questionnaire, the type of circadian questionnaire, Pittsburgh sleep quality questionnaire and Euporth sleepiness questionnaire were completed in equal numbers between men and women of that age group. Using cluster sampling with effect design equal 2, 1300 questionnaires were distributed during the various hours of 24 hours in public places in Kerman city. Data analysis was done using SPSS software and univariate tests and linear regressions at a significance level of 0.05. Results: In this study, 1147 subjects were included in the study, 584 (50.9%) were male and the rest were women. The mean age was 39.50 ± 15.38. 133 (11.60%) subjects from the study participants had sleepiness and 308 (26.90%) subjects had undesirable sleep quality. Using linear regression test, sleep quality was the significant correlation with sex, hours needed for sleep at 24 hours, chronic illness, sleepiness, and circadian rhythm amplitude. Sleepiness was the meaningful relationship with marital status, sleep-wake schedule of other family members and the stability of circadian rhythm. Both women and men, with age, decrease the quality of sleep and increase the rate of sleepiness. Conclusion: Age, sex, and type of circadian people, the need for sleep at 24 hours, marital status, sleep-wake schedule of other family members are significant factors related to the sleep quality and sleepiness and their adaptation to night shift work.

Keywords: circadian type, sleep quality, sleepiness, age, shift work

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Authors: Salwa S. Dawaki, Init Ithoi, Sa’adatu I. Yelwa

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Introduction: Parasitic infections are major public health problems worldwide, particularly in developing countries. Two third of the world population is infected while about 3 billion are at risk of parasitic infections. It is demonstrated that most parasitic infections occur as multiple infections especially among poor and rural communities of most countries in the tropical regions. Parasitic infections are endemic in Nigeria, yet multiple infections are rarely reported. The study aimed to estimate the prevalence and identify factors associating with multiple parasitic infections among rural population in Kano State Nigeria. Methodology: A cross-sectional survey was conducted from June to August 2013 in rural Kano State, Nigeria. Three samples stool, urine, and blood were collected from each of the 551 volunteers aged between one and ninety years old recruited for the survey. A pre-tested questionnaire was used to obtain epidemiological data. Data were analysed using appropriate descriptive, univariate and multivariate logistic regression methods. Major findings: The participants were 61.7% male, 38.3% female, and 69.0% were adults of 15 years and above. Overall, 463 (84%) were infected with parasitic infections among which 60.9% had multiple infections. A total of 15 parasitic species were recovered, and up to 8 different parasitic species were found concurrently in a single host. Plasmodium was the most common parasite followed by Blastocystis, Entamoeba species, and hookworms. It was found that presence of an infected family member (P = 0.017; OR = 1.52; 95% CI = 1.08, 2.13) and not wearing shoes outside home (P = 0.043; OR = 1.50; 95% CI = 1.01, 2.18) significantly associated with higher risk of having multiple parasitic infections among the studied population. Conclusion: Parasitic infections pose a public health challenge in the rural community of Kano. Multiple parasitic infections are highly prevalent and presence of an infected family member as well as not wearing proper foot wear outside home increases the risk of infection. Poor hygiene, unfavourable socioeconomic conditions, and culture promote survival and transmission of parasites. There is a need for implementation of integrated approach aimed at controlling or eliminating the infections with emphasis on public awareness.

Keywords: multiple infections, parasitic infections, poor hygiene, risk of infection

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Authors: Mohammad Moezzibadi, Isabelle Charpentier, Adrien Wanko, Robert Mosé

