Search results for: lower Silurian
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5570

Search results for: lower Silurian

5210 Atypical Familial Amyotrophic Lateral Sclerosis Secondary to Superoxide Dismutase 1 Gene Mutation With Coexistent Axonal Polyneuropathy: A Challenging Diagnosis

Authors: Seraj Makkawi, Abdulaziz A. Alqarni, Himyan Alghaythee, Suzan Y. Alharbi, Anmar Fatani, Reem Adas, Ahmad R. Abuzinadah

Abstract:

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a neurodegenerative disease that involves both the upper and lower motor neurons. Familial ALS, including superoxide dismutase 1 (SOD1) mutation, accounts for 5-10% of all cases of ALS. Typically, the symptoms of ALS are purely motor, though coexistent sensory symptoms have been reported in rare cases. In this report, we describe the case of a 47- year-old man who presented with progressive bilateral lower limb weakness and numbness for the last four years. A nerve conduction study (NCS) showed evidence of coexistent axonal sensorimotor polyneuropathy in addition to the typical findings of ALS in needle electromyography. Genetic testing confirmed the diagnosis of familial ALS secondary to the SOD1 genetic mutation. This report highlights that the presence of sensory symptoms should not exclude the possibility of ALS in an appropriate clinical setting.

Keywords: Saudi Arabia, polyneuropathy, SOD1 gene mutation, familial amyotrophic lateral sclerosis, amyotrophic lateral sclerosis

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5209 The Relationship Between Cultural Factors and Dividend Payouts of the Banks in Some Middle East Countries

Authors: Benjamin Bae, Mahdy Elhusseiny, Sherif El-Halaby

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This study investigates the relationship between some cultural factors and the level of dividend payouts of banks in a number of Muslim countries. We examine whether cultural factors play any role in determining dividend payout policy in banks. The results suggest that banks in high masculinity countries tend to pay higher dividends than low masculinity countries. The results also show that banks in high uncertainty avoidance (UA) countries tend to pay lower dividends than high UA countries. Additionally, the results of this study indicate that banks in high long-term orientation (LTO) countries tend to pay lower dividends than low LTO countries. However, two other cultural factors of power distance (PD) and individualism do not have any incremental explanatory power on the dividend payouts. Overall, this research adds to our understanding of the bank’s dividend payout policies. First, evidence on the relationship between the cultural factors and bank’s level of dividend payouts should be useful to investors. Second, the findings of this study provide financial statement users with useful information about the bank’s dividend payout levels. Third, in general, it also adds to the accounting and finance literature on dividends.

Keywords: cultural factor, dividend payout, Hofstede index, bank industry

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5208 The Role of Metacognitive Strategy Intervention through Dialogic Interaction on Listeners’ Level of Cognitive Load

Authors: Ali Babajanzade, Hossein Bozorgian

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Cognitive load plays an important role in learning in general and L2 listening comprehension in particular. This study is an attempt to investigate the effect of metacognitive strategy intervention through dialogic interaction (MSIDI) on L2 listeners’ cognitive load. A mixed-method design with 50 participants of male and female Iranian lower-intermediate learners between 20 to 25 years of age was used. An experimental group (n=25) received weekly interventions based on metacognitive strategy intervention through dialogic interaction for ten sessions. The second group, which was control (n=25), had the same listening samples with the regular procedure without a metacognitive intervention program in each session. The study used three different instruments: a) a modified version of the cognitive load questionnaire, b) digit span tests, and c) focused group interviews to investigate listeners’ level of cognitive load throughout the process. Results testified not only improvements in listening comprehension in MSIDI but a radical shift of cognitive load rate within this group. In other words, listeners experienced a lower level of cognitive load in MSIDI in comparison with their peers in the control group.

Keywords: cognitive load theory, human mental functioning, metacognitive theory, listening comprehension, sociocultural theory

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5207 Experimental Analysis on the Thermal Performance of Vacuum Membrane Distillation Module Using Polyvinylidene Fluoride Hollow Fiber Membrane

Authors: Hong-Jin Joo, Hee-Yoel Kwak

Abstract:

Vacuum Membrane Distillation (VMD) uses pressure lower than the atmospheric pressure. The feed seawater is capable of producing more vapor at the same temperature than Direct Contact Membrane Distillation (DCMD), Air Gap Membrane Distillation (AGMD) or Sweep Gas Membrane Distillation (SGMD). It is advantageous because it is operable at a lower temperature than other membrane distillations. However, no commercial product is available that uses the VMD method, as it is still in the study stage. In this study, therefore, thermal performance test according to the feed water conditions was performed prior to both construction of the demonstration plant, which uses VMD module of the capacity of 400m³/d in South Korea, and commercialization of VMD module with hollow fiber membrane. Such study was performed by designing and constructing the VMD module of the capacity of 2 m³/day which utilizes the polyvinylidene fluoride (PVDF) hollow fiber membrane. The results obtained from the VMD module manufactured by ECONITY Co., Ltd in South Korea, showed that the maximum performance ratio (PR) value of 0.904, feed water temperature of 75 ℃, and the flow rate of 8 m3/h. As the temperature of and flow rate of the feed water increased, the PR value of the VMD module also increased.

Keywords: membrane distillation, vacuum membrane distillation, hollow fiber membrane, desalination

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5206 Examining the Association of Demographic Factors and Arab Women’s Investment Behavior

Authors: Razan Salem

Abstract:

Men and women are different, and so their investment behaviors may also vary. To the author’s best knowledge, women's investment behavior and its association with demographic factors have not been explored directly in the behavioral finance literature, however, particularly in respect to the Arab region. Thus, this study extends the literature by focusing on examining the association of demographic factors (age, annual income, and education) with Arab women’s investment behavior. To achieve the study’s aim, the researcher distributed 600 close-ended online questionnaires to a sample of Arab male and female individual investors in both Saudi Arabia and Jordan; using Kruskal-Wallis H Test and the Mann-Whitney U Test to analyze the data. The findings reveal that age, education, and level of income are associated with Arab women’s investment behavior. Educational level and level of income are positively associated with Arab women investment confidence level. On the contrary, age is negatively associated with Arab women financial risk tolerance. According to annual income, Arab women with lower incomes have lower confidence and investment literacy levels. Overall, the study concludes that age, income, and education are important demographic factors that must be considered when investigating the investment behavior of women in the Arab region.

