Search results for: risk of non-communicable disease

Authors: Niya Chen, Jennifer Chan

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In the financial market, risk management helps to minimize potential loss and maximize profit. There are two ways to assess risks; the first way is to calculate the risk directly based on the volatility. The most common risk measurements are Value at Risk (VaR), sharp ratio, and beta. Alternatively, we could look at the quantile of the return to assess the risk. Popular return models such as GARCH and stochastic volatility (SV) focus on modeling the mean of the return distribution via capturing the volatility dynamics; however, the quantile/expectile method will give us an idea of the distribution with the extreme return value. It will allow us to forecast VaR using return which is direct information. The advantage of using these non-parametric methods is that it is not bounded by the distribution assumptions from the parametric method. But the difference between them is that expectile uses a second-order loss function while quantile regression uses a first-order loss function. We consider several quantile functions, different volatility measures, and estimates from some volatility models. To estimate the expectile of the model, we use Realized Conditional Autoregressive Expectile (CARE) model with the bayesian method to achieve this. We would like to see if our proposed models outperform existing models in cryptocurrency, and we will test it by using Bitcoin mainly as well as Ethereum.

Keywords: expectile, CARE Model, CARR Model, quantile, cryptocurrency, Value at Risk

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Authors: Mohammad Alkhatatbeh, Nehad Ayoub, Nizar Mhaidat, Nesreen Saadeh, Lisa Lincz

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CD36 is involved in the development of atherosclerosis by enhancing macrophage endocytosis of oxidized-low density lipoproteins and foam cell formation. Soluble CD36 (sCD36) was found to be elevated in type 2 diabetic patients and was supposed to act as a marker of insulin resistance and atherosclerosis. In young subjects, sCD36 was associated with cardiovascular risk factors including obesity and hypertriglyceridemia. This study was conducted to further investigate the relationship between plasma sCD36 and cardiovascular risk factors among middle-aged patients with metabolic syndrome (MetS) and healthy controls. SCD36 concentrations were determined by enzyme-linked immunosorbent assays (ELISA) for 41 patients with MetS and 36 healthy controls. Data for other variables were obtained from patients' medical records. SCD36 concentrations were relatively low compared to most other studies and were not significantly different between the MetS group and controls (P-value=0.17). SCD36 was also not correlated with age, body mass index, glucose, lipid profile, serum electrolytes and blood counts. SCD36 was not significantly different between subjects with obesity, hyperglycemia, dyslipidemia, hypertension or cardiovascular disease and those without these abnormalities (P-value > 0.05). The inconsistency between results reported in this study and other studies may be unique to the study population or be a result of the lack of a reliable standardized method for determining absolute sCD36 concentrations. However, further investigations are required to assess CD36 tissue expression in the study population and to assess the accuracy of various commercially available sCD36 ELISA kits. Thus, the availability of a standardized simple sCD36 ELISA that could be performed in any basic laboratory would be more favorable to the specialized flow cytometry methods that detect CD36+ microparticles if it was to be used as a biomarker.

Keywords: metabolic syndrome, CD36, cardiovascular risk, obesity, type 2 diabetes mellitus

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Authors: Teja Koduru

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Untreated Lyme disease can lead to neurological, cardiac, and dermatological complications. Rapid diagnosis of the erythema migrans (EM) rash, a characteristic symptom of Lyme disease is therefore crucial to early diagnosis and treatment. In this study, we aim to utilize deep learning frameworks including Tensorflow and Keras to create deep convolutional neural networks (DCNN) to detect images of acute Lyme Disease from images of erythema migrans. This study uses a custom database of erythema migrans images of varying quality to train a DCNN capable of classifying images of EM rashes vs. non-EM rashes. Images from publicly available sources were mined to create an initial database. Machine-based removal of duplicate images was then performed, followed by a thorough examination of all images by a clinician. The resulting database was combined with images of confounding rashes and regular skin, resulting in a total of 683 images. This database was then used to create a DCNN with an accuracy of 93% when classifying images of rashes as EM vs. non EM. Finally, this model was converted into a web and mobile application to allow for rapid diagnosis of EM rashes by both patients and clinicians. This tool could be used for patient prescreening prior to treatment and lead to a lower mortality rate from Lyme disease.