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The calibration of hydrodynamic parameters for subsurface constructed wetlands (CWs) is a sensitive process since highly non-linear equations are involved in unsaturated flow modeling. CW systems are engineered systems designed to favour natural treatment processes involving wetland vegetation, soil, and their microbial flora. Their significant efficiency at reducing the ecological impact of urban runoff has been recently proved in the field. Numerical flow modeling in a vertical variably saturated CW is here carried out by implementing the Richards model by means of a mixed hybrid finite element method (MHFEM), particularly well adapted to the simulation of heterogeneous media, and the van Genuchten-Mualem parametrization. For validation purposes, MHFEM results were compared to those of HYDRUS (a software based on a finite element discretization). As van Genuchten-Mualem soil hydrodynamic parameters depend on water content, their estimation is subject to considerable experimental and numerical studies. In particular, the sensitivity analysis performed with respect to the van Genuchten-Mualem parameters reveals a predominant influence of the shape parameters α, n and the saturated conductivity of the filter on the piezometric heads, during saturation and desaturation. Modeling issues arise when the soil reaches oven-dry conditions. A particular attention should also be brought to boundary condition modeling (surface ponding or evaporation) to be able to tackle different sequences of rainfall-runoff events. For proper parameter identification, large field datasets would be needed. As these are usually not available, notably due to the randomness of the storm events, we thus propose a simple, robust and low-cost numerical method for the inverse modeling of the soil hydrodynamic properties. Among the methods, the variational data assimilation technique introduced by Le Dimet and Talagrand is applied. To that end, a variational data assimilation technique is implemented by applying automatic differentiation (AD) to augment computer codes with derivative computations. Note that very little effort is needed to obtain the differentiated code using the on-line Tapenade AD engine. Field data are collected for a three-layered CW located in Strasbourg (Alsace, France) at the water edge of the urban water stream Ostwaldergraben, during several months. Identification experiments are conducted by comparing measured and computed piezometric head by means of the least square objective function. The temporal variability of hydrodynamic parameter is then assessed and analyzed.

Keywords: automatic differentiation, constructed wetland, inverse method, mixed hybrid FEM, sensitivity analysis

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Authors: Baha Eddine Aissou, Aichouche Belhadj Aissa

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Light detection and ranging (LiDAR) is an active remote sensing technology used for several applications. Airborne LiDAR is becoming an important technology for the acquisition of a highly accurate dense point cloud. A classification of airborne laser scanning (ALS) point cloud is a very important task that still remains a real challenge for many scientists. Support vector machine (SVM) is one of the most used statistical learning algorithms based on kernels. SVM is a non-parametric method, and it is recommended to be used in cases where the data distribution cannot be well modeled by a standard parametric probability density function. Using a kernel, it performs a robust non-linear classification of samples. Often, the data are rarely linearly separable. SVMs are able to map the data into a higher-dimensional space to become linearly separable, which allows performing all the computations in the original space. This is one of the main reasons that SVMs are well suited for high-dimensional classification problems. Only a few training samples, called support vectors, are required. SVM has also shown its potential to cope with uncertainty in data caused by noise and fluctuation, and it is computationally efficient as compared to several other methods. Such properties are particularly suited for remote sensing classification problems and explain their recent adoption. In this poster, the SVM classification of ALS LiDAR data is proposed. Firstly, connected component analysis is applied for clustering the point cloud. Secondly, the resulting clusters are incorporated in the SVM classifier. Radial basic function (RFB) kernel is used due to the few numbers of parameters (C and γ) that needs to be chosen, which decreases the computation time. In order to optimize the classification rates, the parameters selection is explored. It consists to find the parameters (C and γ) leading to the best overall accuracy using grid search and 5-fold cross-validation. The exploited LiDAR point cloud is provided by the German Society for Photogrammetry, Remote Sensing, and Geoinformation. The ALS data used is characterized by a low density (4-6 points/m²) and is covering an urban area located in residential parts of the city Vaihingen in southern Germany. The class ground and three other classes belonging to roof superstructures are considered, i.e., a total of 4 classes. The training and test sets are selected randomly several times. The obtained results demonstrated that a parameters selection can orient the selection in a restricted interval of (C and γ) that can be further explored but does not systematically lead to the optimal rates. The SVM classifier with hyper-parameters is compared with the most used classifiers in literature for LiDAR data, random forest, AdaBoost, and decision tree. The comparison showed the superiority of the SVM classifier using parameters selection for LiDAR data compared to other classifiers.

Keywords: classification, airborne LiDAR, parameters selection, support vector machine

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Authors: Di Luo, Maria Buchberger, Anja Pickhard

