Search results for: tail risk

Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

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Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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Authors: Mostafa Aminzadeh, Min Deng

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Modeling loss data is an important part of actuarial science. Actuaries use models to predict future losses and manage financial risk, which can be beneficial for marketing purposes. In the insurance industry, small claims happen frequently while large claims are rare. Traditional distributions such as Normal, Exponential, and inverse-Gaussian are not suitable for describing insurance data, which often show skewness and fat tails. Several authors have studied classical and Bayesian inference for parameters of composite distributions, such as Exponential-Pareto, Weibull-Pareto, and Inverse Gamma-Pareto. These models separate small to moderate losses from large losses using a threshold parameter. This research introduces a computational approach using a nonlinear regression model for loss data that relies on multiple predictors. Simulation studies were conducted to assess the accuracy of the proposed estimation method. The simulations confirmed that the proposed method provides precise estimates for regression parameters. It's important to note that this approach can be applied to datasets if goodness-of-fit tests confirm that the composite distribution under study fits the data well. To demonstrate the computations, a real data set from the insurance industry is analyzed. A Mathematica code uses the Fisher information algorithm as an iteration method to obtain the maximum likelihood estimation (MLE) of regression parameters.

Keywords: maximum likelihood estimation, fisher scoring method, non-linear regression models, composite distributions

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Authors: Luay Alsalmi

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Background: Facial filler is the most common type of cosmetic surgery next to botox. Permanent filler is preferred nowadays due to the low cost brought about by non-recurring injection appointments. However, such fillers pose a higher risk for complications, with even greater adverse effects when the procedure is done using unknown dermal filler injections. AIM: This study aimed to establish an algorithm to categorize and manage patients that receive permanent fillers. Materials and Methods: Twelve participants were presented to the service through emergency or as outpatient from November 2015 to May 2021. Demographics such as age, sex, date of injection, time of onset, and types of complications were collected. After examination, all cases were managed based on an algorithm established. FACE-Q was used to measure overall satisfaction and psychological well-being. Results: The algorithm to diagnose and manage these patients effectively with a high satisfaction rate was established in this study. All participants were non-smoker females with no known medical comorbidities. The algorithm presented determined the treatment plan when faced with complications. Results revealed high appearance-related psychosocial distress was observed prior to surgery, while it significantly dropped after surgery. FACE-Q was able to establish evidence of satisfactory ratings among patients prior to and after surgery. Conclusion: This treatment algorithm can guide the surgeon in formulating a suitable plan with fewer complications and a high satisfaction rate.

Keywords: facial filler, FACE-Q, psycho-social stress, botox, treatment algorithm

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Authors: Nazanin Ahmadi Daryakenari

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Background: Diabetes significantly influences the risk of heart failure. The interplay between distinct types of diabetes, heart failure, and their distribution across various age groups remains an area of active exploration. This study endeavors to scrutinize the age group distribution in publications addressing Type 1 and Type 2 diabetes and heart failure on PubMed while also examining the evolving publication trends. Methods: We leveraged E-utilities and RegEx to search and extract publication data from PubMed using various mesh terms. Subsequently, we conducted descriptive statistics and t-tests to discern the differences between the two diabetes types and the distribution across age groups. Finally, we analyzed the temporal trends of publications concerning both types of diabetes and heart failure. Results: Our findings revealed a divergence in the age group distribution between Type 1 and Type 2 diabetes within heart failure publications. Publications discussing Type 2 diabetes and heart failure were more predominant among older age groups, whereas those addressing Type 1 diabetes and heart failure displayed a more balanced distribution across all age groups. The t-test revealed no significant difference in the means between the two diabetes types. However, the number of publications exploring the relationship between Type 2 diabetes and heart failure has seen a steady increase over time, suggesting an escalating interest in this area. Conclusion: The dissection of publication patterns on PubMed uncovers a pronounced association between Type 2 diabetes and heart failure within older age groups. This highlights the critical need to comprehend the distinct age group differences when examining diabetes and heart failure to inform and refine targeted prevention and treatment strategies.

