Search results for: abnormal returns
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 763

Search results for: abnormal returns

193 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty: A Retrospective Study at a Tertiary Orthopaedic Centre

Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

Abstract:

Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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192 Earnings Management and Tone Management: Evidence from the UK

Authors: Salah Kayed Kayed, Jessica Hong Yang

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This study investigates, whether earnings management in the audited financial statements is associated with tone management in the narrative sections of the annual report in the UK. Earnings management and narrative disclosure are communication strategies used from managers to communicate with investors or other users. Because earnings management and narrative disclosure stem from managers, they can exploit this by doing manipulation in their earnings, and simultaneously disclosing qualitative text (narrative information) in their reports as a tone of words, which will affect users’ perception, and hence users will be misinformed. The association between earnings and tone management can be explained by the self-serving, through cognitive reference points, theory. The sample period lasts from 2010 to 2015, and the sample comprises all non-financial firms that consider under FTSE 350 in any year during the sample period. A list of words from previous research is used to measure the tone in the narrative sections of the annual report. Because this study focuses on the managerial strategic choice and the subjective issues that come from management, it uses the abnormal tone to capture the managerial discretion on tone, and a number of different discretionary accruals proxies to measure earnings management, where accruals management is considered as a manipulation tool from managers to change the users' perception. This research is motivated to fulfil the literature gap by examining the association between earnings and tone management. Moreover, if firms that apply earnings management use tone management to mislead investors, it is beneficial for investors, policy makers, standard setters, or other users to know whether there is an association between earnings management and tone management. Clearly, we believe that this study is fundamental in the accounting context, where it evaluates the communication strategies that are used in firms' financial reports. Consistent with prior research, it is expected that tone management is positively associated with earnings management. This means that firms that use earnings management have incentives to manipulate in their narrative disclosure through tone of words, to reflect a good perception for users, which will conceal the earnings management techniques used in their reporting.

Keywords: earnings management, FTSE 350, narrative disclosure, tone management

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191 Ulnar Nerve Changes Associated with Carpal Tunnel Syndrome and Effect on Median Ersus Ulnar Comparative Studies

Authors: Emmanuel K. Aziz Saba, Sarah S. El-Tawab

Abstract:

Objectives: Carpal tunnel syndrome (CTS) was found to be associated with high pressure within the Guyon’s canal. The aim of this study was to assess the involvement of sensory and/or motor ulnar nerve fibers in patients with CTS and whether this affects the accuracy of the median versus ulnar sensory and motor comparative tests. Patients and methods: The present study included 145 CTS hands and 71 asymptomatic control hands. Clinical examination was done for all patients. The following tests were done for the patients and control: (1) Sensory conduction studies: median nerve, ulnar nerve, dorsal ulnar cutaneous nerve and median versus ulnar digit (D) four sensory comparative study; (2) Motor conduction studies: median nerve, ulnar nerve and median versus ulnar motor comparative study. Results: There were no statistically significant differences between patients and control group as regards parameters of ulnar motor study and dorsal ulnar cutaneous sensory conduction study. It was found that 17 CTS hands (11.7%) had ulnar sensory abnormalities in 17 different patients. The median versus ulnar sensory and motor comparative studies were abnormal among all these 17 CTS hands. There were statistically significant negative correlations between median motor latency and both ulnar sensory amplitudes recording D5 and D4. There were statistically significant positive correlations between median sensory conduction velocity and both ulnar sensory nerve action potential amplitude recording D5 and D4. Conclusions: There is ulnar sensory nerve abnormality among CTS patients. This abnormality affects the amplitude of ulnar sensory nerve action potential. The presence of abnormalities in ulnar nerve occurs in moderate and severe degrees of CTS. This does not affect the median versus ulnar sensory and motor comparative tests accuracy and validity for use in electrophysiological diagnosis of CTS.

Keywords: carpal tunnel syndrome, ulnar nerve, median nerve, median versus ulnar comparative study, dorsal ulnar cutaneous nerve

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190 Well-being of Lagos Urban Mini-bus Drivers: The Influence of Age and Marital Status