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Objectives: The purpose of this study was to assess and compare the diagnostic accuracy of four common morphological approaches, including sonography, computed tomography (CT), positron emission tomography/computed tomography (PET/CT), and magnetic resonance imaging (MRI) for the evaluation of cervical lymph node metastases in head and neck squamous cell carcinoma (HNSCC) patients. Material and Methods: Included in this retrospective study were 26 patients diagnosed with HNSCC between 2010 and 2011 who all underwent sonography, CT, PET/CT, and MRI imaging before neck dissection. Morphological data were compared to the corresponding histopathological results. Statistical analysis was performed with SPSS statistic software (version 26.0), calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of cervical lymph node metastases. Results: The 5-year survival rate of the patient collective was 55.5%.Risk factors for survival included initial primary tumor stage, initial lymph node stage, initial metastasis status, and therapeutic approaches. Cox regression showed initial metastasis status(HR 8.671, 95%CI 1.316-57.123, p=0.025) and therapeutic approaches(HR 6.699, 95%CI 1.746-25.700, p=0.006)to be independent predictive risk factors for survival. Sensitivity was highest for MRI (96% compared to 85% for sonography and 89% for CT and PET/CT). Specificity was comparable with 95 % for CT and 98 % for sonography and PET/CT, but only 68% for MRI. While the MRI showed the least PPV (34%) compared to all other methods (85% for sonography,75% for CT, and 86% for PET/CT), the NPV was comparable in all methods(98-99%). The overall accuracy of cervical lymph node metastases detection was comparable for sonography, CT, and PET/CT with 96%,97%,94%, respectively, while MRI had only 72% accuracy. Conclusion: Since the initial status of metastasis is an independent predictive risk factor for patients’ survival, efficient detection is crucial to plan adequate therapeutic approaches. Sonography, CT, and PET/CT have better diagnostic accuracy than MRI for the evaluation of cervical lymph node metastases in HNSCC patients.

Keywords: cervical lymph node metastases, diagnostic accuracy, head and neck squamous carcinoma, risk factors, survival

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Authors: Anargha A. Dhorde, Deshpande Gauri, Amit G. Dhorde

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Mula-Mutha basin is one of the speedily urbanizing watersheds, wherein two major urban centers, Pune and Pimpri-Chinchwad, have developed at a shocking rate in the last two decades. Such changing land use/land cover (LULC) is prone to hydrological problems and flash floods are a frequent, eventuality in the lower reaches of the basin. The present research brings out the impact of varying LULC, impervious surfaces on urban surface hydrology and generates storm-runoff scenarios for the hydrological units. The two multi-temporal satellite images were processed and supervised classification is performed with > 75% accuracy. The built-up has increased from 14.4% to 34.37% in the 28 years span, which is concentrated in and around the Pune-PCMC region. Impervious surfaces that were obtained by population calibrated multiple regression models. Almost 50% area of the watershed is impervious, which attribute to increase surface runoff and flash floods. The SCS-CN method was employed to calculate surface runoff of the watershed. The comparison between calculated and measured values of runoff was performed in a statistically precise way which shows no significant difference. Increasing built-up areas, as well as impervious surface areas due to rapid urbanization and industrialization, may lead to generating high runoff volumes in the basin especially in the urbanized areas of the watershed and along the major transportation arteries. Simulations generated with 50 mm and 100 mm rainstorm depth conspicuously noted that most of the changes in terms of increased runoff are constricted to the highly urbanized areas. Considering whole watershed area, the runoff values 39 m³ generated with 1'' rainfall whereas only urbanized areas of the basin (Pune and Pimpari-Chinchwad) were generated 11154 m³ runoff. Such analysis is crucial in providing information regarding their intensity and location, which proves instrumental in their analysis in order to formulate proper mitigation measures and rehabilitation strategies.

Keywords: land use/land cover, LULC, impervious surfaces, surface hydrology, storm-runoff scenarios

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Emmanuel Dele Balogun

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This paper analyzes, using descriptive statistics and econometrics data which span the period 1981 to 2014 to gauge the effects of trade policy incentives on economic growth in Nigeria. It argues that the provided incentives penalize economic growth during pre-trade liberalization eras, but stimulated a rapid increase in total factor productivity during the post-liberalization period of 2000 to 2014. The trend analysis shows that Nigeria maintained high tariff walls in economic regulation eras which became low in post liberalization era. The protections were in favor of infant industries, which were mainly appendages of multinationals but against imports of competing food and finished consumer products. The trade openness index confirms the undue exposure of Nigeria’s economy to the vagaries of international market shocks; while banking sector recapitalization and new listing of telecommunications companies deepened the financial markets in post-liberalization era. The structure of economic incentives was biased in favor of construction, trade and services, but against the real sector despite protectionist policies. Total Factor Productivity (TFP) estimates show that the Nigerian economy suffered stagnation in pre-liberalization eras, but experienced rapid growth rates in post-liberalization eras. The regression results relating trade policy incentives to TFP growth rate yielded a significant but negative intercept suggesting that a non-interventionist policy could be detrimental to economic progress, while protective tariff which limits imports of competing products could spur productivity gains in domestic import substitutes beyond factor growth with market liberalization. The main constraint to the effectiveness of trade policy incentives is the failure of benefiting industries to leverage on the domestic factor endowments of the nation. This paper concludes that there is the need to review the current economic transformation strategies urgently with a view to provide policymakers with a better understanding of the most viable options that could make for rapid success.