Keywords: Lyme, untreated Lyme, erythema migrans rash, EM rash

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Authors: Seyedmohammad Mousavian, Hanlu Fan, Quingliang Tang

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Climate change is emerging as a severe threat to our society, so businesses are expected to take actions to mitigate carbon emissions. However, the actions to be taken depend on managers’ perceptions of climate change risks. Yet, there is scant research on this issue, and understanding of the determinants of corporate perceptions of climate change is extremely limited. The purpose of this study is to close this gap by examining the relationship between perceptions of climate risk and firm-level and country-level factors. In this study, climate change risk captures physical, regulatory, and other risks, and we use data from European companies that participated in CDP from 2010 to 2017. This study reveals those perceptions of climate change risk are significantly positively associated with the environmental, social, and governance score, firm size, and membership in a carbon-intensive sector. In addition, we find that managers in firms operating in a geographic area that is sensitive to the consequences of global warming are more likely to perceive and formally recognize carbon-related risks in their CDP reports.

Keywords: carbon actions, CDP, climate change risk, risk perception

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Authors: Zahra Rakhshan Masoudi, Sona Rostampour Yasouri

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Considering that the only way to save the lives of patients and healthy people who have suffered sudden accidents is blood transfusion, what is important is the presence of the known HCV virus as the most important cause of the disease after blood transfusion. HCV is one of the major global problems, and its transmission through blood causes life-threatening complications and extensive legal, social and economic consequences. On the one hand, unfortunately, there is still no effective vaccine available to prevent HCV. In Iran, the exact statistics of the prevalence of this disease have not yet been fully announced. The main purpose of this study is to investigate the prevalence rate and rapid diagnosis of HCV among those who refer to laboratory centers in Tehran. From spring to winter of 1401 (2022-2023), 2166 blood samples were collected from laboratory centers in Tehran. Blood samples were evaluated for the presence of HCV by Electrochemiluminescence (ECL) and PCR techniques along with specific HCV primers. In general, 36 samples (1.6%) were tested positive by the mentioned techniques. The results indicated that the ECL technique is a sensitive and specific diagnostic method for detecting HCV in the early stages of the disease and can be very helpful and provide the possibility of starting the treatment steps to prevent the exacerbation of the disease earlier. Also, the results of PCR technique showed that PCR is an accurate, sensitive and fast method for definitive diagnosis of HCV. It seems that the incidence rate of this disease is increasing in Iran, and investigating the spread of the disease throughout Iran for a longer period of time in the continuation of our research can be helpful in the future to take the necessary measures to prevent the transmission of the disease to people and the rapid onset Treatment steps for patients with HCV should be carried out.

Keywords: electrochemiluminescence, HCV, PCR, prevalence

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Authors: Ritu Nambiar, Shazia Tariq, Sumaira Jamil, Farida Munawar, Imelda Israell

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GBS has emerged as a leading cause of neonatal infections worldwide and clinical trials have demonstrated that giving IAP was effective in reducing early onset GBS (EOGBS) disease of the newborn. There is no available data on the prevalence of GBS in the UAE, therefore, a retrospective chart analysis of our parturients were done to look at our prevalence. The aim of this study is: 1. To study the prevalence of GBS colonization of parturients at al Rahba Hospital following universal screening between 35-37 week. 2. To look at efficacy of GBS intrapartum antibiotic prophylaxis by NICU admission for EO GBS disease of the newborn. 1) The prevalence of GBS in our patient population is 24.15%. 2) Incidence of EO GBS disease of the newborn was 0.6%.

Keywords: GBS Screening, universal intrapartum antibiotic prophylaxis, parturients, newborn

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Authors: S. U. Kunya, S. A. Mohammad

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Construction projects in Nigeria are characterized with risks emanating from delays and accompanying cost-overruns. The aim of the study was to identify and assess factors constraining the utilization of risk management strategies in the execution of public construction project in North-East Nigeria. Data was collected with the aid of a well-structured questionnaire administered to three identified projects in the North-east. Data collected were analysed using the severity index. Findings revealed political involvement, selection of inexperienced contractors and lack of coordinated public sector strategy as the most severe factors constraining the utilization of risk management strategies. The study recommended that: formulation of laws to prevent negative political meddling in construction projects; selection of experienced, risk-informed contractors; and comprehensive risk assessment and planning on all public construction projects.