Authors: Bolajoko I. Malomo, Maryam O. Yusuf

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Lagos urban mini-bus drivers play a critical role in the transportation sector. The current major mode of transportation within Lagos metropolis remains road transportation and this confirms the relevance of urban mini-bus drivers in transporting the populace to their various destinations. Other modes of transportation such as the train and waterways are currently inadequate. Various threats to the well-being of urban bus drivers include congested traffic typical of modern day lifestyles, dwindling financial returns due to long hours in traffic, fewer hours of sleep, inadequate diet, time pressure, and assaults related to fare disputes. Several health-related problems have been documented to be associated with urban bus driving. For instance, greater rates of hypertension, obesity and cholesterol level has been reported. Research studies are yet to identify the influence of age and marital status on the well-being of urban mini-bus drivers in Lagos metropolis. A study of this nature is necessary as it is culturally perceived in Nigeria that older and married people are especially influenced by family affiliation and would behave in ways that would project positive outcomes. The study sample consisted of 150 urban mini-bus drivers who were conveniently sampled from six (6) different terminuses where their journey begins and terminates. The well-being questionnaire was administered to participants. The criteria for inclusion in the study included the ability to read in English language and the confirmation that interested participants were on duty and suited to be driving mini-buses. Due to the nature of the job of bus driving, the researcher administered the questionnaires on participants who were free and willing to respond to the survey. All participants were males of various age groups and of different marital statuses. Results of analyses conducted revealed no significant influence of age and marital status on the well-being of urban mini-bus drivers. This indicates that the well-being of urban mini-bus drivers is not influenced by age nor marital status. The findings of this study have cultural implications. It negates the popularly held belief that older and married people care more about their well-being than younger and single people. It brings to fore the need to also identify and consider other factors when certifying people for the job of urban bus driving.

Keywords: age, Lagos metropolis, marital status, well-being of urban mini bus drivers

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189 A Controlled-Release Nanofertilizer Improves Tomato Growth and Minimizes Nitrogen Consumption

Authors: Mohamed I. D. Helal, Mohamed M. El-Mogy, Hassan A. Khater, Muhammad A. Fathy, Fatma E. Ibrahim, Yuncong C. Li, Zhaohui Tong, Karima F. Abdelgawad

Abstract:

Minimizing the consumption of agrochemicals, particularly nitrogen, is the ultimate goal for achieving sustainable agricultural production with low cost and high economic and environmental returns. The use of biopolymers instead of petroleum-based synthetic polymers for CRFs can significantly improve the sustainability of crop production since biopolymers are biodegradable and not harmful to soil quality. Lignin is one of the most abundant biopolymers that naturally exist. In this study, controlled-release fertilizers were developed using a biobased nanocomposite of lignin and bentonite clay mineral as a coating material for urea to increase nitrogen use efficiency. Five types of controlled-release urea (CRU) were prepared using two ratios of modified bentonite as well as techniques. The efficiency of the five controlled-release nano-urea (CRU) fertilizers in improving the growth of tomato plants was studied under field conditions. The CRU was applied to the tomato plants at three N levels representing 100, 50, and 25% of the recommended dose of conventional urea. The results showed that all CRU treatments at the three N levels significantly enhanced plant growth parameters, including plant height, number of leaves, fresh weight, and dry weight, compared to the control. Additionally, most CRU fertilizers increased total yield and fruit characteristics (weight, length, and diameter) compared to the control. Additionally, marketable yield was improved by CRU fertilizers. Fruit firmness and acidity of CRU treatments at 25 and 50% N levels were much higher than both the 100% CRU treatment and the control. The vitamin C values of all CRU treatments were lower than the control. Nitrogen uptake efficiencies (NUpE) of CRU treatments were 47–88%, which is significantly higher than that of the control (33%). In conclusion, all CRU treatments at an N level of 25% of the recommended dose showed better plant growth, yield, and fruit quality of tomatoes than the conventional fertilizer.

Keywords: nitrogen use efficiency, quality, urea, nano particles, ecofriendly

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188 Literature Review on the Barriers to Access Credit for Small Agricultural Producers and Policies to Mitigate Them in Developing Countries

Authors: Margarita Gáfaro, Karelys Guzmán, Paola Poveda

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This paper establishes the theoretical aspects that explain the barriers to accessing credit for small agricultural producers in developing countries and identifies successful policy experiences to mitigate them. We will test two hypotheses. The first one is that information asymmetries, high transaction costs and high-risk exposure limit the supply of credit to small agricultural producers in developing countries. The second hypothesis is that low levels of financial education and productivity and high uncertainty about the returns of agricultural activity limit the demand for credit. To test these hypotheses, a review of the theoretical and empirical literature on access to rural credit in developing countries will be carried out. The first part of this review focuses on theoretical models that incorporate information asymmetries in the credit market and analyzes the interaction between these asymmetries and the characteristics of the agricultural sector in developing countries. Some of the characteristics we will focus on are the absence of collateral, the underdevelopment of the judicial systems and insurance markets, and the high dependence on climatic factors of production technologies. The second part of this review focuses on the determinants of credit demand by small agricultural producers, including the profitability of productive projects, security conditions, risk aversion or loss, financial education, and cognitive biases, among others. There are policies that focus on resolving these supply and demand constraints and managing to improve credit access. Therefore, another objective of this paper is to present a review of effective policies that have promoted access to credit for smallholders in the world. For this, information available in policy documents will be collected. This information will be complemented by interviews with officials in charge of the design and execution of these policies in a subset of selected countries. The information collected will be analyzed in light of the conceptual framework proposed in the first two parts of this section. The barriers to access to credit that each policy attempts to resolve and the factors that could explain its effectiveness will be identified.

