Search results for: Charlson comorbidity score

Authors: Masri Baharom

Abstract:

The purpose of the study is to identify the age group of children 9 who have experienced delays in gross motor development. Instrument used in this study is Test Gross Motor Development / TGMD-2 (Ulrich, 2000) which was adopted at the international level. Gross motor development data were obtained by video recording (Sony (DRC-SR42 with a 40x optical zoom capability, and software Ultimate Studio 14) on locomotor and manipulative skills. A total n = 192 persons, children of 9 years (9.30 ± .431) at Sekolah Kebangsaan Mutiara Perdana, Bayan Lepas, Penang were involved as subjects. Children age 9 years experienced delays AELS (4.61 ± .69), AEMS (5:52 ± .62) and GMDQ (7.26 ± .2.14). The findings based on descriptive rating indicated that the performance of children age 9 years acquired low levels of AELS, MSS, AEMS and very low in LSS and GMDS.

Keywords: gross motor development score, locomotor standard score, age equivalent locomotor score, manipulative standard score, age equivalent manipulative score

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Authors: Volker Wannack

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The aim of this paper is to present a concept for addressing the Oracle Problem in the context of hydrogen production using renewable energy sources. The proposed approach relies on the authentication of the electricity used for hydrogen production by multiple surrounding actors with similar electricity generation facilities, which attest to the authenticity of the electricity production. The concept introduces an Authenticity Score assigned to each certificate, as well as a Trust Score assigned to each witness. Each certificate must be attested by different actors with a sufficient Trust Score to achieve an Authenticity Score above a predefined threshold, thereby demonstrating that the produced hydrogen is indeed "green."

Keywords: hydrogen, blockchain, sustainability, structural change

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Authors: Salehah Tahkin, Norlaila Mustafa, Dayang Anita Abdul Aziz

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Knowledge of medical ethics is important to all practitioners so the best care can be delivered to all patients through safe practice. Surgeons are not exceptions to this. Knowledge, attitude, and practice (KAP) of medical ethics among paediatric surgeons and trainees in Malaysia has not been evaluated before. This study aims to determine the level of KAP regarding medical ethics among these groups. This was a cross-sectional study involving three groups of samples, i.e., paediatric surgeons (PS), paediatric surgical trainees (PST), and medical officers with a special interest in paediatric surgery (MO). A validated KAP questionnaire was used. Standard formulas were used to calculate objective indexes for measuring KAP, which were then compared for statistical significance across different sample groups; p less than 0.05 is taken as significant. The index is rated into 5 classes using a score of 0 to 10, i.e., poor (1-2.99), fair (3-4.99), good (5-6.99), very good (7-8.99), and excellent (9-10). There were 117 samples, i.e., PS n=45 (38.5%), PST n=25 (21.3%), and MO n=47 (40.2%). For knowledge, all three groups display a good index score (mean score of 5.44). For attitude, PS and MO also display an index score of good (mean score of 5.81), while the PST index score was fair (4.82). For practice, our study shows a highest score of 7.14 (very good) among PST. However, these differences were not statistically significant (p> 0.05). Conclusion: Training in paediatric surgery must continue to emphasize professionalism and medical ethics education to deliver the best health care services.

Keywords: KAP, medical ethics, paediatric, surgeons, trainees

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Authors: Nafisa Banu

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The present study is an attempt to analyze the regional disparities in the level of education in West Bengal. The data based on secondary sources obtained from a census of India. The study is divided into four sections. The first section presents introductions, objectives and brief descriptions of the study area, second part discuss the methodology and data base, while third and fourth comprise the empirical results, interpretation, and conclusion respectively. For showing the level of educational development, 8 indicators have been selected and Z- score and composite score techniques have been applied. The present study finds out there are large variations of educational level due to various historical, economical, socio-cultural factors of the study area.

Keywords: education, regional disparity, literacy rate, Z-score, composite score

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Authors: Ahmad Hashim, Masri Baharom

Abstract:

The purpose of the study is to identify the age group of children 9 who have experienced delays in gross motor development. Instrument used in this study is Test Gross Motor Development / TGMD-2 (Ulrich, 2000) which was adopted at the international level. Gross motor development data were obtained by video recording (Sony (DRC-SR42 with a 40x optical zoom capability, and software Ultimate Studio 14) on locomotor and manipulative skills. A total n = 192 persons, children of 9 years (9.30 ± .431) at Sekolah Kebangsaan Mutiara Perdana, Bayan Lepas, Penang were involved as subjects. Children age 9 years experienced delays AELS (4.61 ± .69), AEMS (5:52 ± .62) and GMDQ (7.26 ± .2.14). The findings based on descriptive rating indicated that the performance of children age 9 years acquired low levels of AELS, MSS, AEMS and very low in LSS and GMDS.