Keywords: factors, Nigeria, north-east, public projects, risk management, strategies, utilization

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Authors: Saleh Alzahrani, Halim Boussabaine

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The majority of Public Private Partnership (PPP) are developed based on the rationale that the design, construction, operation, and financing of a public project is to be awarded to a private party within a single contractual framework. PPP project risks normally include the development and construction of a new asset as well as its operation for decades. Undoubtedly the most serious consequences of risks during the construction period are price and time overruns. These events are amongst the most broadly used scenarios in value for money analysis risks. The sources of risk change over the life cycle of a PPP project. In traditional procurement, the public sector normally has to cover all price distress from these risks. At least there is plenty evidence to suggest that price distress is a norm in some of the projects that are delivered under traditional procurement. This paper will find the impact of construction risk factors into actual construction price into PPP projects. The paper will present a brief literature review on PPP risk pricing strategies, and then using system dynamics (SD) to analyses of the risks associated with the estimated project price. Based on the finding from these analyses a risk pricing association model is presented and discussed. The paper concludes with thoughts for future research.

Keywords: Public Private Partnership (PPP), Risk, Risk Pricing, System Dynamics (SD), construction price

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Authors: Rezvan Hosseinian

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: disease subsets, hand radiography, joint erosion, sclerosis

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Authors: Nasrin Azarbani

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal

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Authors: Montserrat Guillen, Stephania Mosquera-Lopez, Jorge Uribe

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An empirical study of market risk transmission between electricity prices in the Nord Pool interconnected market is done. Crucially, it is differentiated between risk propagation in the two tails of the price variation distribution. Thus, the downside risk from upside risk spillovers is distinguished. The results found document an asymmetric nature of risk and risk propagation in the two tails of the electricity price log variations. Risk spillovers following price increments in the market are transmitted to a larger extent than those after price reductions. Also, asymmetries related to both, the size of the transaction area and related to whether a given area behaves as a net-exporter or net-importer of electricity, are documented. For instance, on the one hand, the bigger the area of the transaction, the smaller the size of the volatility shocks that it receives. On the other hand, exporters of electricity, alongside countries with a significant dependence on renewable sources, tend to be net-transmitters of volatility to the rest of the system. Additionally, insights on the predictive power of positive and negative semivariances for future market volatility are provided. It is shown that depending on the forecasting horizon, downside and upside shocks to the market are featured by a distinctive persistence, and that upside volatility impacts more on net-importers of electricity, while the opposite holds for net-exporters.

Keywords: electricity prices, realized volatility, semivariances, volatility spillovers

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Authors: Suliman Khan, Rabeea Siddique, Mengzhou Xue

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Background: Patients with neurological disorders often display altered circadian rhythms. The disrupted circadian rhythms through chronic jetlag or shiftwork are thought to increase the risk and severity of human disease, including cancer, psychiatric, and related brain diseases. In this study, we investigated the impact of shiftwork or chronic jetlag (CJL) like conditions on mice’s brains. Transcriptome profiling based on RNA sequencing revealed that genes associated with serious neurological disorders were differentially expressed in the nucleus accumbens (NAc) and prefrontal cortex (PFC). According to the qPCR analysis, several key regulatory genes associated with neurological disorders were significantly altered in the NAc, PFC, hypothalamus, hippocampus, and striatum. Serotonin levels and the expression levels of serotonin transporters and receptors were significantly altered in mice treated with CJL. Overall, these results indicate that CJL may increase the risk of neurological disorders by disrupting the key regulatory genes, biological functions, serotonin, and corticosterone. These molecular linkages can further be studied to investigate the mechanism underlying CJL or shiftwork-mediated neurological disorders in order to develop treatment strategies.

Keywords: chronic jetlag, molecular profiles, brain disorders, circadian rhythms

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Authors: Zidane Abderrezzaq

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In contrast to recent successful developments in macro monetary policies, the modelling, measurement and management of systemic financial stability has remained problematical. Indeed, the focus of most effort has been on improving individual, rather than systemic, bank risk management; the Basel II objective has been to bring regulatory bank capital into line with the (sophisticated) banks’ assessment of their own economic capital. Even at the individual bank level there are concerns over appropriate diversification allowances, differing objectives of banks and regulators, the need for a buffer over regulatory minima, and the distinction between expected and unexpected losses (EL and UL). At the systemic level the quite complex and prescriptive content of Basel II raises dangers of ‘endogenous risk’ and procyclicality. Simulations suggest that this latter could be a serious problem. In an extension to the main analysis we study how liquidity effects interact with banking structure to produce a greater chance of systemic breakdown. We finally consider how the risk of contagion might depend on the degree of asymmetry (tiering) inherent in the structure of the banking system. A number of our results have important implications for public policy, which this paper also draws out.