Keywords: Arab region, demographic factors, investment behavior, women investors

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5205 Comparison of Trunk and Hip Muscle Activities and Anterior Pelvic Tilt Angle during Three Different Bridging Exercises in Subjects with Chronic Low Back Pain

Authors: Da-Eun Kim, Heon-Seock Cynn, Sil-Ah Choi, A-Reum Shin

Abstract:

Bridging exercise in supine position with the hips and knees flexed have been commonly performed as one of the therapeutic exercises and is a comfortable and pain-free position to most individuals with chronic low back pain (CLBP). Many previous studies have investigated the beneficial way of performing bridging exercises to improve activation of abdominal and gluteal muscle and reduce muscle activity of hamstrings (HAM) and erector spinae (ES) and compensatory lumbopelvic motion. The purpose of this study was to compare the effects of three different bridging exercises on the HAM, ES, gluteus maximus (Gmax), gluteus medius (Gmed), and transverse abdominis/internal abdominis oblique (TrA/IO) activities and anterior pelvic tilt angle in subjects with CLBP. Seventeen subjects with CLBP participated in this study. They performed bridging under three different conditions (with 30° hip abduction, isometric hip abduction, and isometric hip adduction). Surface electromyography was used to measure muscle activity, and the ImageJ software was used to calculate anterior pelvic tilt angle. One-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. HAM activity was significantly lower in bridging with 30° hip abduction and isometric hip abduction than in bridging with isometric hip adduction. Gmax and Gmed activities were significantly greater in bridging with isometric hip abduction than in bridging with 30° hip abduction and isometric hip adduction. TrA/IO muscle activity was significantly greater and anterior pelvic tilt angle was significantly lower in bridging with isometric hip adduction than in bridging with 30° hip abduction and isometric hip abduction. Bridging with isometric hip abduction using Thera-Band can effectively reduce HAM activity, and increase Gmax and Gmed activities in subjects with CLBP. Bridging with isometric hip adduction using a pressure biofeedback unit can be a beneficial exercise to improve TrA/IO activity and minimize anterior pelvic tilt in subjects with CLBP.

Keywords: bridging exercise, electromyography, low back pain, lower limb exercise

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5204 The Comparative Electroencephalogram Study: Children with Autistic Spectrum Disorder and Healthy Children Evaluate Classical Music in Different Ways

Authors: Galina Portnova, Kseniya Gladun

Abstract:

In our EEG experiment participated 27 children with ASD with the average age of 6.13 years and the average score for CARS 32.41 and 25 healthy children (of 6.35 years). Six types of musical stimulation were presented, included Gluck, Javier-Naida, Kenny G, Chopin and other classic musical compositions. Children with autism showed orientation reaction to the music and give behavioral responses to different types of music, some of them might assess stimulation by scales. The participants were instructed to remain calm. Brain electrical activity was recorded using a 19-channel EEG recording device, 'Encephalan' (Russia, Taganrog). EEG epochs lasting 150 s were analyzed using EEGLab plugin for MatLab (Mathwork Inc.). For EEG analysis we used Fast Fourier Transform (FFT), analyzed Peak alpha frequency (PAF), correlation dimension D2 and Stability of rhythms. To express the dynamics of desynchronizing of different rhythms we've calculated the envelope of the EEG signal, using the whole frequency range and a set of small narrowband filters using Hilbert transformation. Our data showed that healthy children showed similar EEG spectral changes during musical stimulation as well as described the feelings induced by musical fragments. The exception was the ‘Chopin. Prelude’ fragment (no.6). This musical fragment induced different subjective feeling, behavioral reactions and EEG spectral changes in children with ASD and healthy children. The correlation dimension D2 was significantly lower in autists compared to healthy children during musical stimulation. Hilbert envelope frequency was reduced in all group of subjects during musical compositions 1,3,5,6 compositions compared to the background. During musical fragments 2 and 4 (terrible) lower Hilbert envelope frequency was observed only in children with ASD and correlated with the severity of the disease. Alfa peak frequency was lower compared to the background during this musical composition in healthy children and conversely higher in children with ASD.

Keywords: electroencephalogram (EEG), emotional perception, ASD, musical perception, childhood Autism rating scale (CARS)

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5203 Factors Affecting Harvested Rain Water Quality and Quantity in Yatta Area, Palestine

Authors: Nibal Al-Batsh, Issam Al-Khatib, Subha Ghannam

Abstract:

Yatta is the study area for this research, located 9 km south of Hebron City in the West Bank in Palestine. It has been connected to a water network since 1974 serving nearly 85% of the households. The water network is old and inadequate to meet the needs of the population. The water supply made available to the area is also very limited, estimated to be around 20 l/c.d. Residents are thus forced to rely on water vendors which supply water with a lower quality compared to municipal water while being 400% more expensive. As a cheaper and more reliable alternative, rainwater harvesting is a common practice in the area, with the majority of the households owning at least one cistern. Rainwater harvesting is of great socio-economic importance in areas where water sources are scarce or polluted. The quality of harvested rainwater used for drinking and domestic purposes in the Yatta area was assessed throughout a year long period. A total of 100 water samples were collected from (50 rainfed cisterns) with an average capacity of 69 m3, adjacent to cement-roof catchment with an average area of 145 m2. Samples were analyzed for a number of parameters including: pH, Alkalinity, Hardness, Turbidity, Total Dissolved Solids (TDS), NO3, NH4, chloride and salinity. Microbiological contents such as Total Coliforms (TC) and Fecal Coliforms (FC) bacteria were also analyzed. Results showed that most of the rainwater samples were within WHO and EPA guidelines set for chemical parameters while revealing biological contamination. The pH values of mixed water ranged from 6.9 to 8.74 with a mean value of 7.6. collected Rainwater had lower pH values than mixed water ranging from 7.00 to 7.57 with a mean of 7.21. Rainwater also had lower average values of conductivity (389.11 µScm-1) compared to that of mixed water (463.74 µScm-1) thus indicating lower values of salinity (0.75%). The largest TDS value measured in rainwater was 316 mg/l with a mean of 199.86 mg /l. As far as microbiological quality is concerned, TC and FC were detected in 99%, 52% of collected rainwater samples, respectively. The research also addressed the impact of different socio-economic attributes on rainwater harvesting using information collected through a survey from the area. Results indicated that the majority of homeowners have the primary knowledge necessary to collect and store water in cisterns. Most of the respondents clean both the cisterns and the catchment areas. However, the research also arrives at a conclusion that cleaning is not done in a proper manner. Results show that cisterns with an operating capacity of 69 m3 would provide sufficient water to get through the dry summer months. However, the catchment area must exceed 146 m2 to produce sufficient water to fill a cistern of this size in a year receiving average precipitation.