Keywords: gross motor development score, locomotor standard score, age equivalent locomotor score, manipulative standard score, age equivalent manipulative score

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Hatem A. El-Mezayen, Hossam Darwesh

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Background/Aim: Hepatocellular carcinoma (HCC) is often diagnosed at advanced stage where effective therapies are lacking. Identification of new scoring system is needed to discriminate HCC patients from those with chronic liver disease. Based on the link between vascular endothelial growth factor (VEGF) and HCC progression, we aimed to develop a novel score based on combination of VEGF and routine laboratory tests for early prediction of HCC. Methods: VEGF was assayed for HCC group (123), liver cirrhosis group (210) and control group (50) by Enzyme Linked Immunosorbent Assay (ELISA). Data from all groups were retrospectively analyzed including α feto protein (AFP), international normalized ratio (INR), albumin and platelet count, transaminases, and age. Areas under ROC curve were used to develop the score. Results: A novel index named hepatocellular carcinoma-vascular endothelial growth factor score (HCC-VEGF score)=1.26 (numerical constant) + 0.05 ×AFP (U L-1)+0.038 × VEGF(ng ml-1)+0.004× INR –1.02 × Albumin (g l-1)–0.002 × Platelet count × 109 l-1 was developed. HCC-VEGF score produce area under ROC curve of 0.98 for discriminating HCC patients from liver cirrhosis with sensitivity of 91% and specificity of 82% at cut-off 4.4 (ie less than 4.4 considered cirrhosis and greater than 4.4 considered HCC). Conclusion: Hepatocellular carcinoma-VEGF score could replace AFP in HCC screening and follow up of cirrhotic patients.

Keywords: Hepatocellular carcinoma, cirrhosis, HCV, diagnosis, tumor markers

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Authors: Nicholas Marinus Batt, Angus Radford, Khaled Saraya

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Pulmonary Embolus Severity Index (PESI) score is a well-validated decision-making score grading mortality rates (MR) in patients with a suspected or confirmed diagnosis of pulmonary embolism (PE) into 5 classes. Thirty and 90 days MR in class I and II are lower allowing the treatment of these patients as outpatients. In a London District General Hospital (DGH) with mixed ethnicity and high disease burden, we looked at MR at 1, 3, and 7 days of all PESI score classes. Our pilot study of 112 patients showed MR of 0% in class I, II, and III. The current study includes positive Computed Tomographic Scans (CT scans) for PE over the following three years (total of 555). MR was calculated for all PESI score classes at 1, 3 & 7 days. Thirty days MR was additionally calculated to validate the study. Our initial results so far are in line with our pilot studies. Further subgroup analysis accounting for the local co-morbidities and disease burden and its impact on the MR will be undertaken.

Keywords: Pulmonary Embolism (PE), Pulmonary Embolism Severity Index (PESI) score, mortality rate (MR), CT pulmonary artery

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Authors: Faiza Belbachir, Thibault Schienhinski

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The massive development of online social networks allows users to post and share their opinions on various topics. With this huge volume of opinion, it is interesting to extract and interpret these information for different domains, e.g., product and service benchmarking, politic, system of recommendation. This is why opinion detection is one of the most important research tasks. It consists on differentiating between opinion data and factual data. The difficulty of this task is to determine an approach which returns opinionated document. Generally, there are two approaches used for opinion detection i.e. Lexical based approaches and Machine Learning based approaches. In Lexical based approaches, a dictionary of sentimental words is used, words are associated with weights. The opinion score of document is derived by the occurrence of words from this dictionary. In Machine learning approaches, usually a classifier is trained using a set of annotated document containing sentiment, and features such as n-grams of words, part-of-speech tags, and logical forms. Majority of these works are based on documents text to determine opinion score but dont take into account if these texts are really correct. Thus, it is interesting to exploit other information to improve opinion detection. In our work, we will develop a new way to consider the opinion score. We introduce the notion of trust score. We determine opinionated documents but also if these opinions are really trustable information in relation with topics. For that we use lexical SentiWordNet to calculate opinion and trust scores, we compute different features about users like (numbers of their comments, numbers of their useful comments, Average useful review). After that, we combine opinion score and trust score to obtain a final score. We applied our method to detect trust opinions in TRIPADVISOR collection. Our experimental results report that the combination between opinion score and trust score improves opinion detection.