Keywords: Type 1 diabetes, Type 2 diabetes, heart failure, age groups, publication patterns, PubMed

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Authors: Shirin Abbas, Sandeep Kumar Dubey

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Intimate partner violence (IPV) is one of the most common forms of gender-based violence (GBV) and is classified as discrimination on the basis of gender. Article 2 of the non-binding UN Declaration on the Elimination of Violence against Women (DEVAW). This was adopted in 1993 as the first international pronouncement regarding violence against women, including physical, sexual, and psychological violence in the family (i.e., domestic violence, marital rape, battery, statutory rape, rape by male members of the family, etc.) While crime against women continues unabated, the Indian government has strongly refuted the 2018 study by the Thomson Reuters Foundation categorizing India as a risky country for women due to the high risk of sexual violence and being forced into slave labour, according to a poll of global experts. This paper has explored consent, agency, and abuse through the lens of intimate partner violence among women from lower income groups in smart cities in the state of Uttar Pradesh, India. Using focused mapping, the paper has explored the situation on IPV internationally and studied the status of working women from lower income groups to ascertain if their lot was any different where IPV was concerned to study. The findings of the study also vindicate global reports which rate India as a country unsafe for women, even within marriage.

Keywords: consent and agency, domestic violence, gender based violence GBV, intimate partner violence IPV

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Authors: Nima Pirhadi, Shao Yong Bo, Xusheng Wan, Jianguo Lu, Jilei Hu

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Although gravels and gravelly soils are assumed to be non-liquefiable because of high conductivity and small modulus; however, the occurrence of this phenomenon in some historical earthquakes, especially recently earthquakes during 2008 Wenchuan, Mw= 7.9, 2014 Cephalonia, Greece, Mw= 6.1 and 2016, Kaikoura, New Zealand, Mw = 7.8, has been promoted the essential consideration to evaluate risk assessment and hazard analysis of seismic gravelly soil liquefaction. Due to the limitation in sampling and laboratory testing of this type of soil, in situ tests and site exploration of case histories are the most accepted procedures. Of all in situ tests, dynamic penetration test (DPT), Which is well known as the Chinese dynamic penetration test, and shear wave velocity (Vs) test, have been demonstrated high performance to evaluate seismic gravelly soil liquefaction. However, the lack of a sufficient number of case histories provides an essential limitation for developing new models. This study at first investigates recent earthquakes that caused liquefaction in gravelly soils to collect new data. Then, it adds these data to the available literature’s dataset to extend them and finally develops new models to assess seismic gravelly soil liquefaction. To validate the presented models, their results are compared to extra available models. The results show the reasonable performance of the proposed models and the critical effect of gravel content (GC)% on the assessment.

Keywords: liquefaction, gravel, dynamic penetration test, shear wave velocity

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Authors: Glyn Atwal, Douglas Bryson

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The rapid expansion of a consumer class in India has also coincided with an increasing awareness of social and environmental issues. The overall objective of this study explores to what extent Corporate Social Responsibility (CSR) can lead to luxury brand avoidance within an Indian context. In-depth interviews were conducted with luxury consumers in New Delhi. The demographic breakdown of those interviewed was 16 males and 9 females, aged between 21 and 44. Antecedents of brand avoidance could be sorted according to two main categories. The first category was consumer dissatisfaction due to poor product or service performance. Customer service, particularly within the hospitality sector, was identified as a defining source of brand avoidance. The second category was negative stereotypes of brand users. A salient finding was that no single participant explicitly identified CSR as a source of brand avoidance. However, the interviews revealed that luxury consumers are in fact concerned about CSR issues but assume that international luxury brands have a positive record on CSR performance. Interestingly, participants placed greater emphasis on the broader interpretation of ‘corporate reputation’ rather than specific social or environmental issues to determine the CSR performance of a luxury brand. The findings reported in this exploratory study suggest that Indian luxury consumers do value the overall CSR performance of luxury brands expressed as a brand responsibility or brand reputation, and this is a potential source of brand avoidance. International luxury brands need, therefore, consider developing but also communicating a positive CSR strategy in order to reduce the risk of customers forming negative opinions about the brand.

Keywords: brand avoidance, CSR, luxury

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Authors: Muhammad SAFDAR, Mehmet Ozaslan, Musarrat Abbas Khan

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Babesiosis is a haemoparasitic disease due to the multiplication of protozoan’s parasite, Babesia ovis in the red blood cells of the host, and contributes numerous economical losses, including sheep and goat ruminants. The early identification and successful treatment of Babesia Ovis spp. belong to the key steps of control and health management of livestock resources. The objective of this study was to construct a polymerase chain reaction (PCR) based method for the detection of Babesia spp. in small ruminants and to determine the risk factors involved in the spreading of babesiosis infections. A total of 100 blood samples were collected from 50 sheep and 50 goats along with different areas of Muzaffargarh, Pakistan, from randomly selected herds. Data on the characteristics of sheep and goats were collected through questionnaires. Of 100 blood samples examined, 18 were positive for Babesia ovis upon microscopic studies, whereas 11 were positive for the presence of Babesia spp. by PCR assay. For the recognition of parasitic DNA, a set of 500bp oligonucleotide was designed by PCR amplification with sequence 18S rRNA gene for B. ovis. The prevalence of babesiosis in small ruminant’s sheep and goat detected by PCR was significantly higher in female animals (28%) than male herds (08%). PCR analysis of the reference samples showed that the detection limit of the PCR assay was 0.01%. Taken together, all data indicated that this PCR assay was a simple, fast, specific detection method for Babesia ovis species in small ruminants compared to other available methods.