Keywords: rainwater harvesting, runoff coefficient, water quality, microbiological contamination

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5202 Stress Evaluation at Lower Extremity during Walking with Unstable Shoe

Authors: Sangbaek Park, Seungju Lee, Soo-Won Chae

Abstract:

Unstable shoes are known to strengthen lower extremity muscles and improve gait ability and to change the user’s gait pattern. The change in gait pattern affects human body enormously because the walking is repetitive and steady locomotion in daily life. It is possible to estimate the joint motion including joint moment, force and inertia effect using kinematic and kinetic analysis. However, the change of internal stress at the articular cartilage has not been possible to estimate. The purpose of this research is to evaluate the internal stress of human body during gait with unstable shoes. In this study, FE analysis was combined with motion capture experiment to obtain the boundary condition and loading condition during walking. Motion capture experiments were performed with a participant during walking with normal shoes and with unstable shoes. Inverse kinematics and inverse kinetic analysis was performed with OpenSim. The joint angle and muscle forces were estimated as results of inverse kinematics and kinetics analysis. A detailed finite element (FE) lower extremity model was constructed. The joint coordinate system was added to the FE model and the joint coordinate system was coincided with OpenSim model’s coordinate system. Finally, the joint angles at each phase of gait were used to transform the FE model’s posture according to actual posture from motion capture. The FE model was transformed into the postures of three major phases (1st peak of ground reaction force, mid stance and 2nd peak of ground reaction force). The direction and magnitude of muscle force were estimated by OpenSim and were applied to the FE model’s attachment point of each muscle. Then FE analysis was performed to compare the stress at knee cartilage during gait with normal shoes and unstable shoes.

Keywords: finite element analysis, gait analysis, human model, motion capture

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5201 Experimental Investigation of Folding of Rubber-Filled Circular Tubes on Energy Absorption Capacity

Authors: MohammadSadegh SaeediFakher, Jafar Rouzegar, Hassan Assaee

Abstract:

In this research, mechanical behavior and energy absorption capacity of empty and rubber-filled brazen circular tubes under quasi-static axial loading are investigated, experimentally. The brazen tubes were cut out of commercially available brazen circular tubes with the same length and diameter. Some of the specimens were filled with rubbers with three different shores and also, an empty tube was prepared. The specimens were axially compressed between two rigid plates in a quasi-static process using a Zwick testing machine. Load-displacement diagrams and energy absorption of the tested tubes were extracted from experimental data. The results show that filling the brazen tubes with rubber causes those to absorb more energy and the energy absorption of specimens are increased by increasing the shore of rubbers. In comparison to the empty tube, the first fold for the rubber-filled tubes occurs at lower load and it can be concluded that the rubber-filled tubes are better energy absorbers than the empty tubes. Also, in contrast with the empty tubes, the tubes that were filled with lower rubber shore deform asymmetrically.

Keywords: axial compression, quasi-static loading, folding, energy absorbers, rubber-filled tubes

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5200 Designing Information Systems in Education as Prerequisite for Successful Management Results

Authors: Vladimir Simovic, Matija Varga, Tonco Marusic

Abstract:

This research paper shows matrix technology models and examples of information systems in education (in the Republic of Croatia and in the Germany) in support of business, education (when learning and teaching) and e-learning. Here we researched and described the aims and objectives of the main process in education and technology, with main matrix classes of data. In this paper, we have example of matrix technology with detailed description of processes related to specific data classes in the processes of education and an example module that is support for the process: ‘Filling in the directory and the diary of work’ and ‘evaluation’. Also, on the lower level of the processes, we researched and described all activities which take place within the lower process in education. We researched and described the characteristics and functioning of modules: ‘Fill the directory and the diary of work’ and ‘evaluation’. For the analysis of the affinity between the aforementioned processes and/or sub-process we used our application model created in Visual Basic, which was based on the algorithm for analyzing the affinity between the observed processes and/or sub-processes.

Keywords: designing, education management, information systems, matrix technology, process affinity

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5199 The Common Location and the Intensity of Surface Electrical Stimulation on the Thorax and Abdomen Areas: A Systematic Review

Authors: Vu Hoang Thu Huong

Abstract:

Background: Surface electrical stimulation (SES) is a popular non-invasive approach that offers a wide range of treatments for many diseases of physical therapy. It involves applying electrical stimulation to the skin via surface electrodes to stimulate nerve fibers. SES was regularly used to treat the back and upper or lower extremities, but it was rarely used to treat the chest and abdomen. SES on the thorax and abdomen should be administered with more attention because crucial organs are under those areas (i.e., heart, lungs, liver, etc.). In these areas, safety precautions are suggested, and some SES applications might even be a contraindication. The fact that physical therapists have less experience with SES in these situations can also be attributed to these. Although a few earlier studies applied it to these settings and discovered hopeful results, none of them highlight the relationship between the intensity of SES and its depth of impact for safety considerations. Objective: To assure feasibility when using SES in these areas, the purpose of this study is to summarize the common location and intensity of those areas that have been conducted in previous studies. Method: A thorough systematic review was conducted to determine the common surface electrode position for the thorax and abdomen areas. The studies with the randomized controlled design were systematically searched using inclusion and exclusion criteria through nine electronic databases, including Pubmed, Scopus, etc., between 1975 and Dec 2021. Results: Thirty-three studies with over 1800 participants and 4 types of SES (TENS, IFC, NMES, and FES) with various categories of department hospitals were found. Following an anterior, lateral, and posterior observation, the particular SES positions found that it concentrated on 6 regions (the thoracic, abdomen, upper lateral, lower lateral, upper back, and lower back regions), and its intensity for each region was also summarized. Conclusion: This systematic review figured out the popular locations of SES in the thorax and abdominal areas as well as a summarized maximum of intensity that was found in previous studies with outstanding outcomes.

