Search results for: cumulative incidence function

Authors: Yasser Rammah, Wolf-Christian Mueller

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Nonlinear triad interactions in incompressible three-dimensional magnetohydrodynamic (3D-MHD) turbulence are studied by analyzing data from high-resolution direct numerical simulations of decaying isotropic (5123 grid points) and forced anisotropic (10242 x256 grid points) turbulence. An accurate numerical approach toward analyzing nonlinear turbulent energy transfer function and triad interactions is presented. It involves the direct numerical examination of every wavenumber triad that is associated with the nonlinear terms in the differential equations of MHD in the inertial range of turbulence. The technique allows us to compute the spectral energy transfer and energy fluxes, as well as the spectral locality property of energy transfer function. To this end, the geometrical shape of each underlying wavenumber triad that contributes to the statistical transfer density function is examined to infer the locality of the energy transfer. Results show that the total energy transfer is local via nonlocal triad interactions in decaying macroscopically isotropic MHD turbulence. In anisotropic MHD, turbulence subject to a strong mean magnetic field the nonlinear transfer is generally weaker and exhibits a moderate increase of nonlocality in both perpendicular and parallel directions compared to the isotropic case. These results support the recent mathematical findings, which also claim the locality of nonlinear energy transfer in MHD turbulence.

Keywords: magnetohydrodynamic (MHD) turbulence, transfer density function, locality function, direct numerical simulation (DNS)

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Authors: Akhad Ibrokhimov

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Update of preventive medicine has exacerbated the problem of cause-and-effect relationship between the presence of herpetic stomatitis (HS) and periodontal disease. Comprehensive survey of children with herpetic stomatitis, according to WHO equirements, on the territory of Tashkent years was conducted. Objective: To analyze the prevalence and intensity of periodontal tissue diseases in children with herpetic stomatitis. Materials and methods. Dental disease in Tashkent was studied in 156 children with herpetic stomatitis, as a control, the incidence of dental studied in 153 children of comparable age and sex never without a history of herpetic stomatitis. Results and discussion. The study revealed that 42,86 ± 13,23% of children with Herpetic stomatitis in the age group 6 years, 1 month - 10 years suffered from periodontal disease, the incidence of periodontal disease in the control group was 14,29 ± 9,35% (R≥0 05) corresponding to the frequency of detection of sextants with bleeding and tartar was equal to 35,71 ± 12,80% vs. 7,14 ± 6,88% (R≥0,05) and 14,29 ± 9,35% against 7 14 ± 6,88% (R≥0,05). Status of periodontal tissues was assessed in age groups 6 years, 1 month - 10 years and 10 years, 1 month - 15 years. The intensity of periodontal lesions observed at the level of 1,79 ± 0,06 vs. 0,66 ± 0,03 (P ≤ 0,05) affected sextant, including sextants with bleeding 1,62 ± 0,07 vs. 0.65 ± 0 , 03 (P ≤ 0,05) and sextants tartar - 0,17 ± 0,008 vs. 0,10 ± 0,008 (P ≤ 0,05). At age 10 years, 1 month - 15 years, a higher prevalence of signs of periodontal lesion was identified in patients with table of contents in 80,00 ± 12,65% of cases versus 30,00 ± 14,49% (P ≤ 0,05), and prevailed bleeding gums 70,00 ± 14,49% against 20,00 ± 11,83% (p ≤ 0.05), tartar was diagnosed respectively in 30,00 ± 14,49% against 10,00 ± 9,48% (R≥0,05) surveyed.

Keywords: vestibular surface, abnormal abrasion, composites, prosthesis

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Authors: Michael Luc Andre, Célia Maintenant

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Theory of mind is a milestone in child development which allows children to understand that others could have different mental states than theirs. Understanding the developmental stages of theory of mind in children leaded researchers on two Connected research problems. In one hand, the link between executive function and theory of mind, and on the other hand, the relationship of theory of mind and syntax processing. These two lines of research involved a great literature, full of important results, despite certain level of disagreement between researchers. For a long time, these two research perspectives continue to grow up separately despite research conclusion suggesting that the three variables should implicate same developmental period. Indeed, our goal was to study the relation between theory of mind, executive function, and language via a unique research question. It supposed that between executive function and language, one of the two variables could play a critical role in the relationship between theory of mind and the other variable. Thus, 112 children aged between three and six years old were recruited for completing a receptive and an expressive vocabulary task, a syntax understanding task, a theory of mind task, and three executive function tasks (inhibition, cognitive flexibility and working memory). The results showed significant correlations between performance on theory of mind task and performance on executive function domain tasks, except for cognitive flexibility task. We also found significant correlations between success on theory of mind task and performance in all language tasks. Multiple regression analysis justified only syntax and general abilities of language as possible predictors of theory of mind performance in our preschool age children sample. The results were discussed in the perspective of a great role of language abilities in theory of mind development. We also discussed possible reasons that could explain the non-significance of executive domains in predicting theory of mind performance, and the meaning of our results for the literature.