Keywords: Babesia ovis, PCR amplification, 18S rRNA, sheep and goat

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Authors: Niklas Bondesson

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Purpose: This paper attempts to examine how different facets of attitudinal brand loyalty are determined by different brand image elements in business markets. Design/Methodology/Approach: Statistical analysis is employed to data from a web survey, covering 226 professional packaging buyers in eight countries. Findings: The results reveal that different brand loyalty facets have different antecedents. Affective brand loyalties (or loyalty 'feelings') are mainly driven by customer associations to service relationships, whereas customers’ loyalty intentions (to purchase and recommend a brand) are triggered by associations to the general reputation of the company. The findings also indicate that willingness to pay a price premium is a distinct form of loyalty, with unique determinants. Research implications: Theoretically, the paper suggests that corporate B2B brand loyalty needs to be conceptualised with more refinement than has been done in extant B2B branding work. Methodologically, the paper highlights that single-item approaches can be fruitful when measuring B2B brand loyalty, and that multi-item scales can conceal important nuances in terms of understanding why customers are loyal. Practical implications: The idea of a loyalty 'silver metric' is an attractive idea, but this study indicates that firms who rely too much on one single type of brand loyalty risk to miss important building blocks. Originality/Value/Contribution: The major contribution is a more multi-faceted conceptualisation, and measurement, of corporate B2B brand loyalty and its brand image determinants than extant work has provided.

Keywords: brand equity, business-to-business branding, industrial marketing, buying behaviour

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Authors: Ali Kuzu

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There are about 800 thousand chemicals in our environment and the number is increasing more than a thousand every year. While most of these chemicals are used as components in various consumer products, some are faced as industrial waste in the environment. Unfortunately, many of these chemicals are hazardous and affect humans. According to the “International Program on Chemical Safety” of World Health Organization; Among the chronic health effects of chemicals, cancer is of major concern. Many substances have found in recent years to be carcinogenic in one or more species of laboratory animals. Especially with respect to long-term effects, the response to a chemical may vary, quantitatively or qualitatively, in different groups of individuals depending on predisposing conditions, such as nutritional status, disease status, current infection, climatic extremes, and genetic features, sex and age of the individuals. Understanding the response of such specific risk groups is an important area of toxicology research. People with age 65+ is defined as “aged (or elderly)”. The elderly population in the world is about 600 million, which corresponds to ~8 percent of the world population. While every 1 of each 4 people is aged in Japan, the elderly population is quite close to 20 percent in many developed countries. And elderly population in these countries is growing more rapidly than the total population. The negative effects of chemicals on elderly take an important place in health-care related issues in last decades. The aged population is more susceptible to the harmful effects of environmental chemicals. According to the poor health of the organ systems in elderly, the ability of their body to eliminate the harmful effects and chemical substances from their body is also poor. With the increasing life expectancy, more and more people will face problems associated with chemical residues.

Keywords: elderly, chemicals’ effects, aged care, care need

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Authors: Maria Luisa Nozawa Ribeiro, Maria Teresa Miceli Kerbauy

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This paper aims to present the theories of public participation in order to understand the context of the public GMO (Genetic Modified Organisms) policies in Brazil, highlighting the characteristics of its configuration and the dialog with the experts. As a controversy subject, the commercialization of GMO provoked manifestation of some popular and environmental representative groups questioning the decisions of policy makers and experts on the matter. Many aspects and consequences of the plantation and consumption of this crops emerged and the safety of this technology was questioned. Environmentalists, Civil Right's movement, representatives of rural workers, farmers and organics producers, etc. demonstrated their point of view, also sustained by some experts of medical, genetical, environmental, agronomical sciences, etc. fields. Despite this movement, the precautionary principle (risk management), implemented in 1987, suggested precaution facing new technologies and innovations in the sustainable development society. This principle influenced many legislation and regulation on GMO around the world, including Brazil, which became a reference among the world regulatory GMO systems. The Brazilian legislation ensures the citizens participation on GMO discussion, characteristic that was important to establish the connection between the subject and the participation theory. These deliberation spaces materialized in Brazil through the "Public Audiences", which are managed by the National Biosafety Technical Commission (CTNBio), the department responsible for controlling the research, production and commercialization of GMOs in Brazil.