Keywords: Tripadvisor, opinion detection, SentiWordNet, trust score

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Authors: Wangxu Xia

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BACKGROUND BI-RADS 4 lesions raise the possibility of malignancy that warrant further clinical and radiologic work-up. This study aimed to evaluate the predictive performance of diffusion-weighted imaging(DWI) and microcalcifications on mammography for predicting malignancy of BI-RADS 4 lesions. In addition, the predictive performance of DWI combined with microcalcifications was alsocompared with the Kaiser score. METHODS During January 2021 and June 2023, 144 patients with 178 BI-RADS 4 lesions underwent conventional MRI, DWI, and mammography were included. The lesions were dichotomized intobenign or malignant according to the pathological results from core needle biopsy or surgical mastectomy. DWI was performed with a b value of 0 and 800s/mm2 and analyzed using theapparent diffusion coefficient, and a Kaiser score > 4 was considered to suggest malignancy. Thediagnostic performances for various diagnostic tests were evaluated with the receiver-operatingcharacteristic (ROC) curve. RESULTS The area under the curve (AUC) for DWI was significantly higher than that of the of mammography (0.86 vs 0.71, P<0.001), but was comparable with that of the Kaiser score (0.86 vs 0.84, P=0.58). However, the AUC for DWI combined with mammography was significantly highthan that of the Kaiser score (0.93 vs 0.84, P=0.007). The sensitivity for discriminating malignant from benign BI-RADS 4 lesions was highest at 89% for Kaiser score, but the highest specificity of 83% can be achieved with DWI combined with mammography. CONCLUSION DWI combined with microcalcifications on mammography could discriminate malignant BI-RADS4 lesions from benign ones with a high AUC and specificity. However, Kaiser score had a better sensitivity for discrimination.

Keywords: MRI, DWI, mammography, breast disease

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Authors: Azam Najafkouchak, David Todem, Dorothy Pathak, Pramod Pathak, Joseph Gardiner

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Propensity score (PS) methods have recently become the standard analysis tool for causal inference in observational studies where exposure is not randomly assigned. Thus, confounding can impact the estimation of treatment effect on the outcome. Due to the dangers of discretizing continuous variables, the focus of this paper will be on how the variation in cut-points or boundaries will affect the average treatment effect utilizing the stratification of the PS method. In this study, we will develop a new methodology to improve the efficiency of the PS analysis through stratification and simulation study. We will also explore the property of empirical distribution of average treatment effect theoretically, including asymptotic distribution, variance estimation and 95% confident Intervals.

Keywords: propensity score, stratification, emprical distribution, average treatment effect

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Authors: Yuan-Hsiang Chang, Zhong-Xian Peng, Li-Der Jeng

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Music has always been an integral part of human’s daily lives. But, for the most people, reading musical score and turning it into melody is not easy. This study aims to develop an Automatic music score recognition system using digital image processing, which can be used to read and analyze musical score images automatically. The technical approaches included: (1) staff region segmentation; (2) image preprocessing; (3) note recognition; and (4) accidental and rest recognition. Digital image processing techniques (e.g., horizontal /vertical projections, connected component labeling, morphological processing, template matching, etc.) were applied according to musical notes, accidents, and rests in staff notations. Preliminary results showed that our system could achieve detection and recognition rates of 96.3% and 91.7%, respectively. In conclusion, we presented an effective automated musical score recognition system that could be integrated in a system with a media player to play music/songs given input images of musical score. Ultimately, this system could also be incorporated in applications for mobile devices as a learning tool, such that a music player could learn to play music/songs.