Keywords: child development, executive function, general language, syntax, theory of mind

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Authors: Nikhat Iqbal Tamboli

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INTRODUCTION: road traffic accidents (RTAs) are one of the leading and common causes of ocular injuries especially in developing countries like India which are preventable with certain measures and so it is of public health importance. AIM: To study incidence and clinical presentation of ocular morbidity in road traffic accidents. METHOD: Prospective cross-sectional study was conducted on 360 patients reported in department of ophthalmology. Detailed ocular examination and relevant investigations done. RESULTS: Incidence of ocular injuries is 23%. male:female ratio is 4.5:1.Cases having Sub conjunctival haemorrhage [74].eccymosis[217]. lid lcerations [164]orbital fracture[12] corneal tear [7]corneal abrasion[2] sclera tear[6] hyphaema[4] traumatic mydriasis [7]traumatic cataract [2]vitreous haemorrhage [1]traumatic optic neuropathy[1].Maximum cases in age group 20-40 years, with two wheeler vehicles 94.7% .Under influence of alcohol 13.3%. CONCLUSION: Younger age group with male preponderance is involved in ocular trauma due to road traffic accidents .maximum cases reported are with anterior segment injuries. Alcohol and two wheeler vehicles are common risk factors. Injuries involving cornea had bad prognosis and involving retina had worst prognosis.

Keywords: ocular morbidity, eye trauma, RTA, eye injury

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Authors: Yamin Sayyari

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In this paper, we generalized the Jensen's inequality for m-convex functions and also we present a correction of Jensen's inequality which is a better than the generalization of this inequality for m-convex functions. Finally, we have found new lower and new upper bounds for Jensen's discrete inequality.

Keywords: Jensen's inequality, m-convex function, Convex function, Inequality

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Authors: Sarah Gounden, Mukesh Dheda, Boikhutso Tlou, Elizabeth Ojewole, Frasia Oosthuizen

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Background: Antiretroviral therapy (ART) has been effective in the reduction of mortality and resulted in an improvement in the prognosis of HIV-infected patients. However, treatment with antiretrovirals (ARVs) has led to the development of many adverse drug reactions (ADRs). It is, therefore, necessary to determine the safety profile of these medicines in a South African population in order to ensure safe and optimal medicine use. Objectives: The aim of this study was to quantify ADRs experienced with the different ARVs currently used in South Africa, to determine the safety profile of ARV medicine in South Africa based on reported ADRs, and to determine the ARVs with the lowest risk profile based on specific patient populations. Methodology: This was a quantitative study. Individual case safety reports for the period January 2010 – December 2013 were obtained from the National Pharmacovigilance Center; these reports contained information on ADRs, ARV medicine, and patient demographics. Data was analysed to find associations that may exist between ADRs experienced, ARV medicines used and patient demographics. Results: A total of 1916 patient reports were received of which 1534 met the inclusion criteria for the study. The ARV with the lowest risk of ADRs were found to be lamivudine (0.51%, n=12), followed by lopinavir/ritonavir combination (0.8%, n=19) and abacavir (0.64%, n=15). A higher incidence of ADRs was observed in females compared to males. The age group 31–50 years and the weight group 61–80 kg had the highest incidence of ADRs reported. Conclusion: This study found that the safest ARVs to be used in a South African population are lamivudine, abacavir, and the lopinavir/ritonavir combination. Gender differences play a significant role in the occurrence of ADRs and both anatomical and physiological differences account for this. An increased BMI (body mass index) in both men and women showed an increase in the incidence of ADRs associated with ARV therapy.

Keywords: adverse drug reaction, antiretrovirals, HIV/AIDS, pharmacovigilance, South Africa

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Authors: Altaf H. Khan, Frank Stenger, Mohammed A. Hussein, Reaz A. Chaudhuri, Sameera Asif

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This paper discusses a novel approach to approximate quadrature integrals that arise in the estimation of likelihood parameters for the generalized linear mixed models (GLMM) as well as Bayesian methodology also requires computation of multidimensional integrals with respect to the posterior distributions in which computation are not only tedious and cumbersome rather in some situations impossible to find solutions because of singularities, irregular domains, etc. An attempt has been made in this work to apply Sinc function based quadrature rules to approximate intractable integrals, as there are several advantages of using Sinc based methods, for example: order of convergence is exponential, works very well in the neighborhood of singularities, in general quite stable and provide high accurate and double precisions estimates. The Sinc function based approach seems to be utilized first time in statistical domain to our knowledge, and it's viability and future scopes have been discussed to apply in the estimation of parameters for GLMM models as well as some other statistical areas.