Keywords: surface electrical stimulation, electrical stimulation, thoracic, abdomen, abdominal.

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5198 Effects of Harmful Alcohol Consumption and Gender on Academic and Personal-Emotional Adjustment in First Year University Students in Spain

Authors: M. F. Páramo, F. Cadaveira, M. S. Rodríguez

Abstract:

The first year at university is a critical period for personal-emotional and academic adjustment in emerging adults. Moreover, some studies show that alcohol consumption increases in young adults on transition to university. The main purpose of this study was to analyze the impact of hazardous alcohol consumption and gender on adjustment to university, understood as a multidimensional construct involving an array of demands. A sample of 300 first year students in Spain completed the Student Adaptation to College Questionnaire (SACQ) and the Alcohol Use Disorders Identification Test (AUDIT). Examination of the data by analysis of variance revealed that adjustment to university was lower in the students undertaking hazardous alcohol consumption than in the other students. Surprisingly, the personal-emotional adjustment of students with hazardous alcohol consumption was not lower than in the other students. Analysis of the gender effect revealed that levels of personal-emotional adjustment were higher in males than in females. This is our first study examining the influence of alcohol consumption on university adjustment. Future research should examine this relationship more closely, with the aim of designing public health strategies focused on limiting abusive consumption of alcohol in university students.

Keywords: alcohol consumption, first year university students, gender, SACQ

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5197 (De)Criminalising Sex Toys in Thailand: A Law and Economics Approach

Authors: Piyanee Khumpao

Abstract:

Under the Thai Penal Code and Customs Act, sex toys are criminalized and completely prohibited through the legal interpretation as obscene objects by law enforcement, despite there is no explicit legal sanction against them. The purpose of preventing people from accessing sex toys is to preserve public morals. However, sex toys are still available, exposed, and sold publicly in main cities throughout Thailand. They are easily observed by people of any age. This paper argues that sexuality is human nature and human right. Human deserves sexual pleasure as long as getting sexual pleasure does not inflict any harm on others. Using sex toys in private (individually and/or as a couple with mutual consent) does not constitute any harm nor degrade public moral. Therefore, the complete ban of sex toys shall be lifted and decriminalized. Nevertheless, the economic analysis illustrates that criminalization and prohibition of sex toys would lead to its black market – higher price and lower quantity. Although it is socially desirable to have fewer sex toys in the market, there will usually be high demand for them because sexual pleasure is natural and, hence, people have a lower price elasticity of demand for such things, including pornography. Thus, its deterrent effect is not very effective. Moreover, sex toys vendors still always exist because higher price incentivizes them to act illegally and may gain benefits from selling low-quality sex toys. Consequently, consumers do not have a choice to select high-quality sex toys at a reasonable price. Then, they are forced to purchase low quality sex toys at a higher price. They also may suffer from health issues as well as other harms from its dangerous/toxic substances since lower quality products are manufactured poorly to save costs. A law and economics approach supports the decriminalization of sex toys in Thailand. Other measures to control its availability shall be adopted to protect the vulnerable, such as children. Options are i) zoning or regulation on-premises selling sex toys as in Singapore, Japan, and China, ii) regulations of sex toys as medical apparatus like in the state of Alabama, and iii) the prevention of sex toys exposure in the real (physical) appearance (i.e., allowing virtual exposure of sex toys) like in India.

Keywords: human nature, law and economics approach, sex toys, sexual pleasure

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5196 Olive Stone Valorization to Its Application on the Ceramic Industry

Authors: M. Martín-Morales, D. Eliche-Quesada, L. Pérez-Villarejo, M. Zamorano

Abstract:

Olive oil is a product of particular importance within the Mediterranean and Spanish agricultural food system, and more specifically in Andalusia, owing to be the world's main production area. Olive oil processing generates olive stones which are dried and cleaned to remove pulp and olive stones fines to produce biofuel characterized to have high energy efficiency in combustion processes. Olive stones fine fraction is not too much appreciated as biofuel, so it is important the study of alternative solutions to be valorized. Some researchers have studied recycling different waste to produce ceramic bricks. The main objective of this study is to investigate the effects of olive stones addition on the properties of fired clay bricks for building construction. Olive stones were substituted by volume (7.5%, 15%, and 25%) to brick raw material in three different sizes (lower than 1 mm, lower than 2 mm and between 1 and 2 mm). In order to obtain comparable results, a series without olive stones was also prepared. The prepared mixtures were compacted in laboratory type extrusion under a pressure of 2.5MPa for rectangular shaped (30 mm x 60 mm x 10 mm). Dried and fired industrial conditions were applied to obtain laboratory brick samples. Mass loss after sintering, bulk density, porosity, water absorption and compressive strength of fired samples were investigated and compared with a sample manufactured without biomass. Results obtained have shown that olive stone addition decreased mechanical properties due to the increase in water absorption, although values tested satisfied the requirements in EN 772-1 about methods of test for masonry units (Part 1: Determination of compressive strength). Finally, important advantages related to the properties of bricks as well as their environmental effects could be obtained with the use of biomass studied to produce ceramic bricks. The increasing of the percentage of olive stones incorporated decreased bulk density and then increased the porosity of bricks. On the one hand, this lower density supposes a weight reduction of bricks to be transported, handled as well as the lightening of building; on the other hand, biomass in clay contributes to auto thermal combustion which involves lower fuel consumption during firing step. Consequently, the production of porous clay bricks using olive stones could reduce atmospheric emissions and improve their life cycle assessment, producing eco-friendly clay bricks.