Keywords: economic growth, macroeconomic incentives, total factor productivity, trade policies

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Authors: Hitoshi Minakuchi, Izumi Takei, Shu Wakino, Koichi Hayashi, Hiroshi Itoh

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Objectives: Among type 2 diabetics, patients with CKD(chronic kidney disease), insulin resistance, impaired glyconeogenesis in kidney and reduced degradation of insulin are recognized, and we observed different fluctuational patterns of blood sugar between CKD patients and non-CKD patients. On the other hand, non-dipper type blood pressure change is the risk of organ damage and mortality. We performed cross-sectional study to elucidate the characteristic of the fluctuation of blood glucose and blood pressure at insulin-treated diabetic patients with chronic kidney disease. Methods: From March 2011 to April 2013, at the Ichikawa General Hospital of Tokyo Dental College, we recruited 20 outpatients. All participants are insulin-treated type 2 diabetes with CKD. We collected serum samples, urine samples for several hormone measurements, and performed CGMS(Continuous glucose measurement system), ABPM (ambulatory blood pressure monitoring), brain computed tomography, carotid artery thickness, ankle brachial index, PWV, CVR-R, and analyzed these data statistically. Results: Among all 20 participants, hypoglycemia was decided blood glucose 70mg/dl by CGMS of 9 participants (45.0%). The event of hypoglycemia was recognized lower eGFR (29.8±6.2ml/min：41.3±8.5ml/min, P<0.05), lower HbA1c (6.44±0.57%：7.53±0.49%), higher PWV (1858±97.3cm/s：1665±109.2cm/s), higher serum glucagon (194.2±34.8pg/ml：117.0±37.1pg/ml), higher free cortisol of urine (53.8±12.8μg/day：34.8±7.1μg/day), and higher metanephrin of urine (0.162±0.031mg/day：0.076±0.029mg/day). Non-dipper type blood pressure change in ABPM was detected 8 among 9 participants with hypoglycemia (88.9%), 4 among 11 participants (36.4%) without hypoglycemia. Multiplex logistic-regression analysis revealed that the event of hypoglycemia is the independent factor of non-dipper type blood pressure change. Conclusions: Among insulin-treated type 2 diabetic patients with CKD, the events of hypoglycemia were frequently detected, and can associate with the organ derangements through the medium of non-dipper type blood pressure change.

Keywords: chronic kidney disease, hypoglycemia, non-dipper type blood pressure change, diabetic patients

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Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

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Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

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Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

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Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

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Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

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Authors: Daniel Gebreslassie Mekonnen

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Effective leadership has a crucial role in excelling in the overall success of a school. Today there is much attention given to school leadership, without which schools can never be successful. Therefore, the study was aimed at investigating the role of principals’ leadership styles and their emotional intelligence on the work motivation and job performance of teachers in Addis Ababa, Ethiopia. The study, thus, first examined the relationship between work motivation and job performance of the teachers in relation to the perceived leadership styles and emotional intelligence of principals. Second, it assessed the mean differences and the interaction effects of the principals’ leadership styles and emotional intelligence on the work motivation and job performance of the teachers. Finally, the study investigated whether principals’ leadership styles and emotional intelligence variables had significantly predicted the work motivation and job performance of teachers. As a means, a quantitative approach and descriptive research design were employed to conduct the study. Three hundred sixteen teachers were selected using multistage sampling techniques as participants of the study from the eight sub-cities in Addis Ababa. The main data-gathering instruments used in this study were the path-goal leadership questionnaire, emotional competence inventory, multidimensional work motivation scale, and job performance appraisal scale. The quantitative data were analyzed by using the statistical techniques of Pearson–product-moment correlation analysis, two-way analysis of variance, and stepwise multiple regression analysis. Major findings of the study have revealed that the work motivation and job performance of the teachers were significantly correlated with the perceived participative leadership style, achievement-oriented leadership style, and emotional intelligence of principals. Moreover, the emotional intelligence of the principals was found to be the best predictor of the teachers’ work motivation, whereas the achievement-oriented leadership style of the principals was identified as the best predictor of the job performance of the teachers. Furthermore, the interaction effects of all four path-goal leadership styles vis-a-vis the emotional intelligence of the principals have shown differential effects on the work motivation and job performance of teachers. Thus, it is reasonable to conclude that emotional intelligence is the sine qua non of effective school leadership. Hence, this study would be useful for policymakers and educational leaders to come up with policies that would enhance the role of emotional intelligence on school leadership effectiveness. Finally, pertinent recommendations were drawn from the findings and the conclusions of the study.