Keywords: agricultural economics, credit access, smallholder, developing countries

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187 The Presence of Investor Overconfidence in the South African Exchange Traded Fund Market

Authors: Damien Kunjal, Faeezah Peerbhai

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Despite the increasing popularity of exchange-traded funds (ETFs), ETF investment choices may not always be rational. Excess trading volume, misevaluations of securities, and excess return volatility present in financial markets can be attributed to the influence of the overconfidence bias. Whilst previous research has explored the overconfidence bias in stock markets; this study focuses on trading in ETF markets. Therefore, the objective of this study is to investigate the presence of investor overconfidence in the South African ETF market. Using vector autoregressive models, the lead-lag relationship between market turnover and the market return is examined for the market of South African ETFs tracking domestic benchmarks and for the market of South African ETFs tracking international benchmarks over the period November 2000 till August 2019. Consistent with the overconfidence hypothesis, a positive relationship between current market turnover and lagged market return is found for both markets, even after controlling for market volatility and cross-sectional dispersion. This relationship holds for both market and individual ETF turnover suggesting that investors are overconfident when trading in South African ETFs tracking domestic benchmarks and South African ETFs tracking international benchmarks since trading activity depends on past market returns. Additionally, using the global recession as a structural break, this study finds that investor overconfidence is more pronounced after the global recession suggesting that investors perceive ETFs as risk-reducing assets due to their diversification benefits. Overall, the results of this study indicate that the overconfidence bias has a significant influence on ETF investment choices, therefore, suggesting that the South African ETF market is inefficient since investors’ decisions are based on their biases. As a result, the effect of investor overconfidence can account for the difference between the fair value of ETFs and its current market price. This finding has implications for policymakers whose responsibility is to promote the efficiency of the South African ETF market as well as ETF investors and traders who trade in the South African ETF market.

Keywords: exchange-traded fund, market return, market turnover, overconfidence, trading activity

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186 The Effect of Aerobics Course on Fitness Ability of the University Students

Authors: Hui-Fang Lee, Hsuan-Jung Hsieh, Wen-Chi Lu, Meng-Chu Liu

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The purpose of the study was to examine abnormal BMI students of Chien Hsin University of Science and Technology, implement teaching aerobics course through elementary and advanced curriculum design, dietary education and three-day dietary record, analyze participant fitness improvement, an 10-week course as well as pre-test and post-test were carried out to evaluate the effect of the aerobics course on the fitness ability. The actual participate elementary and advanced courses each of 40 people, with low participation deduction course unfinished fitness testing, access to elementary curriculum valid samples 35 (87.5%) people, advanced courses valid samples 38(95%) people, 16 students participated in two consecutive courses. The fitness activities included sit-bending, one-minute sit-ups, standing long jump, and three minutes to board the stage. Analysis and comparison to the average three-day dietary record difference, an independent samples t-test was conducted to analyze the differences in the four activities between pre-test and post-test. The results showed that the elementary course had significant effects on females’ sit-bending and one minute sit-ups, the females also had high fat intake in three-day dietary record. The advanced course had significant effects on males’ sit-bending and on females’ BMI, sit-bending and standing long jump, males and females in three-day dietary record carbohydrate intake slightly low, slightly higher protein and fat intake. In conclusion, aerobics course teaching, dietary education and three-day, dietary record implementation can significantly enhance the physical fitness indicators, and continued to participate in advanced courses better. In the practice of sport should be the future course planning elementary and advanced courses, while introducing dietary education, achieve concrete results in improving physical fitness.

Keywords: physical fitness, aerobics course, dietary education, three-day dietary record

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185 Mike Hat: Coloured-Tape-in-Hat as a Head Circumference Measuring Instrument for Early Detection of Hydrocephalus in an Infant

Authors: Nyimas Annissa Mutiara Andini

Abstract:

Every year, children develop hydrocephalus during the first year of life. If it is not treated, hydrocephalus can lead to brain damage, a loss in mental and physical abilities, and even death. To be treated, first, we have to do a proper diagnosis using some examinations especially to detect hydrocephalus earlier. One of the examination that could be done is using a head circumference measurement. Increased head circumference is a first and main sign of hydrocephalus, especially in infant (0-1 year age). Head circumference is a measurement of a child's head largest area. In this measurement, we want to get the distance from above the eyebrows and ears and around the back of the head using a measurement tape. If the head circumference of an infant is larger than normal, this infant might potentially suffer hydrocephalus. If early diagnosis and timely treatment of hydrocephalus could be done most children can recover successfully. There are some problems with early detection of hydrocephalus using regular tape for head circumference measurement. One of the problem is the infant’s comfort. We need to make the infant feel comfort along the head circumference measurement to get a proper result of the examination. For that, we can use a helpful stuff, like a hat. This paper is aimed to describe the possibility of using a head circumference measuring instrument for early detection of hydrocephalus in an infant with a mike hat, coloured-tape-in-hat. In the first life, infants’ head size is about 35 centimeters. First three months after that infants will gain 2 centimeters each month. The second three months, infant’s head circumference will increase 1 cm each month. And for the six months later, the rate is 0.5 cm per month, and end up with an average of 47 centimeters. This formula is compared to the WHO’s head circumference growth chart. The shape of this tape-in-hat is alike an upper arm measurement. This tape-in-hat diameter is about 47 centimeters. It contains twelve different colours range by age. If it is out of the normal colour, the infant potentially suffers hydrocephalus. This examination should be done monthly. If in two times of measurement there still in the same range abnormal of head circumference, or a rapid growth of the head circumference size, the infant should be referred to a pediatrician. There are the pink hat for girls and blue hat for boys. Based on this paper, we know that this measurement can be used to help early detection of hydrocephalus in an infant.