Keywords: connected component labeling, image processing, morphological processing, optical musical recognition

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Authors: Bara M. Yousef

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Kingdome of Saudi Arabia (KSA). High numbers of traffic accidents with sever, moderate and mild level of impairments admits to Sultan bin Abdulaziz humanitarian city. Over a period of 4 months the city received 111 male and 79 female subjects with CP, who received 4-6 weeks of rehabilitation and using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings shed the light on the fact that nearly 85% of people at admission got better after rehabilitation program services at individual sever moderate and mild and has arrange of (59 out of 128 WeeFIM score) and by the time of discharge they leave the city with better FIM score close to (72 out of 128 WeeFIM score) for the entire study sample. WeeFIM score is providing fair evidence to rehabilitation specialists to assess their outcomes. However there is a need to implement other instruments and compare it to WeeFIM in order to reach better outcomes at discharge level.

Keywords: Cerepral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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Authors: Mohsen Danesh Mesgaran, Ali Hodjatpanah Montazeri, Alireza Vakili, Mansoor Tahmasbei

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To compare peppermint essential oil versus a mixture of formic and propionic acids a study was conducted to their effects on volatile fatty acid proportion and VFA score of corn silage. Chopped whole crop corn (control) was treated with peppermint essential oil (240 mg kg-1 DM) or a mixture of formic and propionic acids (2:1) at 0.4% of fresh forage weight, and ensiled for 30 days. Then, silage extract was provided and the concentration of each VFA was determined using gas chromatography. The VFA score was calculated according to the patented formula proposed by Dairy One Scientific Committee. The score is calculated based on the positive impact of lactic and acetic acids versus the negative effect of butyric acid to achieve a single value for evaluating silage quality. The essential oil declined pH and increased the concentration of lactic and acetic acids in the silage extract. All corn silages evaluated in this study had a VFA score between 6 through 8. However, silage with peppermint essential oils had lower volatile fatty acids score than those of the other treatments. Both of applied additives caused a significant improvement in silage aerobic stability.

Keywords: peppermint, essential oil, corn silage, VFA (volatile fatty acids)

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Authors: Ahmad Shahfarhat, Ashraf Mohammadzade, Reza Saeedi, Hadi Hesari

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Background: Mothers of infants admitted at NICU are vulnerable to depression (affecting 10 to 20% of mothers during the first year after delivery) As you know, about half of women with prominent postpartum depression (PPD) symptoms are not diagnosed. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD. In this study, we checked EPDS score of 12 or more on the second day (D2), discharge, day 28(D28), and day42 (D42) postpartum to determine the risk factors as well as the prevalence of PPD in a sample of mothers of NICU admitted neonates. Methods: A sample of 682 women used the EPDS on admission and at discharge. An assessment for PPD was performed on D28 and D42 by a telephone interview. Results: On admission, the average score on EPDS was 9.72 (SD = 4.4), and 27.4% of women (187) had an EPDS score ≥12. On Discharge, 4weeks and 6weeks postpartum the average score was ordinary 9.34 (SD = 3.8), 9.12 (SD = 3.7), 8.52(SD = 3.36), and (173)25.4 %,( 141)23.3 %,( 88)15.3% of women presented with PPD. a positive correlation was found between scores on EPDS on admission and D42 (P = 0.001). An analysis shows that mothers of twins (P = 0.001) and higher age mothers (P=0.001) are significantly associated with PPD. Conclusion: Women with EPDS score more than 12 and/or older will benefit from a closer follow-up during the rest of the post-partum period, and it is better to be under psychological support.

Keywords: NICU, depression, pregnancy, mothers

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Authors: Larisa Akhmylovskaia, Andriana Barysh

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The present paper is introducing the translation score developing methodology and methods in the cross-cultural communication. The ideas and examples presented by the authors illustrate the universal character of translation score developing methods under analysis. Personal experience in the international theatre-making projects, opera laboratories, cross-cultural master-classes give more opportunities to single out the conditions, forms, means and principles of translation score developing as well as the translator/interpreter’s functions as cultural liaison for multiethnic collaboration.

Keywords: methodology of translation score developing, pre-production, analysis, production, post-production, ethnic scene theory, theatre anthropology, laboratory, master-class, educational project, academic project, participant observation, super-objective

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Authors: Minseock Seo

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Dental education consists of both theoretical and practical learning for students. When dental students encounter practical courses as a new educational experience, they must also learn to evaluate themselves. The aim of this study was to investigate the self-assessment scores of third-year dental students and compare with the scores graded by the faculty in preclinical endodontic practice in a dental school in Korea. Faculty- and student-assigned scores were calculated from preclinical endodontic practice performed on phantom patients. The students were formally instructed on grading procedures for endodontic treatment. After each step, each item was assessed by the student. The students’ self-assessment score was then compared to the score by the faculty. The students were divided into 4 groups by analyzing the scores of self-assessment and faculty-assessment and statistically analyzed by summing the theoretical and practical examination scores. In the theoretical exam score, the group who over-estimated their performance (H group) was lower than the group with lower evaluation (L group). When comparing the first and last score determined by the faculty, H groups didn’t show any improvement, while the other group did. In H group, the less improvement of the self-assessment, the higher the theoretical exam score. In L group, the higher improvement of the self-assessment, the better the theoretical exam score. The results point to the need to develop students’ self-insight with more exercises and practical training.