Keywords: systemic stability, financial regulation, credit risk, systemic risk

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Authors: Wassamon Kun-Amornpong

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When a financial crisis occurs, there will be a law and regulatory reform in order to manage the turmoil and prevent a future crisis. One of the most important regulatory efforts to help cope with systemic risk and a financial crisis is the third version of the Basel Accord. Basel III has introduced some measures and tools (e.g., systemic risk buffer, countercyclical buffer, capital conservation buffer and liquidity risk) in order to mitigate systemic risk. Nevertheless, the effectiveness of these measures in Basel III in adequately addressing the problem of contagious runs that can quickly spread throughout the financial system is questionable. This paper seeks to contribute to the knowledge regarding the role of the Basel Accords in mitigating systemic risk. The research question is to what extent the Basel Accords can help control systemic risk in the financial markets? The paper tackles this question by analysing the concept of systemic risk. It will then examine the weaknesses of the Basel Accords before and after the Global financial crisis in 2008. Finally, it will suggest some possible solutions in order to improve the Basel Accord. The rationale of the study is the fact that academic works on systemic risk and financial crises are largely studied from economic or financial perspective. There is comparatively little research from the legal and regulatory perspective. The finding of the paper is that there are some problems in all of the three pillars of the Basel Accords. With regards to Pillar I, the risk model is excessively complex while the benefits of its complexity are doubtful. Concerning Pillar II, the effectiveness of the risk-based supervision in preventing systemic risk still depends largely upon its design and implementation. Factors such as organizational culture of the regulator and the political context within which the risk-based supervision operates might be a barrier against the success of Pillar II. Meanwhile, Pillar III could not provide adequate market discipline as market participants do not always act in a rational way. In addition, the too-big-to-fail perception reduced the incentives of the market participants to monitor risks. There has been some development in resolution measure (e.g. TLAC and MREL) which might potentially help strengthen the incentive of the market participants to monitor risks. However, those measures have some weaknesses. The paper argues that if the weaknesses in the three pillars are resolved, it can be expected that the Basel Accord could contribute to the mitigation of systemic risk in a more significant way in the future.

Keywords: Basel accords, financial regulation, risk-based supervision, systemic risk

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Authors: Anton Bahtiar, Lukas Tjandra Leksana, Fransiscus D. Suyatna

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Hypercholesterolemia is one of the major risk factors that can trigger the development of cardiovascular disease, especially coronary heart disease. One of the traditional drugs used for hypercholesterolemia is a combination of herbs celery (Apium graveolens) and garlic (Allium sativum). This study aimed to investigate the effects of the extract on lipid profile in hypercholesterolemic subjects. Subjects consisted of patients with traditional medicine clinic in Jakarta. Each subject received treatment capsules containing herbal extract and placebo capsules. On the 44 subjects, the lipid profile was examined blood levels of total cholesterol, HDL, LDL, and triglycerides. Paired two-tailed t-test was used for the difference between lipid profile of the therapy group and the placebo group. The changes in the lipid profile between the treatment groups and the placebo group for total cholesterol, HDL, LDL, and triglycerides was 14,82 ± 6,946;1.45 ± 2,945;6,98 ± 8,105;2,48 ± 6,504 mg/dL. The herbal extract decrease blood cholesterol and LDL levels significantly (P <0.05).

Keywords: Allium sativum, Apium graveolens, hypercholesterolemia, cholesterol, HDL, LDL

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Authors: Maria C. Proença, Maria T. Rebelo, Maria J. Alves, Sofia Cunha

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Vector-borne diseases are transmitted to humans by mosquitos, sandflies, bugs, ticks, and other vectors. Some are re-transmitted between vectors, if the infected human has a new contact when his levels of infection are high. The vector is infected for lifetime and can transmit infectious diseases not only between humans but also from animals to humans. Some vector borne diseases are very disabling and globally account for more than one million deaths worldwide. The mosquitoes from the complex Culex pipiens sl. are the most abundant in Portugal, and we dispose in this moment of a data set from the surveillance program that has been carried on since 2006 across the country. All mosquitos’ species are included, but the large coverage of Culex pipiens sl. and its importance for public health make this vector an interesting candidate to assess risk of disease amplification. This work focus on ports and airports identified as key areas of high density of vectors. Mosquitoes being ectothermic organisms, the main factor for vector survival and pathogen development is temperature. Minima and maxima local air temperatures for each area of interest are averaged by month from data gathered on a daily basis at the national network of meteorological stations, and interpolated in a geographic information system (GIS). The range of temperatures ideal for several pathogens are known and this work shows how to use it with the meteorological data in each port and airport facility, to focus an efficient implementation of countermeasures and reduce simultaneously risk transmission and mitigation costs. The results show an increased alert with decreasing latitude, which corresponds to higher minimum and maximum temperatures and a lower amplitude range of the daily temperature.