Keywords: generalized linear mixed model, likelihood parameters, qudarature, Sinc function

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Authors: Ahmed Noor Al-Qayyim

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During the past decades, the bridge structures are considered very important portions of transportation networks, due to the fast urban sprawling. With the failure of bridges that under operating conditions lead to focus on updating the default bridge inspection methodology. The structures health monitoring (SHM) using the vibration response appeared as a promising method to evaluate the condition of structures. The rapid development in the sensors technology and the condition assessment techniques based on the vibration-based damage detection made the SHM an efficient and economical ways to assess the bridges. SHM is set to assess state and expects probable failures of designated bridges. In this paper, a presentation for Frequency Response function method that uses the captured vibration test information of structures to evaluate the structure condition. Furthermore, the main steps of the assessment of bridge using the vibration information are presented. The Frequency Response function method is applied to the experimental data of a full-scale bridge.

Keywords: bridge assessment, health monitoring, damage detection, frequency response function (FRF), signal processing, structure identification

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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: N. W. I. A. Jayawardana, W. A. T. A. Jayalath, W. M. T. Madhujith, U. Ralapanawa, R. S. Jayasekera, S. A. S. B. Alagiyawanna, A. M. K. R. Bandara, N. S. Kalupahana

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There is mounting evidence to the effect that dietary and lifestyle changes affect the incidence of non-communicable diseases (NCDs). This study was conducted to investigate the association of diet, physical activity, smoking, alcohol consumption and duration of sleep with overweight, obesity, hypertension and diabetes in a cohort of males from the Central Province of Sri Lanka. A total of 2694 individuals aged between 17 – 68 years (Mean = 31) were included in the study. Body Mass Index cutoff values for Asians were used to categorize the participants as normal, overweight and obese. The dietary data were collected using a food frequency questionnaire [FFQ] and data on the level of physical activity, smoking, alcohol consumption and sleeping hours were obtained using a self-administered validated questionnaire. Systolic and diastolic blood pressure, random blood glucose levels were measured to determine the incidence of hypertension and diabetes. Among the individuals, the prevalence of overweight and obesity were 34% and 16.4% respectively. Approximately 37% of the participants suffered from hypertension. Overweight and obesity were associated with older age men (P<0.0001), frequency of smoking (P=0.0434), alcohol consumption level (P=0.0287) and the quantity of lipid intake (P=0.0081). Consumption of fish (P=0.6983) and salty snacks (P=0.8327), sleeping hours (P=0.6847) and the level of physical activity were not significantly (P=0.3301) associated with the incidence of overweight and obesity. Based on the fitted model, only age was significantly associated with hypertension (P < 0.001). Further, age (P < 0.0001), sleeping hours (P=0.0953) and consumption of fatty foods (P=0.0930) were significantly associated with diabetes. Age was associated with higher odds of pre diabetes (OR:1.089;95% CI:1.053,1.127) and diabetes (OR:1.077;95% CI:1.055,1.1) whereas 7-8 hrs. of sleep per day was associated with lesser odds of diabetes (OR:0.403;95% CI:0.184,0.884). High prevalence of overweight, obesity and hypertension in working-age males is a threatening sign for this area. As this population ages in the future and urbanization continues, the prevalence of above risk factors will likely to escalate.

Keywords: age, males, non-communicable diseases, obesity

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Authors: Adrian Millea

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In hierarchical reinforcement learning, one of the main issues encountered is the discovery of subgoal states or options (which are policies reaching subgoal states) by partitioning the environment in a meaningful way. This partitioning usually requires an expensive global clustering operation or eigendecomposition of the Laplacian of the states graph. We propose a local solution to this issue, much more efficient than algorithms using global information, which successfully discovers subgoal states by computing a simple function, which we call heterogeneity for each state as a function of its neighbors. Moreover, we construct a value function using the difference in heterogeneity from one step to the next, as reward, such that we are able to explore the state space much more efficiently than say epsilon-greedy. The same principle can then be applied to higher level of the hierarchy, where now states are subgoals discovered at the level below.