Keywords: dental students, endodontic, preclinical practice, self-assessment

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Authors: Nandu C. Nair, Kamal Bijlani

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This paper proposes a concept-based assessment to track the performance of the students. The idea behind this approach is to map the exam questions with the concepts learned in the course. So at the end of the course, each student will know how well he learned each concept. This system will give a self assessment for the students as well as instructor. By analyzing the score of all students, instructor can decide some concepts need to be teaching again or not. The system’s efficiency is proved using three courses from M-tech program in E-Learning technologies and results show that the concept-wise assessment improved the score in final exam of majority students on various courses.

Keywords: assessment, concept, examination, question, score

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Authors: Nopadol Burananuth, Tawatpupisit Pattaradapa

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The objective of this research is to study opinion of staff responsible for Quality Assurance. Research sample is 50 staff at Suan Sunandha Rajabhat University related to Quality Assurance works from each faculty and organization within the university. Data were analyzed using the computer program. The statistics used in data analysis were frequency, percentage, mean and standard deviation. The results reveal that most of the respondents were female, 92%, aged between 31-40 years, 44%. Most of them have been working on Quality Assurance for 1-3 years, 44%. The staff opinion survey showed that the operation received the highest score. In terms of Planning, committee appointment and job descriptions received the highest mean score. For Checking, acknowledging the results and reviewing quality in education received the highest mean score. For Acting, participating in the meeting in order to revise approach to Quality Assurance received the highest mean score. For Doing, planning an internal quality assurance by assigning period, budget and responsibilities received the highest mean score.

Keywords: education quality assurance, administration, staff, Suan Sunandha Rajabhat University

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Authors: Devina Aprilia Gunawan, Tasya Aspiranti, Inugrah Ratia Pratiwi

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This research aims to classify the mining sector companies based on Altman’s Z-score model, and providing an analysis based on the Altman’s Z-score model’s financial ratios to provide a picture about the financial condition in mining sector companies in Indonesia and their viability in the future, and to find out the partial and simultaneous impact of each of the financial ratio variables in the Altman’s Z-score model, namely (WC/TA), (RE/TA), (EBIT/TA), (MVE/TL), and (S/TA), toward the financial condition represented by the Z-score itself. Among 38 mining sector companies listed in Indonesia Stock Exchange (IDX), 28 companies are selected as research sample according to the purposive sampling criteria.The results of this research showed that during 3 years research period at 2010-2012, the amount of the companies that was predicted to be healthy in each year was less than half of the total sample companies and not even reach up to 50%. The multiple regression analysis result showed that all of the research hypotheses are accepted, which means that (WC/TA), (RE/TA), (EBIT/TA), (MVE/TL), and (S/TA), both partially and simultaneously had an impact towards company’s financial condition.

Keywords: Altman’s Z-score model, financial condition, mining companies, Indonesia

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Authors: Abhijitsinh Gohil, Kaushal Wadhvaniya, Kuldipsinh Jadeja

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Road Safety is a multi-sectoral and multi-dimensional issue. An effective model can assess the risk associated with highway safety. A questionnaire survey is very essential to identify the events or activities which are causing unsafe condition for traffic on an urban highway. A questionnaire of standard questions including vehicular, human and infrastructure characteristics can be made. Responses from the age wise group of road users can be taken on field. Each question or an event holds a specific risk weightage, which contributes in creating an inappropriate and unsafe flow of traffic. The probability of occurrence of an event can be calculated from the data collected from the road users. Finally, the risk score can be calculated by considering the risk factor and the probability of occurrence of individual event and addition of all risk score for the individual event will give the total risk score of a particular road. Standards for risk score can be made and total risk score can be compared with the standards. Thus road can be categorized based on risk associated and traffic safety on it. With this model, one can assess the need for traffic safety improvement on a given road, and qualitative data can be analysed.