Keywords: human health, risk assessment, risk management, vector-borne diseases

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Authors: Leonard Simoni, Ilir Alimehmeti, Ervina Shirka, Endri Hasimi, Ndricim Kallashi, Verona Beka, Suerta Kabili, Artan Goda

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Background: Diabetes Mellitus type 2, small vessel calibre, stented length of vessel, complex lesion morphology, and prior bypass surgery have resulted risk factors for In-Stent Restenosis (ISR). However, there are some contradictory results about body mass index (BMI) as a risk factor for ISR. Purpose: We want to identify clinical, lesional and procedural factors that can predict clinical ISR in our patients. Methods: Were enrolled 759 patients who underwent first-time elective PCI with Bare Metal Stents (BMS) from September 2011 to December 2013 in our Department of Cardiology and followed them for at least 1.5 years with a median of 862 days (2 years and 4 months). Only the patients re-admitted with ischemic heart disease underwent control coronary angiography but no routine angiographic control was performed. Patients were categorized in ISR and non-ISR groups and compared between them. Multivariate analysis - Binary Logistic Regression: Forward Conditional Method was used to identify independent predictive risk factors. P was considered statistically significant when <0.05. Results: ISR compared to non-ISR individuals had a significantly lower BMI (25.7±3.3 vs. 26.9±3.7, p=0.004), higher risk anatomy (LM + 3-vessel CAD) (23% vs. 14%, p=0.03), higher number of stents/person used (2.1±1.1 vs. 1.75±0.96, p=0.004), greater length of stents/person used (39.3±21.6 vs. 33.3±18.5, p=0.01), and a lower use of clopidogrel and ASA (together) (95% vs. 99%, p=0.012). They also had a higher, although not statistically significant, prevalence of Diabetes Mellitus (42% vs. 32%, p=0.072) and a greater number of treated vessels (1.36±0.5 vs. 1.26±0.5, p=0.08). In the multivariate analysis, Diabetes Mellitus type 2 and multiple stents used were independent predictors risk factors for In-Stent Restenosis, OR 1.66 [1.03-2.68], p=0.039, and OR 1.44 [1.16-1.78,] p=0.001, respectively. On the other side higher BMI and use of clopidogrel and ASA together resulted protective factors OR 0.88 [0.81-0.95], p=0.001 and OR 0.2 [0.06-0.72] p=0.013, respectively. Conclusion: Diabetes Mellitus and multiple stents are strong predictive risk factors, whereas the use of clopidogrel and ASA together are protective factors for clinical In-Stent Restenosis. Paradoxically High BMI is a protective factor for In-stent Restenosis, probably related to a larger diameter of vessels and consequently a larger diameter of stents implanted in these patients. Further studies are needed to clarify this finding.

Keywords: body mass index, diabetes mellitus, in-stent restenosis, percutaneous coronary intervention

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Authors: Kingston Rajiah, Mari Kannan Maharajan, Si Jen Yeen, Sara Lew

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder with evolving layers of complexity. Both motor and non-motor symptoms of PD may affect patients’ quality of life (QoL). Life expectancy for an individual with Parkinson’s disease depends on the level of care the individual has access to, can have a direct impact on length of life. Therefore, improvement of the QoL is a significant part of therapeutic plans. Patients with PD, especially those who are in advanced stages, are in great need of assistance, mostly from their family members or caregivers in terms of medical, emotional, and social support. The role of a caregiver becomes increasingly important with the progression of PD, the severity of motor impairment and increasing age of the patient. The nature and symptoms associated with PD can place significant stresses on the caregivers’ burden. As the prevalence of PD is estimated to more than double by 2030, it is important to recognize and alleviate the burden experienced by caregivers. This study focused on the impact of the clinical features on the QoL of PD patients, and of their caregivers. This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr Staging of Parkinson's Disease were used to assess the severity and Parkinson's disease activities of daily living scale were used to assess the disability of Parkinson’s disease patients. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. At least one of the clinical features affected PD patients’ QoL, and at least one of the QoL domains affected the caregivers’ burden. Clinical features ‘Saliva and Drooling’, and ‘Dyskinesia’ explained 29% of variance in QoL of PD patients. The QoL domains ‘stigma’, along with ‘emotional wellbeing’ explained 48.6% of variance in caregivers’ burden. Clinical features such as saliva, drooling and dyskinesia affected the QoL of PD patients. The PD patients’ QoL domains such as ‘stigma’ and ‘emotional well-being’ influenced their caregivers’ burden.