Keywords: clay bricks, olive stones, sustainability, valorization

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5195 A Multidisciplinary Team Approach for Limb Salvage in a Rare Case of Pyoderma Gangrenosum in a Significant Circumferential Lower Extremity Wound Complicated by Diabetes and End-stage Renal Disease

Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

Abstract:

Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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5194 In Search of Zero Beta Assets: Evidence from the Sukuk Market

Authors: Andrea Paltrinieri, Alberto Dreassi, Stefano Miani, Alex Sclip

Abstract:

The financial crises caused a collapse in prices of most asset classes, raising the attention on alternative investments such as Sukuk, a smaller, fast growing but often misunderstood market. We study diversification benefits of Sukuk, their correlation with other asset classes and the effects of their inclusion in investment portfolios of institutional and retail investors, through a comprehensive comparison of their risk/return profiles during and after the financial crisis. We find a beneficial performance adjusted for the specific volatility together with a lower correlation especially during the financial crisis. The distribution of Sukuk returns is positively skewed and leptokurtic, with a risk/return profile similarly to high yield bonds. Overall, our results suggest that Sukuk present diversification opportunities, a significant volatility-adjusted performance and lower correlations especially during the financial crisis. Our findings are relevant for a number of institutional investors. Long term investors, such as life insurers would benefit from Sukuk’s protective features during financial crisis yet keeping return and growth opportunities, whereas banks would gain due to their role of placers, advisors, market makers or underwriters.

Keywords: sukuk, zero beta asset, asset allocation, sukuk market

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5193 Influence of Chelators, Zn Sulphate and Silicic Acid on Productivity and Meat Quality of Fattening Pigs

Authors: A. Raceviciute-Stupeliene, V. Sasyte, V. Viliene, V. Slausgalvis, J. Al-Saifi, R. Gruzauskas

Abstract:

The objective of this study was to investigate the influence of special additives such as chelators, zinc sulphate and silicic acid on productivity parameters, carcass characteristics and meat quality of fattening pigs. The test started with 40 days old fattening pigs (mongrel (mother) and Yorkshire (father)) and lasted up to 156 days of age. During the fattening period, 32 pigs were divided into 2 groups (control and experimental) with 4 replicates (total of 8 pens).  The pigs were fed for 16 weeks’ ad libitum with a standard wheat-barley-soybean meal compound (Control group) supplemented with chelators, zinc sulphate and silicic acid (dosage 2 kg/t of feed, Experimental group). Meat traits in live pigs were measured by ultrasonic equipment Piglog 105. The results obtained throughout the experimental period suggest that supplementation of chelators, zinc sulphate and silicic acid tend to positively affect average daily gain and feed conversion ratio of pigs for fattening (p < 0.05). Pigs’ evaluation with Piglog 105 showed that thickness of fat in the first and second point was by 4% and 3% respectively higher in comparison to the control group (p < 0.05). Carcass weight, yield, and length, also thickness of fat showed no significant difference among the groups. The water holding capacity of meat in Experimental group was lower by 5.28%, and tenderness – lower by 12% compared with that of the pigs in the Control group (p < 0.05). Regarding pigs’ meat chemical composition of the experimental group, a statistically significant difference comparing with the data of the control group was not determined. Cholesterol concentration in muscles of pigs fed diets supplemented with chelators, zinc sulphate and silicic acid was lower by 7.93 mg/100 g of muscle in comparison to that of the control group. These results suggest that supplementation of chelators, zinc sulphate and silicic acid in the feed for fattening pigs had significant effect on pigs growing performance and meat quality.

Keywords: silicic acid, chelators, meat quality, pigs, zinc sulphate

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5192 In Support of Sustainable Water Resources Development in the Lower Mekong River Basin: Development of Guidelines for Transboundary Environmental Impact Assessment

Authors: Kongmeng Ly

Abstract:

The management of transboundary river basins across developing countries, such as the Lower Mekong River Basin (LMB), is frequently challenging given the development and conservation divergences of the basin countries. Driven by needs to sustain economic performance and reduce poverty, the LMB countries (Cambodia, Lao PDR, Thailand, Viet Nam) are embarking on significant land use changes in the form hydropower dam, to fulfill their energy requirements. This pathway could lead to irreversible changes to the ecosystem of the Mekong River, if not properly managed. Given the uncertain trade-offs of hydropower development and operation, the Lower Mekong River Basin Countries through the technical support of the Mekong River Commission (MRC) Secretariat embarked on decade long the development of Technical Guidelines for Transboundary Environmental Impact Assessment. Through a series of workshops, seminars, national and regional consultations, and pilot studies and further development following the recommendations generated through legal and institutional reviews undertaken over two decades period, the LMB Countries jointly adopted the MRC Technical Guidelines for Transboundary Environmental Impact Assessment (TbEIA Guidelines). These guidelines were developed with particular regard to the experience gained from MRC supported consultations and technical reviews of the Xayaburi Dam Project, Don Sahong Hydropower Project, Pak Beng Hydropower Project, and lessons learned from the Srepok River and Se San River case studies commissioned by the MRC under the generous supports of development partners around the globe. As adopted, the TbEIA Guidelines have been designed as a supporting mechanism to the national EIA legislation, processes and systems in each Member Country. In recognition of the already agreed mechanisms, the TbEIA Guidelines build on and supplement the agreements stipulated in the 1995 Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin and its Procedural Rules, in addressing potential transboundary environmental impacts of development projects and ensuring mutual benefits from the Mekong River and its resources. Since its adoption in 2022, the TbEIA Guidelines have already been voluntary implemented by Lao PDR on its underdevelopment Sekong A Downstream Hydropower Project, located on the Sekong River – a major tributary of the Mekong River. While this implementation is ongoing with results expected in early 2024, the implementation thus far has strengthened cooperation among concerned Member Countries with multiple successful open dialogues organized at national and regional levels. It is hope that lessons learnt from this application would lead to a wider application of the TbEIA Guidelines for future water resources development projects in the LMB.