Keywords: probability of occurrence, questionnaire, risk factor, risk score

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Authors: Hassan Hamidi, Fereshteh Zarei

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In this study, we compared amount of compete motivation between young and adult volleyball players. Compete motivation has three sections: success achieves score, defeat avoiding score and ability score. For measuring motivation, we used sports attitude inventory of Willis and Layne. The statistical population was elite's men volleyball players in range of young and adult and the study subjects were randomly selected from participant teams in volleyball professional league. In total, 65 adult and 75 young were selected. For collecting the required information, the research inventories were distributed in practice's locations and then were collected after being completed by players. For analyzing the data, we used descriptive statistics including mean, standard deviation and frequency tables. We also used conceptual statistics such as independent sample t-student and Pierson correlation. The results showed a significant difference between young and adult volleyball players in success achieve score and ability score. However, there was no significant difference between young and adult volleyball players in defeat avoiding score and compete motivation. In addition, there was not significant relationship between the length of activities and motivations' sections in adult and young volleyball player. The application of this study to other sports will be discussed.

Keywords: compete motivation, volleyball player, statistical analysis, sport psychology

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Authors: Greg Zimmerman

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Background: Major depression is a common illness that affects millions of people globally. It is the leading cause of disability and is projected to become the number one cause of the global burden of disease by 2030. Many of those who suffer from depression also suffer from Irritable Bowel Syndrome (IBS). Acupuncture has been shown to help depression. The aim of this study was to investigate the effectiveness of acupuncture in reducing the risk of IBS in patients with depression. Methods: We enrolled patients diagnosed with depression through the Taiwanese National Health Insurance Research Database (NHIRD). Propensity score matching was used to match equal numbers (n=32971) of the acupuncture cohort and no-acupuncture cohort based on characteristics including sex, age, baseline comorbidity, and medication. The Cox regression model was used to compare the hazard ratios (HRs) of IBS in the two cohorts. Results: The basic characteristics of the two groups were similar. The cumulative incidence of IBS was significantly lower in the acupuncture cohort than in the no-acupuncture cohort (Log-rank test, p<0.001). Conclusion: The results provided real-world evidence that acupuncture may have a beneficial effect on IBS risk reduction in patients with depression.

Keywords: acupuncture, depression, irritable bowel syndrome, national health insurance research database, real-world evidence

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Authors: Lubena Achmad, Herman Kristanto, Julian Dewantiningrum

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Background: The Bishop score is a standard method used to predict the success of induction. This examination tends to be subjective with high inter and intraobserver variability, so it was presumed to have a low predictive value in terms of the outcome of labor induction. Cervical length measurement using transvaginal ultrasound is considered to be more objective to assess the cervical length. Meanwhile, this examination is not a complicated procedure and less invasive than vaginal touché. Objective: To compare transvaginal ultrasound and Bishop score in predicting successful induction. Methods: This study was a prospective cohort study. One hundred and twenty women with singleton pregnancies undergoing induction of labor at 37 – 42 weeks and met inclusion and exclusion criteria were enrolled in this study. Cervical assessment by both transvaginal ultrasound and Bishop score were conducted prior induction. The success of labor induction was defined as an ability to achieve active phase ≤ 12 hours after induction. To figure out the best cut-off point of cervical length and Bishop score, receiver operating characteristic (ROC) curves were plotted. Logistic regression analysis was used to determine which factors best-predicted induction success. Results: This study showed significant differences in terms of age, premature rupture of the membrane, the Bishop score, cervical length and funneling as significant predictors of successful induction. Using ROC curves found that the best cut-off point for prediction of successful induction was 25.45 mm for cervical length and 3 for Bishop score. Logistic regression was performed and showed only premature rupture of membranes and cervical length ≤ 25.45 that significantly predicted the success of labor induction. By excluding premature rupture of the membrane as the indication of induction, cervical length less than 25.3 mm was a better predictor of successful induction. Conclusion: Compared to Bishop score, cervical length using transvaginal ultrasound was a better predictor of successful induction.