Keywords: exploration, hierarchical reinforcement learning, locality, options, value functions

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Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Urasri Imsomboon, Sopita Areerob, Kanchaporn Kongchauy, Tuchapong Ngarmukos

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Objective: The Trans-telephonic Electrocardiography (ECG) monitoring is used to diagnose of infrequent cardiac arrhythmias and improve outcome of early detection and treatment on suspected cardiac patients. The objectives of this study were to explore incidence of cardiac arrhythmia using Trans-Telephonic and to explore time to first symptomatic episode and documented cardiac arrhythmia in outpatients. Methods: Descriptive research study was conducted between February 1, 2016, and December 31, 2016. A total of 117 patients who visited outpatient clinic were purposively selected. Research instruments in this study were the personal data questionnaire and the record form of incidence of cardiac arrhythmias using Trans-Telephonic ECG recorder. Results: A total of 117 patients aged between 15-92 years old (mean age 52.7 ±17.1 years), majority of studied sample was women (64.1%). The results revealed that 387 ECGs (Average 2.88 ECGs/person, SD = 3.55, Range 0 – 21) were sent to Cardiac Monitoring Center at Coronary Care Unit. Of these, normal sinus rhythm was found mostly 46%. Top 5 of cardiac arrhythmias were documented at the time of symptoms: sinus tachycardia 43.5%, premature atrial contraction 17.7%, premature ventricular contraction 14.3%, sinus bradycardia 11.5% and atrial fibrillation 8.6%. Presenting symptom were tachycardia 94%, palpitation 83.8%, dyspnea 51.3%, chest pain 19.6%, and syncope 14.5%. Mostly activities during symptom were no activity 64.8%, sleep 55.6% and work 25.6%.The mean time until the first symptomatic episode occurred on average after 6.88 ± 7.72 days (median 3 days). The first documented cardiac arrhythmia occurred on average after 9 ± 7.92 days (median 7 day). The treatments after patients known actual cardiac arrhythmias were observe themselves 68%, continue same medications 15%, got further investigations (7 patients), and corrected causes of cardiac arrhythmias via invasive cardiac procedures (5 patients). Conclusion: Trans-telephonic: portable ECGs recorder is effective in the diagnosis of suspected symptomatic cardiac arrhythmias in outpatient clinic.

Keywords: cardiac arrhythmias, diagnosis, outpatient clinic, trans-telephonic: portable ECG recorder

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Authors: J. Jarolímek, P. Urban, P. Pavlínek, D. Dzúrová

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The industry constitutes a dominant economic sector in Czechia. The automotive industry represents the most important industrial sector in terms of gross value added and the number of employees. The objective of this study was to analyse the occurrence of occupational diseases (OD) in the automotive industry in Czechia during the 2001-2014 period. Whereas the occurrence of OD in other sectors has generally been decreasing, it has been increasing in the automotive industry, including growing spatial discrepancies. Data on OD cases were retrieved from the National Registry of Occupational Diseases. Further, we conducted a survey in automotive companies with a focus on occupational health services and positions of the companies in global production networks (GPNs). An analysis of OD distribution in the automotive industry was performed (age, gender, company size and its role in GPNs, regional distribution of studied companies, and regional unemployment rate), and was accompanied by an assessment of the quality and range of occupational health services. The employees older than 40 years had nearly 2.5 times higher probability of OD occurrence compared with employees younger than 40 years (OR 2.41; 95% CI: 2.05-2.85). The OD occurrence probability was 3 times higher for women than for men (OR 3.01; 95 % CI: 2.55-3.55). The OD incidence rate was increasing with the size of the company. An association between the OD incidence and the unemployment rate was not confirmed.

Keywords: occupational diseases, automotive industry, health geography, unemployment

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Authors: Aman Sharma, Sonali Sengupta

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The study explores the utility of Bayesian optimization in tuning the physical and chemical parameters of reactions in an offline experimental setup. A comparative analysis of the influence of the acquisition function on the optimization performance is also studied. For proxy first and second-order reactions, the results are indifferent to the acquisition function used, whereas, while studying the parameters for oxidative desulphurization of thiophene in an offline setup, upper confidence bound (UCB) provides faster convergence along with a marginal trade-off in the maximum conversion achieved. The work also demarcates the critical number of independent parameters and input observations required for both sequential and offline reaction setups to yield tangible results.

Keywords: acquisition function, Bayesian optimization, desulfurization, kinetics, thiophene

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Authors: Kazuhiro Tateda, Elisa Gonzalez, Shuhei Ito, Kirstin Heinrich, Kevin Sweetland, Pingping Zhang, Catia Ferreira, Michael Pride, Jennifer Moisi, Sharon Gray, Bennett Lee, Fred Angulo