Keywords: public engagement, public participation, science and technology studies, transgenic politics

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Suraj Sharma

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Green infrastructure (GI) offers a contemporary approach for reducing the risk of flooding, improve water quality, and harvesting stormwater for sustainable use. GI promotes landscape planning to enhance sustainable development and urban resilience. However, the existing literature is lacking in ensuring the comprehensive assessment of GI performance in terms of ecosystem function and services for social, ecological, and economical system resilience. We propose a robust indicator set and fuzzy comprehensive evaluation (FCE) for quantitative and qualitative analysis for sustainable water management to assess the capacity of urban resilience. Green infrastructure in urban resilience water management system (GIUR-WMS) supports decision-making for GI planning through scenario comparisons with urban resilience capacity index. To demonstrate the GIUR-WMS, we develop five scenarios for five sectors of Chandigarh (12, 26, 14, 17, and 34) to test common type of GI (rain barrel, rain gardens, detention basins, porous pavements, and open spaces). The result shows the open spaces achieve the highest green infrastructure urban resilience index of 4.22/5. To implement the open space scenario in urban sites, suitable vacant can be converted to green spaces (example: forest, low impact recreation areas, and detention basins) GIUR-WMS is easy to replicate, customize and apply to cities of different sizes to assess environmental, social and ecological dimensions.

Keywords: green infrastructure, assessment, urban resilience, water management system, fuzzy comprehensive evaluation

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Authors: Erez Yerushalmi, Sani Ziv

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The rising demand for healthcare services, without a corresponding rise in public supply, led to a debate on whether to increase private healthcare provision - especially in hospital services and second-tier healthcare. Proponents for increasing private healthcare highlight gains in efficiency, while opponents its risk to social welfare. None, however, provide a measure of the social value and its impact on the economy in terms of a monetary value. In this paper, we impute a minimum social value of public healthcare that corresponds to indifference between gains in efficiency, with losses to social welfare. Our approach resembles contingent valuation methods that introduce a hypothetical market for non-commodities, but is different from them because we use numerical simulation techniques to exploit certain market failure conditions. In this paper, we develop a general equilibrium model that distinguishes between public-private healthcare services and public-private financing. Furthermore, the social value is modelled as a by product of healthcare services. The model is then calibrated to our unique health focused Social Accounting Matrix of Israel, and simulates the introduction of a hypothetical health-labour market - given that it is heavily regulated in the baseline (i.e., the true situation in Israel today). For baseline parameters, we estimate the minimum social value at around 18% public healthcare financing. The intuition is that the gain in economic welfare from improved efficiency, is offset by the loss in social welfare due to a reduction in available social value. We furthermore simulate a deregulated healthcare scenario that internalizes the imputed value of social value and searches for the optimal weight of public and private healthcare provision.

Keywords: contingent valuation method (CVM), general equilibrium model, hypothetical market, private-public healthcare, social value of public healthcare

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Authors: Ru-Yin Yang, Chi Wu, Cheng-Yu Tsai, Yin-Tzu Lin, Wen-Te Liu

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Background: Sleep breathing disorder (SDB) is a condition demonstrated by recurrent episodes of the airway obstruction leading to intermittent hypoxia and quality fragmentation during sleep time. However, the procedures for SDB severity examination remain complicated and costly. Objective: The objective of this study is to establish a simplified examination method for SDB by the respiratory impendence pattern sensor combining the signal processing and machine learning model. Methodologies: We records heart rate variability by the electrocardiogram and respiratory pattern by impendence. After the polysomnography (PSG) been done with the diagnosis of SDB by the apnea and hypopnea index (AHI), we calculate the episodes with the absence of flow and arousal index (AI) from device record. Subjects were divided into training and testing groups. Neuron network was used to establish a prediction model to classify the severity of the SDB by the AI, episodes, and body profiles. The performance was evaluated by classification in the testing group compared with PSG. Results: In this study, we enrolled 66 subjects (Male/Female: 37/29; Age:49.9±13.2) with the diagnosis of SDB in a sleep center in Taipei city, Taiwan, from 2015 to 2016. The accuracy from the confusion matrix on the test group by NN is 71.94 %. Conclusion: Based on the models, we established a prediction model for SDB by means of the wearable sensor. With more cases incoming and training, this system may be used to rapidly and automatically screen the risk of SDB in the future.