Keywords: transboundary, EIA, lower mekong river basin, mekong river

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5191 Evaluating Portfolio Performance by Highlighting Network Property and the Sharpe Ratio in the Stock Market

Authors: Zahra Hatami, Hesham Ali, David Volkman

Abstract:

Selecting a portfolio for investing is a crucial decision for individuals and legal entities. In the last two decades, with economic globalization, a stream of financial innovations has rushed to the aid of financial institutions. The importance of selecting stocks for the portfolio is always a challenging task for investors. This study aims to create a financial network to identify optimal portfolios using network centralities metrics. This research presents a community detection technique of superior stocks that can be described as an optimal stock portfolio to be used by investors. By using the advantages of a network and its property in extracted communities, a group of stocks was selected for each of the various time periods. The performance of the optimal portfolios compared to the famous index. Their Sharpe ratio was calculated in a timely manner to evaluate their profit for making decisions. The analysis shows that the selected potential portfolio from stocks with low centrality measurement can outperform the market; however, they have a lower Sharpe ratio than stocks with high centrality scores. In other words, stocks with low centralities could outperform the S&P500 yet have a lower Sharpe ratio than high central stocks.

Keywords: portfolio management performance, network analysis, centrality measurements, Sharpe ratio

Procedia PDF Downloads 124
5190 Reducing Phytic Acid in Rice Grain by Targeted Mutagenesis of a Phospholipase D Gene

Authors: Muhammad Saad Shoaib Khan, Rasbin Basnet, Qingyao Shu

Abstract:

Phospholipids are one of the major classes of lipid comprising 10% of total grain lipid in rice. Phospholipids are the main phosphorus containing lipid in the rice endosperm, contributing to rice palatability and seed storage property. However, in the rice grain, the majority of phosphorus occur in the form of phytic acid and are highly abundant in the bran. Phytic acid, also known as hexaphosphorylated inositol (IP6), are strong chelating agents which reduces the bioavailability of essential dietary nutrients and are therefore less desirable by rice breeders. We used the CRISPR/Cas9 system to generate mutants of a phospholipase D gene (PLDα1), which is responsible for the degradation of phospholipids into phosphatidic acid (PA). In the mutants, we found a significant reduction in the concentration of phytic acid in the grain as compared to the wild-type. The biochemical analysis of the PLDα1 mutants showed that the decrease in production of phosphatidic acid is due to reduced accumulation of CDP-diacylglycerolderived phosphatidylinositol (PI), ultimately leading to lower accumulation of phytic acid in mutants. These results showed that loss of function of PLD in rice leads to lower production of phytic acid, suggesting the potential application of Ospldα1 in breeding rice with less phytic acid.

Keywords: CRISPR/Cas9, phospholipase D, phytic acid, rice

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5189 Cat Stool as an Additive Aggregate to Garden Bricks

Authors: Mary Joy B. Amoguis, Alonah Jane D. Labtic, Hyna Wary Namoca, Aira Jane V. Original

Abstract:

Animal waste has been rapidly increasing due to the growing animal population and the lack of innovative waste management practices. In a country like the Philippines, animal waste is rampant. This study aims to minimize animal waste by producing garden bricks using cat stool as an additive. The research study analyzes different levels of concentration to determine the most efficient combination in terms of compressive strength and durability of cat stool as an additive to garden bricks. The researcher's first collects the cat stool and incinerates the different concentrations. The first concentration is 25% cat stool and 75% cement mixture. The second concentration is 50% cat stool and 50% cement mixture. And the third concentration is 75% cat stool and 25% cement mixture. The researchers analyze the statistical data using one-way ANOVA, and the statistical analysis revealed a significant difference compared to the controlled variable. The research findings show an inversely proportional relationship: the higher the concentration of cat stool additive, the lower the compressive strength of the bricks, and the lower the concentration of cat stool additive, the higher the compressive strength of the bricks.

Keywords: cat stool, garden bricks, cement, concentrations, animal wastes, compressive strength, durability, one-way ANOVA, additive, incineration, aggregates, stray cats

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5188 Social Justice and Castes Discrimination: Experiences of Scheduled Castes Students in India

Authors: Dhaneswar Bhoi

Abstract:

In Indian History, the Dalits (Scheduled Castes) were exploited with caste, since the Vedic Age (1500 BCE). They were deprived of many rights in the society and their education was also restricted by the upper castes since the introduction of the Law of Manu (1500 BCE). The Dalits were treated as lower castes (Sudras and Ati-Sudra) in the society. Occupation of these caste groups were attached to some low profile and menial occupation. Whereas, the upper caste (Brahamins) declared themselves as the top most caste groups who chose the occupation of priests and had the supreme right to education. During those days occupation was not decided by the caliber of a person rather, it was decided by the upper caste Brahamins and kept on transferring from one generation to another generation. At this juncture of the society, the upper caste people oppressed and suppressed the lower caste people endlessly. To get rid of these social problems the emancipator and the charismatic leader (Prophet for the lower caste communities), Dr. Babasaheb Ambedkar appeard in the scene of Indian unjust society. Restlessly he fought against the caste oppression, social dogmas and tyranny on the basis of caste. Finally, he succeeded to affirm statutory safeguards for the oppressed and depressed or lower caste communities. Today these communities are scheduled as Scheduled Castes to access social justice for their upliftment and development. Through the liberty, equality and fraternity, he established social justice for the first time in the Indian history with the implementation of Indian Constitution on 26th January 1950. Since then the social justice has been accessed through the Constitution and Indian Republics. However, even after sixty five years of the Indian Republic and Constitutional safeguards the Scheduled Castes (SCs) are suffering many problems in the phases of their life. Even if there are special provisions made by the state aimed to meet the challenges of the weaker sections, they are still deprived of access to it, which is true especially for the Dalits or SCs. Many of the people of these communities are still not accessing education and particularly, higher education. Those who are managing to access the education have been facing many challenges in their educational premises as well as in their social life. This paper tries to find out the problem of discrimination in educational and societal level. Secondly, this paper aims to know the relation between the discrimination and access to social justice for the SCs in the educational institution and society. It also enquires the experiences of SCs who faced discrimination in their educational and social life. This study is based on the both quantitative and qualitative methods. Both of which were interpreted through the data triangulation method in mixed methodology approach. In this paper, it is found that the SCs are struggling with injustice in their social and educational spheres. Starting from their primary level to higher education, they were discriminated in curricular, co-curricular and extra-curricular activities.