Keywords: emotional intelligence, leadership style, job performance, work motivation

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Authors: Soodabeh Shahid Sales, Azam Rastgar Moghadam, Mehrane Mehramiz, Malihe Entezari, Kazem Anvari, Mohammad Sadegh Khorrami, Saeideh Ahmadi Simab, Ali Moradi, Seyed Mahdi Hassanian, Majid Ghayour-Mobarhan, Gordon A. Ferns, Amir Avan

Abstract:

Background Esophageal cancer has been reported as the eighth most common cancer universal and the seventh cause of cancer-related death in men .recent studies have revealed that cytochrome P450, family 1, subfamily B, polypeptide 1, which plays a role in metabolizing xenobiotics, is associated with different cancers. Therefore in the present study, we investigated the impact of CYP1B1-rs1056836 on esophagus squamous cell carcinoma (ESCC) patients. Method: 317 subjects, with and without ESCC were recruited. DNA was extracted and genotyped via Real-time PCR-Based Taq Man. Kaplan Meier curves were utilized to assess overall and progression-free survival. To evaluate the relationship between patients clinicopathological data, genotypic frequencies, disease prognosis, and patients survival, Pearson chi-square and t-test were used. Logistic regression was utilized to assess the association between the risk of ESCC and genotypes. Results: the genotypic frequency for GG, GC, and CC are respectively 58.6% , 29.8%, 11.5% in the healthy group and 51.8%, 36.14% and 12% in ESCC group. With respect to the recessive genetic inheritance model, an association between the GG genotype and stage of ESCC were found. Also, statistically significant results were not found for this variation and risk of ESCC. Patients with GG genotype had a decreased risk of nodal metastasis in comparison with patients with CC/CG genotype, although this link was not statistically significant. Conclusion: Our findings illustrated the correlation of CYP1B1-rs1056836 as a potential biomarker for ESCC patients, supporting further studies in larger populations in different ethnic groups. Moreover, further investigations are warranted to evaluate the association of emerging marker with dietary intake and lifestyle.

Keywords: Cytochrome P450, esophagus squamous cell carcinoma, dietary intake, lifestyle

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Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

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Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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Authors: Bilgen Özlük, Ülkü Baykal

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The study was conducted with the aim of determining the evaluations of nurses directed at the restructuring process carried out in the nursing services of a private hospital, and reveal how they have been affected by this process, in an integrated manner between a prospective approach and methods of quantitative and qualitative research, and as a comparative study, comparing the changes over a period of three years. The sample for the study is comprised of all of the nurses employed at a private hospital, and data has been collected from 17 nurses (a total of 30 interviews) for the qualitative part 377 nurses in 2013 and 429 nurses in 2014 for the quantitative part. As vehicles of data collection, the study used a form directed at identifying the changes in the organisational and management structure of the hospital, a nurses' interview form, a questionnaire identifying the personal and occupational characteristics of the nurses, the "Minnesota Job Satisfaction Scale", the "Organisational Citizenship Behaviour Scale" and the "Organisational Trust Scale". Qualitative data by researchers, quantitative data was analysed using number and percentage tests, a t-test, and ANOVA, progressive analysis Tukey and regression tests. While in the qualitative part of the study the nurses stated in the first year of the restructuring that they were satisfied with their relationship with top level management, the increases in salaries and changes in the working environment such as the increase in the number of staff, in later years, they stated that there had been a fall in their satisfaction levels due to reasons such as nursing services instead of nurse practitioners in a position they are not satisfied that the director, nursing services outside the nursing profession appointment of persons to positions of management and the lack of appropriate training and competence of these persons, increases in the burden of work, insufficient salaries and the lack of a difference in the salaries of senior and more junior staff. On the other hand, in the quantitative part, it was found that there was no difference in the levels of job satisfaction and organisational trust in any of the two years, that as the level of organisational trust increased the level of job satisfaction also increased, and that as the levels of job satisfaction and organisational trust a positive impact on organisational citizenship behaviour also increased.