Keywords: Bishop Score, cervical length, induction, successful induction, transvaginal sonography

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Authors: Aml M. El-Sharkawy, Hossam M. Darwesh

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Abstract— Background/Aim: Hepatocellular carcinoma (HCC) is often diagnosed at advanced stage where effective therapies are lacking. Identification of new scoring system is needed to discriminate HCC patients from those with chronic liver disease. Based on the link between tumor associated trypsin inhibitor (TATI) and HCC progression, we aimed to develop a novel score based on combination of TATI and routine laboratory tests for early prediction of HCC. Methods: TATI was assayed for HCC group (123), liver cirrhosis group (210) and control group (50) by Enzyme Linked Immunosorbent Assay (ELISA). Data from all groups were retrospectively analyzed including α feto protein (AFP), international normalized ratio (INR), albumin and platelet count, transaminases, and age. Areas under ROC curve were used to develop the score. Results: A novel index named hepatocellular carcinoma-vascular endothelial growth factor score (HCC-TATI score) = 3.1 (numerical constant) + 0.09 ×AFP (U L-1) + 0.067 × TATI (ng ml-1) + 0.16 × INR – 1.17 × Albumin (g l-1) – 0.032 × Platelet count × 109 l-1 was developed. HCC-TATI score produce area under ROC curve of 0.98 for discriminating HCC patients from liver cirrhosis with sensitivity of 91% and specificity of 82% at cut-off 6.5 (ie less than 6.5 considered cirrhosis and greater than 4.4 considered HCC). Conclusion: Hepatocellular carcinoma-TATI score could replace AFP in HCC screening and follow up of cirrhotic patients.

Keywords: Hepatocellular carcinoma, cirrhosis, HCV, diagnosis, TATI

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Authors: Meltem Ramoglu, Ertugrul Safran, Hikmet Ucgun, Busra Kepenek Varol, Hulya Nilgun Gurses

Abstract:

Down’s syndrome (DS) is a human genetic disorder caused by the presence of all or part of an extra chromosome 21. Many patients with DS have musculoskeletal problems that affect weak muscle tone (hypotonia) and ligament laxity. This leads to excessive joint hypermobility and decreased position sense (proprioception). Lack of proprioception may cause balance problems. The aim of our study was to investigate how does joint hypermobility affect balance in patients with DS. Our study conducted with 13 DS patients age between 18 to 40 years. Demographic data were recorded. Beighton Hypermobility Score (BHS) was used to evaluate joint hypermobility. Balance score of participants was evaluated with Berg Balance Scale (BBS). Mean age of our participants was 29,8±3,57 year. Average score of body mass index and BHS were; 33,23 ±3,78 kg/m2 and 7,61±1,04, respectively. Out of a maximum possible score of 56 on the Berg Balance Scale, scores of participants with DS ranged from 36–51, with a mean of 43±4,45. Significant correlation was found between BHS and BBS (r: -,966, p=0.00). All of our participants have 6/9 or higher grade from BHS. As a conclusion of our study; joint hypermobility may affect balance score in patients with DS. The results suggest that people with DS have worse balance scores which affected by hypermobility. Further studies need larger population for more reliable results.

Keywords: adults, balance, Down's syndrome, joint hypermobility

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Authors: Pawan Kumar, Dhananjoy Shaw

Abstract:

Heart rate variability (HRV) is the physiological phenomenon of variation in the time interval between heartbeats and is alterable with fitness, age and different medical conditions including withdrawal/retirement from games/sports. Objectives of the study were to develop (a) percentile norms of heart rate variability (HRV) variables derived from time domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity (b) percentile norms of heart rate variability (HRV) variables derived from frequency domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity. The study was conducted on 430 males. Ages of the sample ranged from 30 to 35 years of same socio-economic status. Date was collected using ECG polygraphs. Data were processed and extracted using frequency domain analysis and time domain analysis. Collected data were computed with percentile from one to hundred. The finding showed that the percentile norms of heart rate variability (HRV) variables derived from time domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity namely, NN50 count (ranged from 1 to 189 score as percentile range). pNN50 count (ranged from .24 to 60.80 score as percentile range). SDNN (ranged from 17.34 to 167.29 score as percentile range). SDSD (ranged from 11.14 to 120.46 score as percentile range). RMMSD (ranged from 11.19 to 120.24 score as percentile range) and SDANN (ranged from 4.02 to 88.75 score as percentile range). The percentile norms of heart rate variability (HRV) variables derived from frequency domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity namely Low Frequency (Normalized Power) ranged from 20.68 to 90.49 score as percentile range. High Frequency (Normalized Power) ranged from 14.37 to 81.60 score as percentile range. LF/ HF ratio(ranged from 0.26 to 9.52 score as percentile range). LF (Absolute Power) ranged from 146.79 to 5669.33 score as percentile range. HF (Absolute Power) ranged from 102.85 to 10735.71 score as percentile range and Total Power (Absolute Power) ranged from 471.45 to 25879.23 score as percentile range. Conclusion: The analysis documented percentile norms for time domain analysis and frequency domain analysis for versatile use and evaluation.