Keywords: head circumference, hydrocephalus, infant, mike hat

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184 Breast Cancer: The Potential of miRNA for Diagnosis and Treatment

Authors: Abbas Pourreza

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MicroRNAs (miRNAs) are small single-stranded non-coding RNAs. They are almost 18-25 nucleotides long and very conservative through evolution. They are involved in adjusting the expression of numerous genes due to the existence of a complementary region, generally in the 3' untranslated regions (UTR) of target genes, against particular mRNAs in the cell. Also, miRNAs have been proven to be involved in cell development, differentiation, proliferation, and apoptosis. More than 2000 miRNAs have been recognized in human cells, and these miRNAs adjust approximately one-third of all genes in human cells. Dysregulation of miRNA originated from abnormal DNA methylation patterns of the locus, cause to down-regulated or overexpression of miRNAs, and it may affect tumor formation or development of it. Breast cancer (BC) is the most commonly identified cancer, the most prevalent cancer (23%), and the second-leading (14%) mortality in all types of cancer in females. BC can be classified based on the status (+/−) of the hormone receptors, including estrogen receptor (ER), progesterone receptor (PR), and the Receptor tyrosine-protein kinase erbB-2 (ERBB2 or HER2). Currently, there are four main molecular subtypes of BC: luminal A, approximately 50–60 % of BCs; luminal B, 10–20 %; HER2 positive, 15–20 %, and 10–20 % considered Basal (triple-negative breast cancer (TNBC)) subtype. Aberrant expression of miR-145, miR-21, miR-10b, miR-125a, and miR-206 was detected by Stem-loop real-time RT-PCR in BC cases. Breast tumor formation and development may result from down-regulation of a tumor suppressor miRNA such as miR-145, miR-125a, and miR-206 and/or overexpression of an oncogenic miRNA such as miR-21 and miR-10b. MiR-125a, miR-206, miR-145, miR-21, and miR-10b are hugely predicted to be new tumor markers for the diagnosis and prognosis of BC. MiR-21 and miR-125a could play a part in the treatment of HER-2-positive breast cancer cells, while miR-145 and miR-206 could speed up the evolution of cure techniques for TNBC. To conclude, miRNAs will be presented as hopeful molecules to be used in the primary diagnosis, prognosis, and treatment of BC and battle as opposed to its developed drug resistance.

Keywords: breast cancer, HER2 positive, miRNA, TNBC

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183 The Magnitude and Associated Factors of Coagulation Abnormalities Among Liver Disease Patients at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia

Authors: Melkamu A., Woldu B., Sitotaw C., Seyoum M., Aynalem M.

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Background: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. Methods: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood was collected and analyzed by the Genrui CA51 coagulation analyzer. Data was entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. Result: In this study, a total of 307 study participants were included. Of them, the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. Conclusion: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.

Keywords: coagulation, liver disease, PT, Aptt

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182 Clinical Relevance of TMPRSS2-ERG Fusion Marker for Prostate Cancer