Keywords: services, nursing management, re-structuring, job satisfaction, organisational citizenship behaviour, organisational trust

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Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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Authors: Regina A. Tayong, Reza Barati

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A stable, fast and robust three-phase, 2D IMPES simulator has been developed for assessing the influence of; breaker concentration on yield stress of filter cake and broken gel viscosity, varying polymer concentration/yield stress along the fracture face, fracture conductivity, fracture length, capillary pressure changes and formation damage on fracturing fluid cleanup in tight gas reservoirs. This model has been validated as against field data reported in the literature for the same reservoir. A 2-D, two-phase (gas/water) fracture propagation model is used to model our invasion zone and create the initial conditions for our clean-up model by distributing 200 bbls of water around the fracture. A 2-D, three-phase IMPES simulator, incorporating a yield-power-law-rheology has been developed in MATLAB to characterize fluid flow through a hydraulically fractured grid. The variation in polymer concentration along the fracture is computed from a material balance equation relating the initial polymer concentration to total volume of injected fluid and fracture volume. All governing equations and the methods employed have been adequately reported to permit easy replication of results. The effect of increasing capillary pressure in the formation simulated in this study resulted in a 10.4% decrease in cumulative production after 100 days of fluid recovery. Increasing the breaker concentration from 5-15 gal/Mgal on the yield stress and fluid viscosity of a 200 lb/Mgal guar fluid resulted in a 10.83% increase in cumulative gas production. For tight gas formations (k=0.05 md), fluid recovery increases with increasing shut-in time, increasing fracture conductivity and fracture length, irrespective of the yield stress of the fracturing fluid. Mechanical induced formation damage combined with hydraulic damage tends to be the most significant. Several correlations have been developed relating pressure distribution and polymer concentration to distance along the fracture face and average polymer concentration variation with injection time. The gradient in yield stress distribution along the fracture face becomes steeper with increasing polymer concentration. The rate at which the yield stress (τ_o) is increasing is found to be proportional to the square of the volume of fluid lost to the formation. Finally, an improvement on previous results was achieved through simulating yield stress variation along the fracture face rather than assuming constant values because fluid loss to the formation and the polymer concentration distribution along the fracture face decreases as we move away from the injection well. The novelty of this three-phase flow model lies in its ability to (i) Simulate yield stress variation with fluid loss volume along the fracture face for different initial guar concentrations. (ii) Simulate increasing breaker activity on yield stress and broken gel viscosity and the effect of (i) and (ii) on cumulative gas production within reasonable computational time.

Keywords: formation damage, hydraulic fracturing, polymer cleanup, multiphase flow numerical simulation

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Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

Procedia PDF Downloads 153

Authors: Muhammad Naveed Tahir, Wang Yingkuan, Huang Wenjiang, Raheel Osman

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Numerous models used in prediction and decision-making process but most of them are linear in natural environment, and linear models reach their limitations with non-linearity in data. Therefore accurate estimation is difficult. Artificial Neural Networks (ANN) found extensive acceptance to address the modeling of the complex real world for the non-linear environment. ANN’s have more general and flexible functional forms than traditional statistical methods can effectively deal with. The link between information technology and agriculture will become more firm in the near future. Monitoring crop biophysical properties non-destructively can provide a rapid and accurate understanding of its response to various environmental influences. Crop chlorophyll content is an important indicator of crop health and therefore the estimation of crop yield. In recent years, remote sensing has been accepted as a robust tool for site-specific management by detecting crop parameters at both local and large scales. The present research combined the ANN model with satellite-derived chlorophyll indices from LANDSAT 8 imagery for predicting real-time wheat chlorophyll estimation. The cloud-free scenes of LANDSAT 8 were acquired (Feb-March 2016-17) at the same time when ground-truthing campaign was performed for chlorophyll estimation by using SPAD-502. Different vegetation indices were derived from LANDSAT 8 imagery using ERADAS Imagine (v.2014) software for chlorophyll determination. The vegetation indices were including Normalized Difference Vegetation Index (NDVI), Green Normalized Difference Vegetation Index (GNDVI), Chlorophyll Absorbed Ratio Index (CARI), Modified Chlorophyll Absorbed Ratio Index (MCARI) and Transformed Chlorophyll Absorbed Ratio index (TCARI). For ANN modeling, MATLAB and SPSS (ANN) tools were used. Multilayer Perceptron (MLP) in MATLAB provided very satisfactory results. For training purpose of MLP 61.7% of the data, for validation purpose 28.3% of data and rest 10% of data were used to evaluate and validate the ANN model results. For error evaluation, sum of squares error and relative error were used. ANN model summery showed that sum of squares error of 10.786, the average overall relative error was .099. The MCARI and NDVI were revealed to be more sensitive indices for assessing wheat chlorophyll content with the highest coefficient of determination R²=0.93 and 0.90 respectively. The results suggested that use of high spatial resolution satellite imagery for the retrieval of crop chlorophyll content by using ANN model provides accurate, reliable assessment of crop health status at a larger scale which can help in managing crop nutrition requirement in real time.