Keywords: sleep breathing disorder, apnea and hypopnea index, body parameters, neuron network

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Authors: Yung-Feng Yen, Yun-Ju Lai

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Background: Animal studies have shown that alcohol exposure may cause immunosuppression and increase the susceptibility to tuberculosis (TB) infection. However, the temporality of alcohol consumption with subsequent TB development remains unclear. This nationwide population-based cohort study aimed to investigate the impact of alcohol exposure on TB development in Taiwanese adults. Methods: We included 46 196 adult participants from three rounds (2001, 2005, 2009) of the Taiwan National Health Interview Survey. Alcohol consumption was classified into heavy, regular, social, or never alcohol use. Heavy alcohol consumption was defined as intoxication at least once/week. Alcohol consumption and other covariates were collected by in-person interviews at baseline. Incident cases of active TB were identified from the National Health Insurance database. Multivariate logistic regression was used to estimate the association between alcohol consumption and active TB, with adjustment for age, sex, smoking, socioeconomic status, and other covariates. Results: A total of 279 new cases of active TB occurred during the study follow-up period. Heavy (adjusted odds ratio [AOR], 5.21; 95% confident interval [CI], 2.41-11.26) and regular alcohol use (AOR, 1.73; 95% CI, 1.26-2.38) were associated with higher risks of incident TB after adjusting for the subject demographics and comorbidities. Moreover, a strong dose-response effect was observed between increasing alcohol consumption and incident TB (AOR, 2.26; 95% CI, 1.59-3.21; P <.001). Conclusion: Heavy and regular alcohol consumption were associated with higher risks of active TB. Future TB control programs should consider strategies to lower the overall level of alcohol consumption to reduce the TB disease burden.

Keywords: alcohol consumption, tuberculosis, risk factor, cohort study

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Authors: James Killian, Sarah Cox

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The use of stability criteria within geotechnical engineering is the way the results of analyses are conveyed, and sensitivities and risk assessments are performed. Historically, the primary stability criteria for slope design has been the Factor of Safety (FOS) coming from a limit calculation. Increasingly, the value derived from Strength Reduction Factor (SRF) analysis is being used as the criteria for stability analysis. The purpose of this work was to study in detail the relationship between SRF values produced from a numerical modeling technique and the traditional FOS values produced from Limit Equilibrium (LEM) analyses. This study utilized a model of a 3000-foot-high slope with a 45-degree slope angle, assuming a perfectly plastic mohr-coulomb constitutive model with high cohesion and friction angle values typical of a large hard rock mine slope. A number of variables affecting the values of the SRF in a numerical analysis were tested, including zone size, in-situ stress, tensile strength, and dilation angle. This paper demonstrates that in most cases, SRF values are lower than the corresponding LEM FOS values. Modeled zone size has the greatest effect on the estimated SRF value, which can vary as much as 15% to the downside compared to FOS. For consistency when using SRF as a stability criteria, the authors suggest that numerical model zone sizes should not be constructed to be smaller than about 1% of the overall problem slope height and shouldn’t be greater than 2%. Future work could include investigations of the effect of anisotropic strength assumptions or advanced constitutive models.

Keywords: FOS, SRF, LEM, comparison

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Authors: Anisa Suraya Ab Razak, Izza Hayat

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Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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Authors: Danielle Preziuso, Kamila Kazimierczuk, Annalise Stein, Bethel Tarekegne

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Coastal communities experience a variety of distinct socioeconomic, technical, and environmental vulnerabilities, all of which accrue heightened risk with increasingly frequent and severe climate change impacts. Marine renewable energy (MRE) offers a potential solution for mitigating coastal community vulnerabilities, especially water-energy dependencies while delivering promising co-benefits such as increased resilience and more sustainable energy outcomes. This paper explores coastal community vulnerabilities and service dependencies based on the local drivers that create them, with attention to climate change impacts and how they catalyze water-energy unmet needs in these communities. We examine the vulnerabilities through the lens of coastal Tribal communities (i.e., the Makah Tribe, the Kenaitze Tribe, Quinault Nation), as indigenous communities often face compounded impacts of technical, economic, and environmental vulnerabilities due to their underlying socio-demographic inequalities. We offer an environmental and energy justice indicators framework to understand how these vulnerabilities disproportionately manifest and impact the most vulnerable community members, and we subsequently utilize the framework to inform a weighted decision matrix tool that compares the viability of MRE-based alternative energy futures in addressing these vulnerabilities. The framework and complementary tool highlight opportunities for future MRE research and pilot demonstrations that directly respond to the vulnerabilities of coastal communities.