Authors: Shalu Jain, Anju Bansal, Anup Kumar, Sunita Saxena

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Objectives: The novel TMPRSS2:ERG gene fusion is a common somatic event in prostate cancer that in some studies is linked with a more aggressive disease phenotype. Thus, this study aims to determine whether clinical variables are associated with the presence of TMPRSS2:ERG-fusion gene transcript in Indian patients of prostate cancer. Methods: We evaluated the clinical variables with presence and absence of TMPRSS2:ERG gene fusion in prostate cancer and BPH association of clinical patients. Patients referred for prostate biopsy because of abnormal DRE or/and elevated sPSA were enrolled for this prospective clinical study. TMPRSS2:ERG mRNA copies in samples were quantified using a Taqman chemistry by real time PCR assay in prostate biopsy samples (N=42). The T2:ERG assay detects the gene fusion mRNA isoform TMPRSS2 exon1 to ERG exon4. Results: Histopathology report has confirmed 25 cases as prostate cancer adenocarcinoma (PCa) and 17 patients as benign prostate hyperplasia (BPH). Out of 25 PCa cases, 16 (64%) were T2: ERG fusion positive. All 17 BPH controls were fusion negative. The T2:ERG fusion transcript was exclusively specific for prostate cancer as no case of BPH was detected having T2:ERG fusion, showing 100% specificity. The positive predictive value of fusion marker for prostate cancer is thus 100% and the negative predictive value is 65.3%. The T2:ERG fusion marker is significantly associated with clinical variables like no. of positive cores in prostate biopsy, Gleason score, serum PSA, perineural invasion, perivascular invasion and periprostatic fat involvement. Conclusions: Prostate cancer is a heterogeneous disease that may be defined by molecular subtypes such as the TMPRSS2:ERG fusion. In the present prospective study, the T2:ERG quantitative assay demonstrated high specificity for predicting biopsy outcome; sensitivity was similar to the prevalence of T2:ERG gene fusions in prostate tumors. These data suggest that further improvement in diagnostic accuracy could be achieved using a nomogram that combines T2:ERG with other markers and risk factors for prostate cancer.

Keywords: prostate cancer, genetic rearrangement, TMPRSS2:ERG fusion, clinical variables

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181 Time to Cure from Obstetric Fistula and Its Associated Factors among Women Admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa Ethiopia: A Survival Analysis

Authors: Chernet Mulugeta, Girma Seyoum, Yeshineh Demrew, Kehabtimer Shiferaw

Abstract:

Background: Obstetric fistula (OF) is a serious medical condition that includes an abnormal opening between the vagina and bladder (vesico-vaginal fistula) or the vagina and rectum (recto-vaginal fistula). It is usually caused by prolonged obstructed labour. Despite its serious health and psychosocial consequences, there is a paucity of evidence regarding the time it takes to heal from OF. Objective: The aim of this study was to assess the time to cure from obstetric fistula and its predictors among women admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Methodology: An institution-based retrospective cohort study was conducted from January 2015 to December 2020 among a randomly selected 434 women with OF in Addis Ababa Hamlin Fistula Hospital. Data was collected using a structured checklist adapted from a similar study. The open data kit (ODK) collected data was exported and analyzed by using STATA (14.2). Kaplan Meir was used to compare the recovery time from OF. To identify the predictors of OF, a Cox regression model was fitted, and an adjusted hazard ratio with a 95% confidence interval was used to estimate the strength of the associations. Results: The average time to recover from obstetric fistula was 3.95 (95% CI: 3.0-4.6) weeks. About ¾ of the women [72.8% (95% CI - 0.65-1.2)] were physically cured of obstetric fistula. Having secondary education and above [AHR=3.52; 95% CI (1.98, 6.25)] compared to no formal education, having a live birth [AHR=1.64; 95% CI (1.22, 2.21)], having an intact bladder [AHR=2.47; 95% CI (1.1, 5.54)] compared to totally destructed, and having a grade 1 fistula [AHR=1.98; 95% CI (1.19, 3.31)] compared to grade 3 were the significant predictors of shorter time to cure from an obstetric fistula. Conclusion and recommendation: Overall, the proportion of women with OF who were not being cured was unacceptably high. The time it takes for them to recover from the fistula was also extended. It connotes us to work on the identified predictors to improve the time to recovery from OF.

Keywords: time to recovery, obstetric fistula, predictors, Ethiopia

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180 Analysis of a IncResU-Net Model for R-Peak Detection in ECG Signals

Authors: Beatriz Lafuente Alcázar, Yash Wani, Amit J. Nimunkar

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Cardiovascular Diseases (CVDs) are the leading cause of death globally, and around 80% of sudden cardiac deaths are due to arrhythmias or irregular heartbeats. The majority of these pathologies are revealed by either short-term or long-term alterations in the electrocardiogram (ECG) morphology. The ECG is the main diagnostic tool in cardiology. It is a non-invasive, pain free procedure that measures the heart’s electrical activity and that allows the detecting of abnormal rhythms and underlying conditions. A cardiologist can diagnose a wide range of pathologies based on ECG’s form alterations, but the human interpretation is subjective and it is contingent to error. Moreover, ECG records can be quite prolonged in time, which can further complicate visual diagnosis, and deeply retard disease detection. In this context, deep learning methods have risen as a promising strategy to extract relevant features and eliminate individual subjectivity in ECG analysis. They facilitate the computation of large sets of data and can provide early and precise diagnoses. Therefore, the cardiology field is one of the areas that can most benefit from the implementation of deep learning algorithms. In the present study, a deep learning algorithm is trained following a novel approach, using a combination of different databases as the training set. The goal of the algorithm is to achieve the detection of R-peaks in ECG signals. Its performance is further evaluated in ECG signals with different origins and features to test the model’s ability to generalize its outcomes. Performance of the model for detection of R-peaks for clean and noisy ECGs is presented. The model is able to detect R-peaks in the presence of various types of noise, and when presented with data, it has not been trained. It is expected that this approach will increase the effectiveness and capacity of cardiologists to detect divergences in the normal cardiac activity of their patients.