Keywords: carers, quality of life, clinical features, Malaysia

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Authors: Abraham J. Rizkalla, Tristan D. Yan

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Purpose: Durable mitral valve repair is preferred to a replacement, avoiding the need for anticoagulation or re-intervention, with a reduced risk of endocarditis. Robotic mitral repair has been gaining favour globally as a safe, effective, and reproducible method of minimally invasive valve repair. In this work, we showcase the use of the Davinci© Xi robotic platform to perform several advanced techniques, working synergistically to achieve successful mitral repair in advanced mitral disease. Techniques: We present the case of a Barlow type mitral valve disease with a tall and redundant posterior leaflet resulting in severe mitral regurgitation and systolic anterior motion. Firstly, quadrangular resection of P2 is performed to remove the excess and redundant leaflet. Secondly, a sliding leaflet plasty of P1 and P3 is used to reconstruct the posterior leaflet. To anchor the newly formed posterior leaflet to the papillary muscle, CV-4 Goretex neochordae are fashioned using the innovative string, ruler, and bulldog technique. Finally, mitral valve annuloplasty and closure of a patent foramen ovale complete the repair. Results: There was no significant residual mitral regurgitation and complete resolution of the systolic anterior motion of the mitral valve on post operative transoesophageal echocardiography. Conclusion: This work highlights the robotic approach to complex repair techniques for advanced mitral valve disease. Familiarity with resection and sliding plasty, neochord implantation, and annuloplasty allows the modern cardiac surgeon to achieve a minimally-invasive and durable mitral valve repair when faced with complex mitral valve pathology.

Keywords: robotic mitral valve repair, Barlow's valve, sliding plasty, neochord, annuloplasty, quadrangular resection

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Authors: Sharaf S. Omar

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In the current study, level and prevalence of deoxynivalenol (DON), aflatoxin B1 AFB1), zearalenone (ZEN), and ochratoxin A (OTA) in fried poultry eggs in Jordan was investigated. Poultry egg samples (n = 250) were collected. The level of DON, AFB1, ZEN and OTA in the white and yolk of poultry eggs was measured using LC-MS-MS. The health risk assessment was calculated using Margin of Exposures (MOEs) for AFB1 and OTA and hazard index (HI) for ZEN and DON. The highest prevalence in yolk and white of eggs was related to ZEN (96.56%) and OTA (97.44%), respectively. Also, the highest level in white and yolk was related to DON (1.07µg/kg) and DON (1.65 µg/kg), respectively. Level of DON in the yolk of eggs was significantly higher than white of eggs (P-value < 0.05). Risk assessment indicated that exposed population are at high risk of AFB1 (MOEs < 10,000) in fried poultry eggs.

Keywords: mycotoxins 2, aflatoxin b1, risk assessment, poultry egg

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Authors: Charuvan Kasemsap

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This research was studied in Bangnampriao District, Chachernsao Province, Thailand. The primary data relating to flooding, drought, and saline intrusion problem on agriculture were collected by surveying, focus group, and in-depth interview with agricultural officers, technical officers of irrigation department, and local government leader of Bangnampriao District. The likelihood and consequence of risk were determined the risk index by risk assessment matrix. In addition, the risk index and the total coping capacity scores were investigated the vulnerability index by vulnerability matrix. It was found that the high-risk drought and saline intrusion was dramatically along Bang Pakong River owing to the end destination of Chao Phraya Irrigation system of Central Thailand. This leads yearly the damage of rice paddy, mango tree, orchard, and fish pond. Therefore, some agriculture avoids rice growing during January to May, and also pumps fresh water from a canal into individual storage pond. However, Bangnampriao District will be strongly affected by the impacts of climate change. Monthly precipitations are expected to decrease in number; dry seasons are expected to be more in number and longer in duration. Thus, the risk and vulnerability of agriculture are also increasing. Adaptation strategies need to be put in place in order to enhance the resilience of the agriculture.