Keywords: coastal communities, decision matrix, energy equity, energy vulnerability, marine energy, service dependency

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Authors: Sibusiso Trevor Tshabalala, Samuel Lubbe, Vince Vuledzani Ndou

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Dependency on chemicals has had many disadvantages in pest management control strategies. Such genetic rodenticide resistance and secondary exposure risk are what is currently being experienced. Emphasis on integrated pest management suggests that to control future pests, early intervention and economic threshold development are key starting points in crop production. The significance of this research project is to help establish a relationship between Giant African Land Snail (Achatina Fulica) solution extract, its shell chemical properties, and farmer’s perceptions of biological control in eThekwini Municipality Agri-hubs. A mixed design approach to collecting data will be explored using a trial layout in the field and through interviews. The experimental area will be explored using a split-plot design that will be replicated and arranged in a randomised complete block design. The split-plot will have 0, 10, 20 and 30 liters of water to one liter of snail solution extract. Plots were 50 m² each with a spacing of 12 m between each plot and a plant spacing of 0.5 m (inter-row) ‘and 0.5 m (intra-row). Trials will be irrigated using sprinkler irrigation, with objective two being added to the mix every 4-5 days. The expected outcome will be improved soil fertility and micro-organisms population proliferation.

Keywords: giant african land snail, integrated pest management, photosynthesis, genetic rodenticide resistance, control future pests, shell chemical properties

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Authors: Hongxin Zhao, Shibing Yang, Bingming Yi, Yi Ning

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Background: A few studies have found evidence that exposure to endogenous or postmenopausal exogenous estrogens may be associated with a lower prevalence of age-related macular degeneration (AMD), but dispute over this association is ongoing due to inconsistent results reported by different studies. Objectives: To conduct a systematic review and meta-analysis to investigate the association between hormone replacement therapy (HRT) use and AMD. Methods: Relevant studies that assessed the association between HRT and AMD were searched through four databases (PubMed, Web of Science, Cochrane Library, EMBASE) and reference lists of retrieved studies. Study selection, data extraction and quality assessment were conducted by three independent reviewers. The fixed-effect meta-analyses were performed to estimate the association between HRT ever-use and AMD by pooling risk ratio (RR) or odds ratio (OR) across studies. Results: The review identified 2 prospective and 7 cross-sectional studies with 93992 female participants that reported an estimate of the association between HRT ever-use and presence of early AMD or late AMD. Meta-analyses showed that there were no statistically significant associations between HRT ever-use and early AMD (pooled RR for cohort studies was 1.04, 95% CI 0.86 - 1.24; pooled OR for cross-sectional studies was 0.91, 95% CI 0.82 - 1.01). The pooled results from cross-sectional studies also showed no statistically significant association between HRT ever-use and late AMD (OR 1.01; 95% CI 0.89 - 1.15). Conclusions: The pooled effects from observational studies published to date indicate that HRT use is associated with neither early nor late AMD. Exposure to HRT may not protect women from developing AMD.

Keywords: hormone replacement therapy, age-related macular degeneration, meta-analysis, systematic review

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Authors: Abdelmounaim Lahrech, Hajar Bousfiha

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This paper examines equity market integration between Morocco and France and its consequent implications on international portfolio diversification. In the absence of stock market linkages, Morocco can act as a diversification destination to European investors, allowing higher returns at a comparable level of risk in developed markets. In contrast, this attractiveness is limited if both financial markets show significant linkage. The research empirically measures financial market’s integration in by capturing the conditional correlation between the two markets using the Generalized Autoregressive Conditionally Heteroscedastic (GARCH) model. Then, the research uses the Dynamic Conditional Correlation (DCC) model of Engle (2002) to track the correlations. The research findings show that there is no important increase over the years in the correlation between the Moroccan and the French equity markets, even though France is considered Morocco’s first trading partner. Failing to prove evidence of the stock index linkage between the two countries, the volatility series of each market were assumed to change over time separately. Yet, the study reveals that despite the important historical and economic linkages between Morocco and France, there is no evidence that equity markets follow. The small correlations and their stationarity over time show that over the 10 years studied, correlations were fluctuating around a stable mean with no significant change at their level. Different explanations can be attributed to the absence of market linkage between the two equity markets.