Keywords: arrhythmia, deep learning, electrocardiogram, machine learning, R-peaks

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179 Extracorporeal Shock Wave Therapy versus Functional Electrical Stimulation on Spasticity, Function and Gait Parameters in Hemiplegic Cerebral Palsy

Authors: Mohamed A. Eid, Sobhy M. Aly

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Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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178 Review and Analysis of Parkinson's Tremor Genesis Using Mathematical Model

Authors: Pawan Kumar Gupta, Sumana Ghosh

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Parkinson's Disease (PD) is a long-term neurodegenerative movement disorder of the central nervous system with vast symptoms related to the motor system. The common symptoms of PD are tremor, rigidity, bradykinesia/akinesia, and postural instability, but the clinical symptom includes other motor and non‐motor issues. The motor symptoms of the disease are consequence of death of the neurons in a region of the midbrain known as substantia nigra pars compacta, leading to decreased level of a neurotransmitter known as dopamine. The cause of this neuron death is not clearly known but involves formation of Lewy bodies, an abnormal aggregation or clumping of the protein alpha-synuclein in the neurons. Unfortunately, there is no cure for PD, and the management of this disease is challenging. Therefore, it is critical for a patient to be diagnosed at early stages. A limited choice of drugs is available to improve the symptoms, but those become less and less effective over time. Apart from that, with rapid growth in the field of science and technology, other methods such as multi-area brain stimulation are used to treat patients. In order to develop advanced techniques and to support drug development for treating PD patients, an accurate mathematical model is needed to explain the underlying relationship of dopamine secretion in the brain with the hand tremors. There has been a lot of effort in the past few decades on modeling PD tremors and treatment effects from a computational point of view. These models can effectively save time as well as the cost of drug development for the pharmaceutical industry and be helpful for selecting appropriate treatment mechanisms among all possible options. In this review paper, an effort is made to investigate studies on PD modeling and analysis and to highlight some of the key advances in the field over the past centuries with discussion on the current challenges.

Keywords: Parkinson's disease, deep brain stimulation, tremor, modeling

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177 Analysis of Human Toxicity Potential of Major Building Material Production Stage Using Life Cycle Assessment

Authors: Rakhyun Kim, Sungho Tae

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Global environmental issues such as abnormal weathers due to global warming, resource depletion, and ecosystem distortions have been escalating due to rapid increase of population growth, and expansion of industrial and economic development. Accordingly, initiatives have been implemented by many countries to protect the environment through indirect regulation methods such as Environmental Product Declaration (EPD), in addition to direct regulations such as various emission standards. Following this trend, life cycle assessment (LCA) techniques that provide quantitative environmental information, such as Human Toxicity Potential (HTP), for buildings are being developed in the construction industry. However, at present, the studies on the environmental database of building materials are not sufficient to provide this support adequately. The purpose of this study is to analysis human toxicity potential of major building material production stage using life cycle assessment. For this purpose, the theoretical consideration of the life cycle assessment and environmental impact category was performed and the direction of the study was set up. That is, the major material in the global warming potential view was drawn against the building and life cycle inventory database was selected. The classification was performed about 17 kinds of substance and impact index, such as human toxicity potential, that it specifies in CML2001. The environmental impact of analysis human toxicity potential for the building material production stage was calculated through the characterization. Meanwhile, the environmental impact of building material in the same category was analyze based on the characterization impact which was calculated in this study. In this study, establishment of environmental impact coefficients of major building material by complying with ISO 14040. Through this, it is believed to effectively support the decisions of stakeholders to improve the environmental performance of buildings and provide a basis for voluntary participation of architects in environment consideration activities.

Keywords: human toxicity potential, major building material, life cycle assessment, production stage

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176 Improving Chest X-Ray Disease Detection with Enhanced Data Augmentation Using Novel Approach of Diverse Conditional Wasserstein Generative Adversarial Networks

Authors: Malik Muhammad Arslan, Muneeb Ullah, Dai Shihan, Daniyal Haider, Xiaodong Yang