Keywords: ANN, chlorophyll content, chlorophyll indices, satellite images, wheat

Procedia PDF Downloads 139

Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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Authors: Stephen Anim, Emmanuel O. Sarpong, Daniel Apaak

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This study investigates the relationship between morphological predictors and running ability, emphasizing gender-specific variations among male and female athletes in Cape Coast Metropolis (CCM), Ghana. The dynamic interplay between an athlete's physique and their performance capabilities holds particular relevance in the realm of sports science, influencing training methodologies and talent identification processes. The research aims to contribute comprehensive insights into the morphological determinants of running proficiency, with a specific focus on the local athletic community in Cape Coast Metropolis. Utilizing a correlational research design, a thorough analysis of morphological features, encompassing 22 morphological features including body weight, 6 measurements related to body length, 7 body girth, and knee diameter, and 7 skinfold measurements against 50m dash, among male and female athletes, was conducted. The study involved 420 athletes both male (N=210) and female (N=210) aged 16-22 from 10 Senior High Schools (SHS) in the Cape Coast Metropolis, providing a representative sample of the local athletic community. The collected data were statistically analysed using means and standard deviation, and stepwise multiple regression to determine how morphological variables contribute to and predict running proficiency outcomes. The investigation revealed that athletes from Senior High Schools (SHS) in Cape Coast Metropolis (CCM) exhibit well-developed physiques and sufficient fitness levels suitable for overall athletic performance, taking into account gender differences. Moreover, the findings suggested that approximately 77% of running ability could be attributed to morphological factors, leading to diverse predictive models for male and female athletes within SHS in CCM, Ghana. Consequently, these formulated equations hold promise for predicting running ability among young athletes, particularly in the context of SHS environments.

Keywords: body fat, body girth, body length, morphological features, running ability, senior high school

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Authors: Phill-Seung Jung, Dae-Yeon Kim

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Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.

Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus

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Authors: Thapa M., J.P. Dutta, K.R. Pandey, R.R. Kattel

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Nepal is extremely vulnerable to the impact of climate change. To mitigate the climate change effects on agricultural production and productivity a range of adaptive strategies needs to be considered. The study was conducted to assess organic paddy production as a coping strategy to the adverse impact of climate change in Phulbari, VDC of Chitwan district. Altogether, 120 respondents (60 adopters of organic farming and 60 from non adopter) were selected using snowball technique of sampling. Pre- tested interview schedule, direct observation, focus group discussion, key informant interview as well as secondary data were used to collect the required information. Factors determining the adoption of organic farming were found to be age, year of schooling, training, frequency of extension contact, perception about climate change, economically active members and poor. A unit increase in these factors except poor would increase the probability of adoption by 4.1%, 7.5%, 7.8%, 43.1%, 41.8% and 7% respectively. However, for poor, it would decrease the probability of adoption of organic farming by 5.1%. Average organic matter content in the adopters' field was higher (2.7%) than the non-adopters' field (2.5%). The regression result showed that type of farmer, price and area under rice cultivation had positive and significant relationship with income; however dependency ratio had negative relationship. As the year of adoption of organic farming increases, the production of rice decline in the first two years then after goes on increasing but the cost of production goes on decreasing with the year of adoption. The respondents adapted to the changing climate through diversification of crops, use of resistance varieties and following good cropping pattern. Gradually growing consumers' awareness about health, preference towards quality food products are the strong points behind organic farming, whereas lacks of bio-fertilizers, lack of effective extension services, no price differentiation between organic and inorganic products were the weak points. There is need for more training and education to change the attitude of farmers and enhance their confidence about the role of organic farming to cope with climate change impact.