Keywords: equity market linkage, DCC GARCH, international portfolio diversification, Morocco, France

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Authors: Oluwatofunmi Musa-Ajakaiye, Paul Olorunfemi M.D MPH, John Obafaiye

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Introduction: The U.S Food and Drug Administration (FDA) reports the public notices for recalled FDA-regulated products over periods of time. It study reviewed the primary reasons for recalls of products of various types over a period of 7 years. Methods: The study analyzed data provided in the FDA’s archived recalls for the years 2010-2017. It identified the various reasons for product recalls in the categories of foods, beverages, drugs, medical devices, animal and veterinary products, and dietary supplements. Using SPSS version 29, descriptive statistics and chi-square analysis of the data were performed. Results (numbers, percentages, p-values, chi-square): Over the period of analysis, a total of 931 recalls were reported. The most frequent reason for recalls was undeclared products (36.7%). The analysis showed that the most recalled product type in the data set was foods and beverages, representing 591 of all recalled products (63.5%).In addition, it was observed that foods and beverages represent 77.2% of products recalled due to the presence of microorganisms. Also, a sub-group analysis of recall reasons of food and beverages found that the most prevalent reason for such recalls was undeclared products (50.1%) followed by Listeria (17.3%) then Salmonella (13.2%). Conclusion: This analysis shows that foods and beverages have the greatest percentages of total recalls due to the presence of undeclared products listeria contamination and Salmonella contamination. The prevalence of Salmonella and Listeria contamination suggests that there is a high risk of microbial contamination in FDA-approved products and further studies on the effects of such contamination must be conducted to ensure consumer safety.

Keywords: food, beverages, listeria, salmonella, FDA, contamination, microbial

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Authors: Riddhi Shukla, Rajeshri Patel, Prakruti Buch, Tejas Sharma, Mihir Raval, Navin Sheth

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Many classical drugs are claimed to have blood sugar lowering properties that make them valuable for people with or at high risk of type 2 diabetes. Vijaysar (Pterocarpus marsupium) and Gaumutra (Indian cow urine) both have been shown antidiabetic property since primordial time and both shows synergistic effect in combination for hypoglycaemic activity. The study was undertaken to investigate the hypoglycaemic and anti-diabetic effects of the combination of Vijaysar and Gaumutra which is a classical preparation mentioned in Ayurveda named as Pramehari ark. Rats with Type 2 diabetes which is induced by streptozotocin (STZ, 35mg/kg) given a high-fat diet for one month and compared with normal rats. Diabetic rats showed raised level of body weight, triglyceride (TG), total cholesterol, HDL, LDL, and D-glucose concentration and other serum, cardiac and hypertrophic parameters in comparison of normal rats. After treatment of different doses of drug the level of parameters like TG, total cholesterol, HDL, LDL, and D-glucose concentration found to be decreased in standard as well as in treatment groups. In addition treatment groups also found to be decreased in the level of serum markers, cardiac markers, and hypertrophic parameters. The findings demonstrated that Pramehari ark prevented the pathological progression of type 2 diabetes in rats.

Keywords: cow urine, hypoglycemic effect, synergic effect, type 2 diabetes, vijaysar

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

Procedia PDF Downloads 164

Authors: Shubeska Stratrova S., Muca A., Panovska S. Clinic of endocrinology, diabetes, metabolic disorders, Medical Faculty, Skopje, N. Macedonia

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Rationale: Obese subjects have a high energy density diet, low physical activity levels, a sedentary lifestyle, as well as eating disorders, which are considered important risk factors for the development of obesity. Methods: In order to discover the imbalance of energy intake and energy expenditure in obese women (W), two groups of examinees answered questionnaires regarding nutrition and physical activity: 1st group of women with normal body mass index (BMI <25 kg/m²) and 2nd group of obese women with BMI >30 kg/m². Results: 61.11% of obese W from the 2nd group reported good appetite, which was higher than the 1st group (45%). In 55.56% W, frustrations were a provocation for over nutrition. In the 2nd group, 38.89% W ate too much compared to 9.09% W from the 1st group. In the ²ⁿᵈ group, 35.29% W reported consuming food rarely and too much, while 29.41% W reported consuming food often and too much. All examinees from the ²ⁿᵈ group had consumed food in less than 5 hours, compared to only 8.33% W from the ¹ⁿᵈ group and had consumed hyper-caloric food. Consumption of fruits and vegetables was lower in the 2nd group compared to the 1st group. Half of the subjects in the 2nd group were physically inactive, compared to only 8% in the 1st group. All of the examinees in the 2nd group walked for less than 3 hours a day, compared to 54% in the 1st group. In the 2nd group, 67% W reported watching TV very often, 39% reported watching TV longer than 3 hours, which is significantly higher than 8.33% W in the 1st group. Overall, 81.25% of examinees from the 2nd group reported sitting for more than 3 hours a day, which is significantly more compared to the 1st group (45.45%). Conclusions: Obese women are less physically active, have a sedentary lifestyle, good appetite, and consume too much hyper-caloric food very often.