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Chest X-rays are instrumental in the detection and monitoring of a wide array of diseases, including viral infections such as COVID-19, tuberculosis, pneumonia, lung cancer, and various cardiac and pulmonary conditions. To enhance the accuracy of diagnosis, artificial intelligence (AI) algorithms, particularly deep learning models like Convolutional Neural Networks (CNNs), are employed. However, these deep learning models demand a substantial and varied dataset to attain optimal precision. Generative Adversarial Networks (GANs) can be employed to create new data, thereby supplementing the existing dataset and enhancing the accuracy of deep learning models. Nevertheless, GANs have their limitations, such as issues related to stability, convergence, and the ability to distinguish between authentic and fabricated data. In order to overcome these challenges and advance the detection and classification of CXR normal and abnormal images, this study introduces a distinctive technique known as DCWGAN (Diverse Conditional Wasserstein GAN) for generating synthetic chest X-ray (CXR) images. The study evaluates the effectiveness of this Idiosyncratic DCWGAN technique using the ResNet50 model and compares its results with those obtained using the traditional GAN approach. The findings reveal that the ResNet50 model trained on the DCWGAN-generated dataset outperformed the model trained on the classic GAN-generated dataset. Specifically, the ResNet50 model utilizing DCWGAN synthetic images achieved impressive performance metrics with an accuracy of 0.961, precision of 0.955, recall of 0.970, and F1-Measure of 0.963. These results indicate the promising potential for the early detection of diseases in CXR images using this Inimitable approach.

Keywords: CNN, classification, deep learning, GAN, Resnet50

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175 Pomegranate Attenuated Levodopa-Induced Dyskinesia and Dopaminergic Degeneration in MPTP Mice Models of Parkinson’s Disease

Authors: Mahsa Hadipour Jahromy, Sara Rezaii

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Parkinson’s disease (PD) results primarily from the death of dopaminergic neurons in the substantia nigra. Soon after the discovery of levodopa and its beneficial effects in chronic administration, debilitating involuntary movements observed, termed levodopa-induced dyskinesia (LID) with poorly understood pathogenesis. Polyphenol-rich compounds, like pomegranate, provided neuroprotection in several animal models of brain diseases. In the present work, we investigated whether pomegranate has preventive effects following 4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced dopaminergic degenerations and the potential to diminish LID in mice. Mice model of PD was induced by MPTP (30 mg/kg daily for five consecutive days). To induce a mice model of LID, valid PD mice were treated with levodopa (50 mg/kg, i.p) for 15 days. Then the effects of chronic co-administration of pomegranate juice (20 ml/kg) with levodopa and continuing for 10 days, evaluated. Behavioural tests were performed in all groups, every other day including: Abnormal involuntary movements (AIMS), forelimb adjusting steps, cylinder, and catatonia tests. Finally, brain tissue sections were prepared to study substantia nigra changes and dopamine neuron density after treatments. With this MPTP regimen, significant movement disorders revealed in AIMS tests and there was a reduction in dopamine striatal density. Levodopa attenuates their loss caused by MPTP, however, in chronic administration, dyskinesia observed in forelimb adjusting step and cylinder tests. Besides, catatonia observed in some cases. Chronic pomegranate co-administration significantly improved LID in both tests and reduced dopaminergic loss in substantia nigra. These data indicate that pomegranate might be a good adjunct for preserving dopaminergic neurons in the substantia nigra and reducing LID in mice.

Keywords: levodopa-induced dyskinesia, MPTP, Parkinson’s disease, pomegranate

Procedia PDF Downloads 473
174 Standard Protocol Selection for Acquisition of Breast Thermogram in Perspective of Early Breast Cancer Detection

Authors: Mrinal Kanti Bhowmik, Usha Rani Gogoi Jr., Anjan Kumar Ghosh, Debotosh Bhattacharjee

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In the last few decades, breast thermography has achieved an average sensitivity and specificity of 90% for breast tumor detection. Breast thermography is a non-invasive, cost-effective, painless and radiation-free breast imaging modality which makes a significant contribution to the evaluation and diagnosis of patients, suspected of having breast cancer. An abnormal breast thermogram may indicate significant biological risk for the existence or the development of breast tumors. Breast thermography can detect a breast tumor, when the tumor is in its early stage or when the tumor is in a dense breast. The infrared breast thermography is very sensitive to environmental changes for which acquisition of breast thermography should be performed under strictly controlled conditions by undergoing some standard protocols. Several factors like air, temperature, humidity, etc. are there to be considered for characterizing thermal images as an imperative tool for detecting breast cancer. A detailed study of various breast thermogram acquisition protocols adopted by different researchers in their research work is provided here in this paper. After going through a rigorous study of different breast thermogram acquisition protocols, a new standard breast thermography acquisition setup is proposed here in this paper for proper and accurate capturing of the breast thermograms. The proposed breast thermogram acquisition setup is being built in the Radiology Department, Agartala Government Medical College (AGMC), Govt. of Tripura, Tripura, India. The breast thermograms are captured using FLIR T650sc thermal camera with the thermal sensitivity of 20 mK at 30 degree C. The paper is an attempt to highlight the importance of different critical parameters of breast thermography like different thermography views, patient preparation protocols, acquisition room requirements, acquisition system requirements, etc. This paper makes an important contribution by providing a detailed survey and a new efficient approach on breast thermogram capturing.