Keywords: agriculture, bangnampriao, climate change, risk assessment

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Authors: H. N. Agiza, M. A. Sohaly, M. A. Elfouly

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Parkinson's disease (PD) is a heterogeneous disorder with common age of onset, symptoms, and progression levels. In this paper we will solve analytically the PD model as a non-linear delay differential equation using the steps method. The step method transforms a system of delay differential equations (DDEs) into systems of ordinary differential equations (ODEs). On some numerical examples, the analytical solution will be difficult. So we will approximate the analytical solution using Picard method and Taylor method to ODEs.

Keywords: Parkinson's disease, step method, delay differential equation, two delays

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Authors: Qisheng Hu, Jianglei Han, Yue Yang, My Hoa Ha

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When a company is considering purchasing software for commercial use, contract risk assessment is critical to identify risks to mitigate the potential adverse business impact, e.g., security, financial and regulatory risks. Contract risk assessment requires reviewers with specialized knowledge and time to evaluate the legal documents manually. Specifically, validating contracts for a software vendor requires the following steps: manual screening, interpreting legal documents, and extracting risk-prone segments. To automate the process, we proposed a framework to assist legal contract document risk identification, leveraging pre-trained deep learning models and natural language processing techniques. Given a set of pre-defined risk evaluation problems, our framework utilizes the pre-trained transformer-based models for question-answering to identify risk-prone sections in a contract. Furthermore, the question-answering model encodes the concatenated question-contract text and predicts the start and end position for clause extraction. Due to the limited labelled dataset for training, we leveraged transfer learning by fine-tuning the models with the CUAD dataset to enhance the model. On a dataset comprising 287 contract documents and 2000 labelled samples, our best model achieved an F1 score of 0.687.

Keywords: contract risk assessment, NLP, transfer learning, question answering

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

Abstract:

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

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

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Authors: Shripad Kulkarni

Abstract:

Plant disease is an impairment of the normal state of a plant that interrupts or modifies its vital functions. Disease occurs on different parts of plants and cause heavy losses. Diagnosis of Problem is very important before planning any management practice and this can be done based on appearance of the crop, examination of the root and examination of the soil. There are various types of diseases such as biotic (transmissible) which accounts for ~30% whereas , abiotic (not transmissible) diseases are the major one with ~70% incidence. Plant diseases caused by different groups of organism’s belonging fungi, bacteria, viruses, nematodes and few others have remained important in causing significant losses in different crops indicating the urgent need of their integrated management. Various factors favor disease development and different steps and methods are involved in management of diseases under protected condition. Management of diseases through botanicals and bioagents by modifying root and aerial environment, vector management along with care to be taken while managing the disease are analysed.

Keywords: organic production system, diseases, bioagents and polyhouse, agriculture

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Authors: Yuxi Wang, Xuan Gao

Abstract:

Traditional Chinese medicine has been used in the treatment of coronary heart disease (CHD) for centuries, and in recent years, the research data on the efficacy of traditional Chinese medicine through clinical trials has gradually increased to explore its real efficacy and internal pharmacology. However, due to the complexity of traditional Chinese medicine prescriptions, the efficacy of each component is difficult to clarify, and pharmacological research is challenging. This study aims to systematically review and clarify the clinical efficacy of traditional Chinese medicine in the treatment of coronary heart disease through a meta-analysis. Based on PubMed, CNKI database, Wanfang data, and other databases, eleven randomized controlled trials and 1091 CHD subjects were included. Two researchers conducted a systematic review of the papers and conducted a meta-analysis supporting the positive therapeutic effect of traditional Chinese medicine in the treatment of CHD.

Keywords: coronary heart disease, Chinese medicine, treatment, meta-analysis

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Authors: Manoel Pereira, Alvaro Veiga, Camila Epprecht, Renato Costa

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This paper introduces an empirical version of the Esscher transform for risk-neutral option pricing. Traditional parametric methods require the formulation of an explicit risk-neutral model and are operational only for a few probability distributions for the returns of the underlying. In our proposal, we make only mild assumptions on the pricing kernel and there is no need for the formulation of the risk-neutral model for the returns. First, we simulate sample paths for the returns under the physical distribution. Then, based on the empirical Esscher transform, the sample is reweighted, giving rise to a risk-neutralized sample from which derivative prices can be obtained by a weighted sum of the options pay-offs in each path. We compare our proposal with some traditional parametric pricing methods in four experiments with artificial and real data.