Keywords: (W) obese women, BMI(Body mass Index), nutrition, hyper-caloric food

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Authors: Holly D. Shan, Monique L. Bautista Neughebauer

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Sunscreen usage is emphasized in public health strategy as it reduces the risk of sunburns and skin cancers. This study aims to explore factors that influence sun protective behavior and outcomes. Data was received from the National Health Interview Survey (NHIS) 2020. Adults were asked how often they wore sunscreen when outside on a sunny day. Consistent use (“always”) of sunscreen, the incidence of sunburn within a year, and ever having a diagnosis of skin melanoma were compared by gender, race, and the diagnosis of anxiety, depression, and dementia. Individuals identifying as a mixed race were excluded. Statistical analysis was adjusted for large-scale surveys using STATA VSN 7.0, and a two-sided p<0.05 was considered significant. Of the 37,352 participants (53.18% females, 75.01% white, 10.49% black, 0.76% Indian Americans,5.60% Asian), 13.11% had a diagnosis of anxiety, 14.78% depression, and 0.84% dementia. Females wore sunscreen more often than males (24.72% vs. 10.91%, p<0.001). White individuals wore sunscreen most frequently; black individuals the least (17.37% vs. 6.49%, p<0.001). White individuals had the highest rate of sunburn (25.61%, p<0.001) and a history of skin melanoma (3.38%, p<0.001). Participants with anxiety, depression, and dementia all had statistically significantly decreased sunscreen use and increased frequency of sunburn compared to the general population. Only those with dementia had an increased incidence of skin melanoma (2.85% vs. 1.22%, p=0.009). Dermatologists and public health professionals should consider gender, race, and psychiatric comorbidities when counseling patients on sun protection.

Keywords: sun protective behavior, psychiatric disorder, melanoma, sunburn

Procedia PDF Downloads 90

Authors: Aravella Flores, Jose Rafael E. Sotelo, Luis Romulus Phillippe R. Javier, Josh Christian V. Nunez

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This study focuses on analyzing the performance of Grade 12 STEM students of De La Salle University - Integrated School that has completed the Disaster Readiness and Risk Reduction course in handling fire hazards through Minecraft Java Edition. This platform is suitable because fire DRRR is challenging to learn in a practical setting as well as questionable with regard to supplementing the successful implementation of textbook knowledge into actual practice. The purpose of this study is to acknowledge whether Minecraft can be a suitable environment to familiarize oneself to fire DRRR. The objectives are achieved through utilizing Minecraft in simulating fire scenarios which allows the participants to freely act upon and practice fire DRRR. The experiment was divided into the grounding and validation phase, where researchers observed the performance of the participants in the simulation. A pre-simulation and post-simulation survey was given to acknowledge the change in participants’ perception of being able to utilize fire DRRR procedures and their vulnerabilities. The paired t-test was utilized, showing significant differences in the pre-simulation and post-simulation survey scores, thus, insinuating improved judgment of DRRR, lessening their vulnerabilities in the possibility of encountering a fire hazard. This research poses a model for future research which can gather more participants and dwell on more complex codes outside just command blocks and into the code lines of Minecraft itself.

Keywords: minecraft, DRRR, fire, disaster, simulation

Procedia PDF Downloads 137

Authors: B. Tiseo, V. Quaranta, G. Bruno, G. Sisinni

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There is an increasing demand of nano-satellite development among universities, small companies, and emerging countries. Low-cost and fast-delivery are the main advantages of such class of satellites achieved by the extensive use of commercial-off-the-shelf components. On the other side, the loss of reliability and the poor success rate are limiting the use of nano-satellite to educational and technology demonstration and not to the commercial purpose. Standardization of nano-satellite environmental testing by tailoring the existing test standard for medium/large satellites is then a crucial step for their market growth. Thus, it is fundamental to find the right trade-off between the improvement of reliability and the need to keep their low-cost/fast-delivery advantages. This is particularly even more essential for satellites of CubeSat family. Such miniaturized and standardized satellites have 10 cm cubic form and mass no more than 1.33 kilograms per 1 unit (1U). For this class of nano-satellites, the qualification process is mandatory to reduce the risk of failure during a space mission. This paper reports the description and results of the space qualification test campaign performed on Endurosat’s CubeSat nano-satellite and modules. Mechanical and environmental tests have been carried out step by step: from the testing of the single subsystem up to the assembled CubeSat nano-satellite. Functional tests have been performed during all the test campaign to verify the functionalities of the systems. The test duration and levels have been selected by tailoring the European Space Agency standard ECSS-E-ST-10-03C and GEVS: GSFC-STD-7000A.

Keywords: CubeSat, nano-satellite, shock, testing, vibration

Procedia PDF Downloads 186

Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

Procedia PDF Downloads 88