Keywords: social justice, discrimination, caste, scheduled castes, education

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5187 Effect of Foot Posture and Fatigue on Static Balance and Electromyographic Activity of Selected Lower Limb Muscles in School Children Aged 12 to 14 Years

Authors: Riza Adriyani, Tommy Apriantono, Suprijanto

Abstract:

Objective: Several studies have revealed that flatfoot posture has some effect on altered lower limb muscle function, in comparison to normal foot posture. There were still limited studies to examine the effect of fatigue on flatfoot posture in children. Therefore, this study was aimed to find out jumping fatiguing effect on static balance and to compare lower limb muscle function between flatfoot and normal foot in school children. Methods: Thirty junior high school children aged 12 to 14 years took part in this study. Of these all children, 15 had the normal foot (8 males and 7 females) and 15 had flatfoot (6 males and 9 females). Foot posture was classified based on an arch index of the footprint by a foot scanner which calculated the data using AUTOCAD 2013 software. Surface electromyography (EMG) activity was recorded from tibialis anterior, gastrocnemius medialis, and peroneus longus muscles while those participants were standing on one leg barefoot with opened eyes. All participants completed the entire protocol (pre-fatigue data collection, fatigue protocol, and post fatigue data collection) in a single session. Static balance and electromyographic data were collected before and after a functional fatigue protocol. Results: School children with normal foot had arch index 0.25±0.01 whereas those with flatfoot had 0.36±0.01. In fact, there were no significant differences for anthropometric characteristics between children with flatfoot and normal foot. This statistical analysis showed that fatigue could influence static balance in flatfoot school children (p < 0.05), but not in normal foot school children. Based on electromyographic data, the statistical analysis showed that there were significant differences (p < 0.05) of the decreased median frequency on tibialis anterior in flatfoot compared to normal foot school children after fatigue. However, there were no significant differences on the median frequency of gastrocnemius medialis and peroneus longus between both groups. After fatigue, median frequency timing was significantly different (p < 0.05) on tibialis anterior in flatfoot compared to normal foot children and tended to appear earlier on tibialis anterior, gastrocnemius medialis and peroneus longus (at 7s, 8s, 9s) in flatfoot compared to normal foot (at 15s, 11s , 12s). Conclusion: Fatigue influenced static balance and tended to appear earlier on selected lower limb muscles while performing static balance in flatfoot school children. After fatigue, tremor (median frequency decreased) showed more significant differences on tibialis anterior in flatfoot rather than in normal foot school children.

Keywords: fatigue, foot postures, median frequency, static balance

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5186 Microstructure Dependent Fatigue Crack Growth in Aluminum Alloy

Authors: M. S. Nandana, K. Udaya Bhat, C. M. Manjunatha

Abstract:

In this study aluminum alloy 7010 was subjected to three different ageing treatments i.e., peak ageing (T6), over-ageing (T7451) and retrogression and re ageing (RRA) to study the influence of precipitate microstructure on the fatigue crack growth rate behavior. The microstructural modification was studied by using transmission electron microscope (TEM) to examine the change in the size and morphology of precipitates in the matrix and on the grain boundaries. The standard compact tension (CT) specimens were fabricated and tested under constant amplitude fatigue crack growth tests to evaluate the influence of heat treatment on the fatigue crack growth rate properties. The tests were performed in a computer-controlled servo-hydraulic test machine applying a load ratio, R = 0.1 at a loading frequency of 10 Hz as per ASTM E647. The fatigue crack growth was measured by adopting compliance technique using a CMOD gauge attached to the CT specimen. The average size of the matrix precipitates were found to be of 16-20 nm in T7451, 5-6 nm in RRA and 2-3 nm in T6 conditions respectively. The grain boundary precipitate which was continuous in T6, was disintegrated in RRA and T7451 condition. The PFZ width was lower in RRA compared to T7451 condition. The crack growth rate was higher in T7451 and lowest in RRA treated alloy. The RRA treated alloy also exhibits an increase in threshold stress intensity factor range (∆Kₜₕ). The ∆Kₜₕ measured was 11.1, 10.3 and 5.7 MPam¹/² in RRA, T6 and T7451 alloys respectively. The fatigue crack growth rate in RRA treated alloy was nearly 2-3 times lower than that in T6 and was one order lower than that observed in T7451 condition. The surface roughness of RRA treated alloy was more pronounced when compared to the other conditions. The reduction in fatigue crack growth rate in RRA alloy was majorly due to the increase in roughness and partially due to increase in spacing between the matrix precipitates. The reduction in crack growth rate and increase in threshold stress intensity range is expected to benefit the damage tolerant capability of aircraft structural components under service loads.

Keywords: damage tolerance, fatigue, heat treatment, PFZ, RRA

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5185 Dynamic Response of Magnetorheological Fluid Tapered Laminated Beams Reinforced with Nano-Particles

Authors: Saman Momeni, Abolghassem Zabihollah, Mehdi Behzad

Abstract:

Non-uniform laminated composite structures are being used in many engineering applications where the structures are subjected to unpredicted vibration. To mitigate the vibration response of these structures, recently, magnetorheological fluid (MR), is added to non-uniform (tapered) thickness laminated composite structures to achieve a new generation of the smart composite as MR tapered beam. However, due to the nature of MR fluid, especially the low stiffness, MR tapered beam exhibit lower stiffness and in turn, lower natural frequencies. To achieve the basic design requirements of the structure without MR fluid, one may need to apply a predefined magnetic energy to the structures, requiring a constant source of energy. In the present work, a passive initial stiffness control of MR tapered beam has been studied. The effects of adding nanoparticles on the dynamic response of MR tapered beam has been investigated. It is observed that adding nanoparticles up to 3% may significantly modify the natural frequencies of the structures and achieve dynamic behavior of the structures before addition of MR fluid. Two Models of tapered structures have been taken into consideration. It is observed that adding only 3% of nanoparticles backs the structures to its initial dynamic behavior.