Keywords: esscher transform, generalized autoregressive Conditional Heteroscedastic (GARCH), nonparametric option pricing

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Authors: Nicholas Agyepong, Paul Gyan

Abstract:

Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Mahzad Yousefi, Azin Tavakoli

Abstract:

Periodontal disease is an inflammatory reaction; therefore, it is predicted that changes may occur in some inflammatory parameters that can be detected in routine blood tests. The objective of this study was to evaluate the hematological and biochemistry changes that occur in dogs affected with advanced stages of periodontal disease. 87 dogs were diagnosed with periodontal disease (PD group), and 76 healthy dogs entered the study. The PD dogs had been affected with periodontitis stage 3 or 4 and were candidates for any dental extractions. The healthy dogs were either referred for annual checkups or for issuing health travel certificates that their owners asked for complete lab tests. Neither the diseased nor healthy subjects had a history of infectious, or other general health problems or surgery in the past 3 months. Age, as well as all hematologic including PCV, WBC and RBC count, Hb, MCV, MCH, MCHC, PLT, CBC, NLR, and biochemistry data, including total protein, albumin, glucose, BUN, Creatinine, ALT, AST, and ALP, were recorded and analyzed statistically. Results confirmed that aging has a significant direct relationship with the advanced stages of periodontal disease. Mild leukocytosis occurred in the diseased group; however, it was not significant. Also, the mean total protein of the PD group was lower than that of the healthy dogs, and serum levels of albumin were found to be lower significantly in the diseased group (P<0.05). Mean ±SD amount of Platelet, MCH, and ALT were significantly higher in the diseased group in comparison to the healthy dogs (P<0.05). No significant differences were reported in other evaluated parameters. It is concluded that CBC indices of PD dogs are not systemic inflammatory; however, only a decrease in albumin showed inflammatory responses. Some indices in routine laboratory tests can be changed significantly during advanced stages of the periodontal disease dogs.

Keywords: periodontal disease, dogs, hematological factors, advanced stages, blood tests

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Authors: Małgorzata Tomczyńska, Joanna Saluk-Bijak

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Background: Graves’ disease is a frequent organ-specific autoimmune thyroid disease, which characterized by the presence of different kind autoantibodies, that, in most cases, act as agonists of the thyrotropin receptor, leading to hyperthyroidism. Role of platelets and lymphocytes can be modulated in the pathophysiology of thyroid autoimmune diseases. Interference in the physiology of platelets can lead to enhanced activity of these cells. Activated platelets can bind to circulating lymphocytes and to affect lymphocyte adhesion. Platelets and lymphocytes can regulate mutual functions. Therefore, the activation of T lymphocytes, as well as blood platelets, is associated with the development of inflammation and oxidative stress within the target tissue. The present study was performed to investigate a platelet-lymphocyte relation by assessing the degree of their mutual aggregation in whole blood of patients with Graves’ disease. Also, the purpose of this study was to examine the impact of platelet interaction on lymphocyte migration capacity. Methods: 30 patients with Graves’ disease were recruited in the study. The matched 30 healthy subjects were served as the control group. Immunophenotyping of lymphocytes was carried out by flow cytometry method. A CytoSelect™ Cell Migration Assay Kit was used to evaluate lymphocyte migration and adhesion to blood platelets. Visual assessment of lymphocyte-platelet aggregate morphology was done using confocal microscope after magnetic cell isolation by Miltenyi Biotec. Results: The migration and functional responses of lymphocytes to blood platelets were greater in the group of Graves’ disease patients compared with healthy controls. The group of Graves’ disease patients exhibited a reduced T lymphocyte and a higher B cell count compared with controls. Based on microscopic analysis, more platelet-lymphocyte aggregates were found in patients than in control. Conclusions: Studies have shown that in Graves' disease, lymphocytes show increased platelet affinity, more strongly migrating toward them, and forming mutual cellular conglomerates. This may be due to the increased activation of blood platelets in this disease.

Keywords: blood platelets, cell migration, Graves’ disease, lymphocytes, lymphocyte-platelet aggregates

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