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Clostridium difficile (C. difficile) is the most common cause of antibiotic-associated diarrhea and infectious diarrhea in healthcare settings. Japan has an aging population; the elderly are at increased risk of hospitalization, antibiotic use, and C. difficile infection (CDI). Little is known about the population-based incidence and disease burden of CDI in Japan although limited hospital-based studies have reported a lower incidence than the United States. To understand CDI disease burden in Japan, CLOUD (Clostridium difficile Infection Burden of Disease in Adults in Japan) was developed. CLOUD will derive population-based incidence estimates of the number of CDI cases per 100,000 population per year in Ota-ku (population 723,341), one of the districts in Tokyo, Japan. CLOUD will include approximately 14 of the 28 Ota-ku hospitals including Toho University Hospital, which is a 1,000 bed tertiary care teaching hospital. During the 12-month patient enrollment period, which is scheduled to begin in November 2018, Ota-ku residents > 50 years of age who are hospitalized at a participating hospital with diarrhea ( > 3 unformed stools (Bristol Stool Chart 5-7) in 24 hours) will be actively ascertained, consented, and enrolled by study surveillance staff. A stool specimen will be collected from enrolled patients and tested at a local reference laboratory (LSI Medience, Tokyo) using QUIK CHEK COMPLETE® (Abbott Laboratories). which simultaneously tests specimens for the presence of glutamate dehydrogenase (GDH) and C. difficile toxins A and B. A frozen stool specimen will also be sent to the Pfizer Laboratory (Pearl River, United States) for analysis using a two-step diagnostic testing algorithm that is based on detection of C. difficile strains/spores harboring toxin B gene by PCR followed by detection of free toxins (A and B) using a proprietary cell cytotoxicity neutralization assay (CCNA) developed by Pfizer. Positive specimens will be anaerobically cultured, and C. difficile isolates will be characterized by ribotyping and whole genomic sequencing. CDI patients enrolled in CLOUD will be contacted weekly for 90 days following diarrhea onset to describe clinical outcomes including recurrence, reinfection, and mortality, and patient reported economic, clinical and humanistic outcomes (e.g., health-related quality of life, worsening of comorbidities, and patient and caregiver work absenteeism). Studies will also be undertaken to fully characterize the catchment area to enable population-based estimates. The 12-month active ascertainment of CDI cases among hospitalized Ota-ku residents with diarrhea in CLOUD, and the characterization of the Ota-ku catchment area, including estimation of the proportion of all hospitalizations of Ota-ku residents that occur in the CLOUD-participating hospitals, will yield CDI population-based incidence estimates, which can be stratified by age groups, risk groups, and source (hospital-acquired or community-acquired). These incidence estimates will be extrapolated, following age standardization using national census data, to yield CDI disease burden estimates for Japan. CLOUD also serves as a model for studies in other countries that can use the CLOUD protocol to estimate CDI disease burden.

Keywords: Clostridium difficile, disease burden, epidemiology, study protocol

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Authors: Truong Nguyen Luan Vu, Le Hieu Giang, Le Linh

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The FOPI controller is proposed based on the main properties of the decoupling control scheme, as well as the fractional calculus. By using the simplified decoupling technique, the transfer function of decoupled apparent process is firstly separated into a set of n equivalent independent processes in terms of a ratio of the diagonal elements of original open-loop transfer function to those of dynamic relative gain array and the fraction – order PI controller is then developed for each control loops due to the Bode’s ideal transfer function that gives the desired fractional closed-loop response in the frequency domain. The simulation studies were carried out to evaluate the proposed design approach in a fair compared with the other existing methods in accordance with the structured singular value (SSV) theory that used to measure the robust stability of control systems under multiplicative output uncertainty. The simulation results indicate that the proposed method consistently performs well with fast and well-balanced closed-loop time responses.

Keywords: ideal transfer function of bode, fractional calculus, fractional order proportional integral (FOPI) controller, decoupling control system

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Authors: Boukari Nassim

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This paper describes the use of odd pair autoregressive coefficients (Yule _Walker and Burg) for the feature extraction of electroencephalogram (EEG) signals. In the classification: the radial basis function neural network neural network (RBFNN) is employed. The RBFNN is described by his architecture and his characteristics: as the RBF is defined by the spread which is modified for improving the results of the classification. Five types of EEG signals are defined for this work: Set A, Set B for normal signals, Set C, Set D for interictal signals, set E for ictal signal (we can found that in Bonn university). In outputs, two classes are given (AC, AD, AE, BC, BD, BE, CE, DE), the best accuracy is calculated at 99% for the combined odd pair autoregressive coefficients. Our method is very effective for the diagnosis of epileptic EEG signals.