Keywords: RMSSD, Percentile, SDANN, HF, LF

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Authors: A. K. Putri, A.Fitri, C. A. Batubara

Abstract:

Diabetes Mellitus (DM) is a chronic disease that could cause complications. The complication can be Peripheral Arterial Disease (PAD) or Diabetic Neuropathy (DN). Peripheral Arterial Disease is checked by Ankle Brachial Index (ABI), DN is checked by Diabetic Neuropathy Examination (DNE) score. To determine the association of ABI and DNE score in DM type 2. This study uses a cross-sectional design. The subjects were DM patients at the neurology and endocrinology polyclinic at Haji Adam Malik Hospital Medan and its network hospital and this study subjects were examined for ABI and DNE scores. The data were analysed using the Fisher Exact statistics test. Demographics characteristic showed most of subject are female (51,6%), age range ≥ 60 (45.2% ; average 57,6 ± 9,8 years ), and history of DM 5-10 years (45,2%). The most patient ABI characteristics were mild PAD (42%) and moderate PAD (29%). The most patient DNE Score characteristics were≥ 3 (51,6%). There’s a significant relationship between ABI and DNE score in DM type 2 (p =0.016). Conclusion: There is a significant association between ABI and DNE scores in DM type 2 patients

Keywords: diabetic neuropathy, diabetes mellitus, ankle-brachial index, diabetic neuropathy examination

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Authors: Promise Ekpo Osaine, Daniel Melesse

Abstract:

Image captioning is an active area of research in the multi-modal artificial intelligence (AI) community as it connects vision and language understanding, especially in settings where it is required that a model understands the content shown in an image and generates semantically and grammatically correct descriptions. In this project, we followed a standard approach to a deep learning-based image captioning model, injecting architecture for the encoder-decoder setup, where the encoder extracts image features, and the decoder generates a sequence of words that represents the image content. As such, we investigated image encoders, which are ResNet101, InceptionResNetV2, EfficientNetB7, EfficientNetV2M, and CLIP. As a caption generation structure, we explored long short-term memory (LSTM). The CLIP-LSTM model demonstrated superior performance compared to the encoder-decoder models, achieving a BLEU-1 score of 0.904 and a BLEU-4 score of 0.640. Additionally, among the CNN-LSTM models, EfficientNetV2M-LSTM exhibited the highest performance with a BLEU-1 score of 0.896 and a BLEU-4 score of 0.586 while using a single-layer LSTM.

Keywords: multi-modal AI systems, image captioning, encoder, decoder, BLUE score

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Authors: Carl van Walraven, Meltem Tuna

Abstract:

Background: Network meta-analysis (NMA) quantifies the relative efficacy of 3 or more interventions from studies containing a subgroup of interventions. This study applied the analytical approach of NMA to quantify the relative accuracy of prediction models with distinct inclusion criteria that are evaluated on a common population (‘concurrent external validation’). Methods: We simulated binary events in 5000 patients using a known risk function. We biased the risk function and modified its precision by pre-specified amounts to create 15 prediction models with varying accuracy and distinct patient applicability. Prediction model accuracy was measured using the Scaled Brier Score (SBS). Overall prediction model accuracy was measured using fixed-effects methods that accounted for model applicability patterns. Prediction model accuracy was summarized as the Network Relative Model Accuracy (NeRMA) Score which ranges from -∞ through 0 (accuracy of random guessing) to 1 (accuracy of most accurate model in concurrent external validation). Results: The unbiased prediction model had the highest SBS. The NeRMA score correctly ranked all simulated prediction models by the extent of bias from the known risk function. A SAS macro and R-function was created to implement the NeRMA Score. Conclusions: The NeRMA Score makes it possible to quantify the accuracy of binomial prediction models having distinct inclusion criteria in a concurrent external validation.

Keywords: prediction model accuracy, scaled brier score, fixed effects methods, concurrent external validation

Procedia PDF Downloads 206