Keywords: non uniform laminated structures, MR fluid, nanoparticles, vibration, stiffness

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5184 Vitamin A Status and Its Correlation with the Dietary Intake of Young Females of Lahore, Pakistan

Authors: Sarah Fatima, Ahmad A. Malik, Saima Sadaf

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This study was conducted in order to assess the dietary record and vitamin A status of young females of Lahore. A total sample of 376 consisted of 16 – 20 years of unmarried college going females. Three main tools were adopted: questionnaire, 3-day food diary and serum retinol test. The anthropometric measurements showed that a total of 32.6% of the sample was underweight (BMI < 18.5) and 54.5% had a healthy weight (BMI 18.5 – 22.9). The average Vitamin A intake of the sample was 257.95 µg/day while the RDA for the selected age group was 700 µg/day. The mean energy intake of the adolescents was 1153.64 kcal/ day, whereas the Estimated Energy Requirement (EER) for this age group was 2368 kcal/day. The mean serum Vitamin A level was 24.81µg/dL. 69.6% of the sample was deficient in serum Vitamin A i.e. serum retinol < 24 µg/dL. 30.4% had serum retinol in normal limit (24 – 84 µg/dL) from which 25.3% lied in lower limit (24 – 44 µg/dL) and only 5.1% had serum retinol in 44 – 64 µg/dL range. A slightly negative correlation (r = - 0.21, 95% confidence interval) was found between dietary intake of Vitamin A and serum Vitamin A It was concluded that the dietary intake of major nutrients and vitamin A is not adequate in the selected group. This is also confirmed by the lower serum retinol levels. Hence, vitamin An intake and status are generally inadequate, and vitamin deficiency is prevalent in the unmarried young females of Lahore.

Keywords: vitamin A, young Females, vitamin deficiency, Lahore

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5183 Effects of Porosity Logs on Pore Connectivity and Volumetric Estimation

Authors: Segun S. Bodunde

Abstract:

In Bona Field, Niger Delta, two reservoirs across three wells were analyzed. The research aimed at determining the statistical dependence of permeability and oil volume in place on porosity logs. Of the three popular porosity logs, two were used; the sonic and density logs. The objectives of the research were to identify the porosity logs that vary more with location and direction, to visualize the depth trend of both logs and to determine the influence of these logs on pore connectivity determination and volumetric analysis. The focus was on density and sonic logs. It was observed that the sonic derived porosities were higher than the density derived porosities (in well two, across the two reservoir sands, sonic porosity averaged 30.8% while density derived porosity averaged 23.65%, and the same trend was observed in other wells.). The sonic logs were further observed to have lower co-efficient of variation when compared to the density logs (in sand A, well 2, sonic derived porosity had a co-efficient of variation of 12.15% compared to 22.52% from the density logs) indicating a lower tendency to vary with location and direction. The bulk density was observed to increase with depth while the transit time reduced with depth. It was also observed that for an 8.87% decrease in porosity, the pore connectivity was observed to decrease by about 38%.

Keywords: pore connectivity, co-efficient of variation, density derived porosity, sonic derived porosity

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5182 Caspase-11 and AIM2 Inflammasome are Involved in Smoking-Induced COPD and Lung Adenocarcinoma

Authors: Chiara Colarusso, Michela Terlizzi, Aldo Pinto, Rosalinda Sorrentino

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Cigarette smoking is the main cause and the most common risk factor for both COPD and lung cancer. In our previous studies, we proved that caspase-11 in mice and its human analogue, caspase-4, are involved in lung carcinogenesis and that AIM2 inflammasome might play a pro-cancerous role in lung cancer. Therefore, the aim of this study was to investigate potential crosstalk between COPD and lung cancer, focusing on AIM2 and caspase-11-dependent inflammasome signaling pathway. To mimic COPD, we took advantage of an experimental first-hand smoking mouse model and, to confirm what was observed in mice, we used human samples of lung adenocarcinoma patients stratified according to the smoking and COPD status. We demonstrated that smoke exposure led to emphysema-like features, bronchial tone impairment, and release of IL-1-like cytokines (IL-1α, IL-1β, IL-33, IL-18) in a caspase-1 independent manner in C57Bl/6N. Rather, a dysfunctional caspase-11 in smoke-exposed 129Sv mice was associated to lower bronchial inflammation, collagen deposition, and IL-1-like inflammation. In addition, for the first time, we found that AIM2 inflammasome is involved in lung inflammation in smoking and COPD, in that its expression was higher in smoke-exposed C57Bl/6N compared to 129Sv smoking mice, who instead did not show any alteration of AIM2 in both macrophages and dendritic cells. Moreover, we found that AIM2 expression in the cancerous tissue, albeit higher than non-cancerous tissue, was not statistically different according to the COPD and smoking status. Instead, the higher expression of AIM2 in non-cancerous tissue of smoker COPD patients than smokers who did not have COPD was correlated to a higher hazard ratio of poor survival rate than patients who presented lower levels of AIM2. In conclusion, our data highlight that caspase-11 in mice is associated to smoke-induced lung latent inflammation which could drive the establishment of lung cancer, and that AIM2 inflammasome plays a role at the crosstalk between smoking/COPD and lung adenocarcinoma in that its higher presence is correlated to lower survival rate of smoker COPD adenocarcinoma.

Keywords: COPD, inflammasome, lung cancer, lung inflammation, smoke

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5181 Determinants of Hospital Obstetric Unit Closures in the United States 2002-2013: Loss of Hospital Obstetric Care 2002-2013

Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

Abstract:

Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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