Keywords: epilepsy, EEG signals classification, combined odd pair autoregressive coefficients, radial basis function neural network

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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: Fedorova Elena

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In this article, we draw a distinction between two important functions of public policy in private international law. The first function is widely recognized and relates to the prevention of application of foreign laws and enforcement of foreign court judgments whenever their effects are incompatible with the domestic legal system of the forum. This effectively protects sovereign rights of the forum state as it allows to resist against the undesirable effects of foreign law-making and law-enforcement policies. The second function is less obvious, but not less important. As the internal private legal relationships, international private relationships are usually governed by rules of public policy, to which the parties can not derogate by mutual agreement. Thefore, for international private law relations public policy has a different function than previously mentioned: in this case, the public policy acts as a defense against unacceptable effects of the party autonomy. Thus, this second function of public policy consists in the limitation of the party autonomy wich effects would be unacceptable for the local legal system. In the frame of this second function the author will analyse two types of public policy which can limit the party autonomy: « substantial » public policy (which regulates the substance of international legal relationship) and « conflictual » public policy (which regulates the party autonomy to choose the law applicable for the substance of relationship). The author provides an analysis of these functions of the public policy in the field of international contract law because of the important role of the principle of party autonomy for international contract relations.

Keywords: public policy, general theory of private international law, substantial public policy, conflictual public policy

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Authors: P. H. G. J. Pushpakumara, Andrew Dawson

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Introduction: Deliberate self harm (DSH) is a major public health problem globally. Suicide rates of Sri Lanka are being among the highest national rates in the world, since 1950. Previous DSH is the most important independent predictor of repetition. The estimated 1 year non-fatal repeat self-harm rate was 16.3%. Asian countries had considerably lower rate, 10.0%. Objectives: To calculate incidence of deliberate self-poisoning (DSP) and suicides, repetition rate of DSP in Kurunegala District (KD). To determine the pattern of repeated DSP in KD. Methods: Study had two components. In the first component, demographic and event related details of, DSP admission in 46 hospitals and suicides in 28 police stations of KD were collected for 3 years from January 2011. Demographic details of cohort of DSP patients admitted to above hospitals in 2011 were linked with hospital admissions and police records of next two years period from the index admission. Records were screened for links with high sensitivity using the computer then did manual matching which would have been much more specific. In the second component, randomly selected DSP patients (n=438), who admitted to main referral centre which receives 60% of DSP cases of the district, were interviewed to assess life-time repetition. Results: There were 16,993 DSP admissions and 1078 suicides for the three year period. Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011, 2012 and 2013. Average male to female ratio for suicide incidences was 5.5. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population. Male incidences were slightly greater than the female incidences, male: female ratio was 1.1:1. Highest age standardized male and female incidence was reported in 20-24 years age group, 769.6/100,000, and 15-19 years age group 1304.0/100,000. Male to female ratio of the incidence increased with the age. There were 318 (179 male and 139 female) patients attempted DSH within two years. Female repetitive patients were ounger compared to the males, p < 0.0001, median age: males 28 and females 19 years. 290 (91.2%) had only one repetitive attempt, 24 (7.5%) had two, 3 (0.9%) had three and one (0.3%) had four in that period. One year repetition rate was 5.6 and two year repetition rate was 7.9%. Average intervals between indexed events and first repetitive DSP events were 246.8 (SD:223.4) and 238.5 (SD:207.0) days among males and females. One fifth of first repetitive events occurred within first two weeks in both males and females. Around 50% of males and females had the second event within 28 weeks. Within the first year of the indexed event, around 70% had the second event. First repetitive event was fatal for 28 (8.8%) individuals. Ages of those who died, mean 49.7 years (SD:15.3), were significantly higher compared to those who had non-fatal outcome, p<0.0001. 9.5% had life time history of DSH attempts. Conclusions: Both, DSP and suicide incidences were very high in KD. However, repetition rates were lesser compared regional values. Prevention of repetition alone may not produce significant impact on prevention of DSH.

Keywords: deliberate self-harm, incidence, repetition, Sri Lanka, suicide

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Authors: Muhammad Saqib Manzoor, Camille Dickson-Deane, Prashan Karunaratne

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Cobb-Douglas production (utility) function is a fundamental function widely used in economics teaching and research. The key reason is the function's characteristics to describe the actual production using inputs like labour and capital. The characteristics of the function like returns to scale, marginal, and diminishing marginal productivities are covered in the introductory units in both microeconomics and macroeconomics with a 2-dimensional static visualisation of the function. However, less insight is provided regarding three-dimensional surface, changes in the curvature properties due to returns to scale, the linkage of the short-run production function with its long-run counterpart and marginal productivities, the level curves, and the constraint optimisation. Since (freshman) learners have diverse prior knowledge and cognitive skills, the existing “one size fits all” approach is not very helpful. The aim of this study is to bridge this gap by introducing technological intervention with interactive animations of the three-dimensional surface and sequential unveiling of the characteristics mentioned above using Python software. A small classroom intervention has helped students enhance their analytical and visualisation skills towards active and authentic learning of this topic. However, to authenticate the strength of our approach, a quasi-Delphi study will be conducted to ask domain-specific experts, “What value to the learning process in economics is there using a 2-dimensional static visualisation compared to using a 3-dimensional dynamic visualisation?’ Here three perspectives of the intervention were reviewed by a panel comprising of novice students, experienced students, novice instructors, and experienced instructors in an effort to determine the learnings from each type of visualisations within a specific domain of knowledge. The value of this approach is key to suggesting different pedagogical methods which can enhance learning outcomes.