Keywords: Organic farming, climate change, sustainable development

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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Authors: Gagan Brar, Munruchi Kaur

Abstract:

Macrocybe gigantea was collected from the wild, growing as pure white, fleshy, robust fruit bodies in caespitose clusters. Initially, the few ladies collecting these fruiting bodies for cooking revealed their edibility status, which was later confirmed through classical and molecular taxonomy. The culture of this potential wild edible taxa was raised with an aim of domesticating it. Various solid and liquid media were evaluated for their vegetative growth, in which Malt Extract Agar was found to be the best solid medium and Glucose Peptone medium as the best liquid medium. The effect of different temperatures as well as pH was also evaluated for the vegetative growth of M. gigantea, and it was found that it shows maximum vegetative growth at 30° and pH 5. For spawn preparation, various grains viz. Wheat grains, Jowar grains, Bajra grains and Maize grains were evaluated, and it was found that wheat grains boiled for 30 minutes gave the maximum mycelial growth. Mother spawn was thus prepared on wheat grains boiled for 30 minutes. For raising the fruiting bodies, different locally available agro-wastes were tried, and it was found that paddy straw gives the best growth. Both wilds as well as cultivated M. gigantea were compared through HPLC to evaluate the different nutritional and nutraceutical values. For the evaluation of different sugars in wild and cultivated M. gigantea, 15 sugars were taken for analysis. Among these Melezitose, Trehalose, Glucose, Xylose and Mannitol were found in the wild collection of M. gigantea; in the cultivated sample, Melezitose, Trehalose, Xylose and Dulcitol were detected. Among the 20 different amino acids, 18 amino acids were found, except Asparagine and Glutamine in both wild as well as cultivated samples. Among the 37 tested fatty acids, only 6 fatty acids, namely Palmitic acid, Stearic acid, Cis-9 Oleic acid, Linoleic acid, Gamma-Linolenic acid and Tricosanoic acid, were found in both wild and cultivated samples, although the concentration of these fatty acids was more in the cultivated sample. From the various vitamins tested, Vitamin C, D and E were present in both wild and cultivated samples. Both wild as well as cultivated samples were evaluated for the presence of phenols; for this purpose, eleven phenols were taken as standards in HPLC analysis, and it was found that Gallic acid, Resorcinol, Ferulic acid and Pyrogallol were present in the wild mushroom sample whereas in the cultivated sample Ferulic acid, Caffeic Acid, Vanillic acid and Vanillin are present. The flavonoid analysis revealed the presence of Rutin, Naringin and Quercetin in wild M. gigantea, while 5 Naringin, Catechol, Myrecetin, Gossypin and Quercetin were found in cultivated one. From the comparative chromatographic profiling of both wild as well as cultivated M. gigantea, it is concluded that no nutrient loss was found during its cultivation. An increase in percentage of secondary metabolites (i.e., phenols and flavonoids) was found in cultivated one as compared to wild M. gigantea. Thus, from future perspective cultivated species of M. gigantea can be recommended for the commercial purpose as a good food supplement.

Keywords: culture, edible, fruit bodies, wild

Procedia PDF Downloads 55

Authors: Lizel Bertie, Kim Johnston

Abstract:

Parental emotion regulation plays a central role in the socialisation of emotion, especially when teaching young children to cope with negative emotions. Despite evidence which shows non-supportive parental responses to children’s expression of negative emotions has implications for the social and emotional development of the child, few studies have investigated risk factors which impact parental emotion socialisation processes. The current study aimed to explore the extent to which parental stress contributes to both difficulties in parental emotion regulation and non-supportive parental responses to children’s expression of negative emotions. In addition, the study examined whether parental use of expressive suppression as an emotion regulation strategy facilitates the influence of parental stress on non-supportive responses by testing the relations in a mediation model. A sample of 140 Australian adults, who identified as parents with children aged 5 to 10 years, completed an online questionnaire. The measures explored recent symptoms of depression, anxiety, and stress, the use of expressive suppression as an emotion regulation strategy, and hypothetical parental responses to scenarios related to children’s expression of negative emotions. A mediated regression indicated that parents who reported higher levels of stress also reported higher levels of expressive suppression as an emotion regulation strategy and increased use of non-supportive responses in relation to young children’s expression of negative emotions. These findings suggest that parents who experience heightened symptoms of stress are more likely to both suppress their emotions in parent-child interaction and engage in non-supportive responses. Furthermore, higher use of expressive suppression strongly predicted the use of non-supportive responses, despite the presence of parental stress. Contrary to expectation, no indirect effect of stress on non-supportive responses was observed via expressive suppression. The findings from the study suggest that parental stress may become a more salient manifestation of psychological distress in a sub-clinical population of parents while contributing to impaired parental responses. As such, the study offers support for targeting overarching factors such as difficulties in parental emotion regulation and stress management, not only as an intervention for parental psychological distress, but also the detection and prevention of maladaptive parenting practices.

Keywords: emotion regulation, emotion socialisation, expressive suppression, non-supportive responses, parental stress

Procedia PDF Downloads 150