Keywords: cobb-douglas production function, quasi-Delphi method, effective teaching and learning, 3D-visualisations

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Authors: Matthew Cameron, Stephen Yang, Latifa Al Kharusi, Adam Gosselin, Anissa Chirico, Pouya Gholipour Baradari

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Background: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for the potential to increase baseline hemoglobin and decrease the incidence of red blood cell (RBC) transfusion during cardiac surgery. This study's main objective was to evaluate the evidence for iron administration in cardiac surgery patients for its effect on the incidence of perioperative RBC transfusion. Methods: This systematic review protocol was registered with PROSPERO (CRD42020161927) on Dec. 19th, 2019, and was prepared as per the PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar were searched for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. Each abstract was independently reviewed by two reviewers using predefined eligibility criteria. The primary outcome was perioperative RBC transfusion, with secondary outcomes of the number of RBC units transfused, change in ferritin level, reticulocyte count, hemoglobin, and adverse events, after iron administration. The risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and the primary and secondary outcomes were analyzed with a random-effects model. Results: Out of 1556 citations reviewed, five studies (n = 554 patients) met the inclusion criteria. The use of iron demonstrated no difference in transfusion incidence (RR 0.86; 95% CI 0.65 to 1.13). There was a low heterogeneity between studies (I²=0%). The trial sequential analysis suggested an optimal information size of 1132 participants, which the accrued information size did not reach. Conclusion: The current literature does not support the routine use of iron supplementation before cardiac surgery; however, insufficient data is available to draw a definite conclusion. A critical knowledge gap has been identified, and more robust RCTs are required on this topic.

Keywords: cardiac surgery, iron, iron supplementation, perioperative medicine, meta-analysis, systematic review, randomized controlled trial

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Authors: Amanpreet Kaur

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Wavelet transform (WT) is a powerful statistical tool used in applied mathematics for signal and image processing. The different mother, wavelet basis function, has been compared to select the optimal wavelet function that represents the electromyogram signal characteristics of upper limb amputees. Four different EMG electrode has placed on different location of shoulder muscles. Twenty one wavelet functions from different wavelet families were investigated. These functions included Daubechies (db1-db10), Symlets (sym1-sym5), Coiflets (coif1-coif5) and Discrete Meyer. Using mean square error value, the significance of the mother wavelet functions has been determined for teres, pectorals, and infraspinatus around shoulder muscles. The results show that the best mother wavelet is the db3 from the Daubechies family for efficient classification of the signal.

Keywords: Daubechies, upper limb amputation, shoulder muscles, Symlets, Coiflets

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Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

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Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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Authors: Francis N. Okpaleke

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The threat of Fulani herder militancy in Nigeria has led to a volatile security situation characterized by communal strife, arms proliferation, rural banditry, and insurgency. The exigency of this situation resonates in the eco-survivalist theory of farmer-herder conflict which holds that the herder deems the farmers’ unwarranted incursions into his grazing terrain as an effrontery that must reprised and a call to war. In spite of the rising incidence of Fulani militancy in Nigeria, only little is known concerning the phenomenon. The bulk of prevailing ideas on the subject has been largely and unnecessarily journalistic and anecdotal, lacking in intellectual depth, fecundity and rigour. The issue has remained scarcely documented by way of organized research. There is therefore a need for a systematic investigation that would leverage scholarly and policy insights on the subject which is the purpose of this study. The study will therefore, seek to examine the nexus between nomadic pastoralism and the incidence of herder-farmer conflicts in Nigeria with particular reference to the central region of the country. By means of qualitative descriptive analysis predicated on the theory of eco-violence, the paper explores the contemporary historical and structural drivers of this conflict, its relationship with the dynamics of climate change in Nigeria and its implication of human security in Nigeria. The paper also proffers theoretical and policy recommendations to mitigate the onto ward conflict.

Keywords: eco-survivalism, conflict, pastoralism, nomads

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Authors: Tejasvi Parupudi, Mochen Li, Lakshya Mittal, Ignacio G. Camarillo, Raji Sundararajan

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With breast cancer becoming a global pandemic, it is very important to assess a woman’s risk profile accurately in a timely manner. Providing an estimate of the risk of developing breast cancer to a woman gives her an opportunity to consider options to decrease this risk. Women at low risk may be suggested yearly screenings whereas women with a high risk of developing breast cancer would be candidates for aggressive surveillance. Fortunately, there is a set of risk factors that are used to predict the probability of a woman being diagnosed with breast cancer in the future. Studying risk factors and understanding how they correlate to cancer is important for early diagnosis, prevention and reducing mortality rates. The effect of crucial risk factors among black and white women was compared in this study. The various risk factors analyzed include breast density, age, cancer in a first-degree relative, menopausal status, body mass index (BMI) and prior breast cancer diagnosis, etc. Breast density, age at first full-term birth and BMI were utilized in this study as important risk factors for the comparison of incidence rates between women of black and white races in the USA. Understanding the differences could lead to the development of solutions to reduce disparity in mortality rates among black women by improving overall access to care.

Keywords: big data, breast cancer, risk factors, incidence rates, mortality, race

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Authors: Rizky Oktaviana

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The main purpose of studying lies in improving students’ understanding. Teachers usually use written test to measure students’ understanding about learning material especially mathematical learning material. This common method actually has a lack point, such that in mathematics content, written test only show procedural steps to solve mathematical problems. Therefore, teachers unable to see whether students actually understand about mathematical concepts and the relation between concepts or not. One of the best tools to observe students’ understanding about the mathematical concepts is concept map. The goal of this research is to describe junior high school students understanding about mathematical concepts through Concept Maps based on the difference of mathematical ability. There were three steps in this research; the first step was choosing the research subjects by giving mathematical ability test to students. The subjects of this research are three students with difference mathematical ability, high, intermediate and low mathematical ability. The second step was giving concept mapping training to the chosen subjects. The last step was giving concept mapping task about the function to the subjects. Nodes which are the representation of concepts of function were provided in concept mapping task. The subjects had to use the nodes in concept mapping. Based on data analysis, the result of this research shows that subject with high mathematical ability has formal understanding, due to that subject could see the connection between concepts of function and arranged the concepts become concept map with valid hierarchy. Subject with intermediate mathematical ability has relational understanding, because subject could arranged all the given concepts and gave appropriate label between concepts though it did not represent the connection specifically yet. Whereas subject with low mathematical ability has poor understanding about function, it can be seen from the concept map which is only used few of the given concepts because subject could not see the connection between concepts. All subjects have instrumental understanding for the relation between linear function concept, quadratic function concept and domain, co domain, range.

Keywords: concept map, concept mapping, mathematical concepts, understanding

Procedia PDF Downloads 250

Authors: K. R. Balabiyev, A. O. Kaipbayeva

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The article discusses the legal framework of the government’s environmental function and analyzes the role of the national policy in protection of wetlands. The problem is of interest for it deals with the most important branch of economy–utilization of Kazakhstan’s natural resources, protection of health and environmental well being of the population. Development of a long-term environmental program addressing the protection of wetlands represents the final stage of the government’s environmental policy, and is a relatively new function for the public administration system. It appeared due to the environmental measures that require immediate decisions to be taken. It is an integral part of the effort in the field of management of state-owned natural resource, as well as of the measures aimed at efficient management of natural resources to avoid their early depletion or contamination.

Keywords: environmental focus, government’s environmental function, protection of wetlands, Kazakhstan

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Authors: Salah R. Al Zaidee, Ali S. Mahdi

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Except for simple problems of statically determinate structures, optimum design problems in structural engineering have implicit objective functions where structural analysis and design are essential within each searching loop. With these implicit functions, the structural engineer is usually enforced to write his/her own computer code for analysis, design, and searching for optimum design among many feasible candidates and cannot take advantage of available software for structural analysis, design, and searching for the optimum solution. The meta-model is a regression model used to transform an implicit objective function into objective one and leads in turn to decouple the structural analysis and design processes from the optimum searching process. With the meta-model, well-known software for structural analysis and design can be used in sequence with optimum searching software. In this paper, the meta-model has been used to develop an explicit objective function for plane steel frames subjected to dead, live, and seismic forces. Frame topology is assumed as predefined based on architectural and functional requirements. Columns and beams sections and different connections details are the main design variables in this study. Columns and beams are grouped to reduce the number of design variables and to make the problem similar to that adopted in engineering practice. Data for the implicit objective function have been generated based on analysis and assessment for many design proposals with CSI SAP software. These data have been used later in SPSS software to develop a pure quadratic nonlinear regression model for the explicit objective function. Good correlations with a coefficient, R², in the range from 0.88 to 0.99 have been noted between the original implicit functions and the corresponding explicit functions generated with meta-model.

Keywords: meta-modal, objective function, steel frames, seismic analysis, design

Procedia PDF Downloads 221