Keywords: acquisition protocol, breast cancer, breast thermography, infrared thermography

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173 Efficacy of Coconut Shell Pyrolytic Oil Distillate in Protecting Wood Against Bio-Deterioration

Authors: K. S. Shiny, R. Sundararaj

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Coconut trees (Cocos nucifera L.) are grown in many parts of India and world because of its multiple utilities. During pyrolysis, coconut shells yield oil, which is a dark thick liquid. Upon simple distillation it produces a more or less colourless liquid, termed coconut shell pyrolytic oil distillate (CSPOD). This manuscript reports and discusses the use of coconut shell pyrolytic oil distillate as a potential wood protectant against bio-deterioration. Since botanical products as ecofriendly wood protectant is being tested worldwide, the utilization of CPSOD as wood protectant is of great importance. The efficacy of CSPOD as wood protectant was evaluated as per Bureau of Indian Standards (BIS) in terms of its antifungal, antiborer, and termiticidal activities. Specimens of Rubber wood (Hevea brasiliensis) in six replicate each for two treatment methods namely spraying and dipping (48hrs) were employed. CSPOD was found to impart total protection against termites for six months compared to control under field conditions. For assessing the efficacy of CSPOD against fungi, the treated blocks were subjected to the attack of two white rot fungi Tyromyces versicolor (L.) Fr. and Polyporus sanguineus (L.) G. Mey and two brown rot fungi, Polyporus meliae (Undrew.) Murrill. and Oligoporus placenta (Fr.) Gilb. & Ryvarden. Results indicated that treatment with CSPOD significantly protected wood from the damage caused by the decay fungi. Efficacy of CSPOD against wood borer Lyctus africanus Lesne was carried out using six pairs of male and female beetles and it gave promising results in protecting the treated wood blocks when compared to control blocks. As far as the treatment methods were concerned, dip treatment was found to be more effective when compared to spraying. The results of the present investigation indicated that CSPOD is a promising botanical compound which has the potential to replace synthetic wood protectants. As coconut shell, pyrolytic oil is a waste byproduct of coconut shell charcoal industry, its utilization as a wood preservative will expand the economic returns from such industries.

Keywords: coconut shell pyrolytic oil distillate, eco-friendly wood protection, termites, wood borers, wood decay fungi

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172 Serum Interlukin-8 and Immunomodulation in Beta Thalassemia Patients

Authors: Shahira El Shafie, Hanaa Eldash, Engy Ghabbour, Mohamed Eid

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Several immunologic defects can be found in patients with beta-thalassemia, among which the impairment of neutrophil phagocytic function is of utmost importance. Attention has been directed to the role of proinflammatory cytokines in neutrophil chemotaxis and phagocytosis. Interleukin-8 (IL-8) is an important chemotactic and activation peptide for neutrophils; changes in IL-8 level and potential correlation with neutrophil function can be relevant to immunomodulation pathophysiology in beta-thalassemia patients. This case-control study aimed to evaluate IL-8 level and to assess granulocyte recruitment, as markers of immunomodulation, in poly-transfused thalassemia patients attending Fayoum University Hospitals. The study was conducted on 50 patients with ß thalassemia and 32 age-matched controls. 21/50 patients were transfused more than ten times, and 29/50 were transfused in a lower frequency. Patients and controls were subjected to thorough history taking and clinical examination, measurement of IL-8 level using human IL-8 ELISA kit, and Rebuck skin window technique (RSWT) to assess granulocyte recruitment. Our data showed statistically significant higher levels of IL-8 in ß thalassemia patients compared to control with a much higher difference in patients transfused more than ten times. Neutrophil recruitment was significantly lower in ß thalassemia patients compared to control at 4 hours and 24 hours test time. Although IL-8, the main chemotactic pro-inflammatory cytokine showed a higher level in thalassemia patients, neutrophils recruitment was significantly lower, especially in those receiving more than ten transfusion times. Our findings suggest a possible role of other neutrophil chemotactic factors, defective neutrophil response, or increased IL-8 as compensation of abnormal function. We recommend the use of IL-8 and Rebuck skin window technique as useful markers of immunomodulation in thalassemia and further study for these biomarkers to assess their clinical implications and impact on the management of thalassemia patients.

Keywords: beta-thalassemia, Interleukin-8, Rebuck skin window technique, immunomodulation

Procedia PDF Downloads 171
171 The Use of Hearing Protection Devices and Hearing Loss in Steel Industry Workers in Samut Prakan Province, Thailand

Authors: Petcharat Kerdonfag, Surasak Taneepanichskul, Winai Wadwongtham

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Background: Although there have not been effective treatments for Noise Induced Hearing Loss (NIHL), it can be definitely preventable with promoting the use of Hearing Protection devices (HPDs) among workers who have been exposed to excessive noise for a long period. Objectives: The objectives of this study were to explore the use of HPDs among steel industrial workers in the high noise level zone in Samut Prakan province, Thailand and to examine the relationships of the HPDs use and hearing loss. Materials and Methods: In this cross-sectional study, eligible ninety-three participants were recruited in the designated zone of higher noise (> 85dBA) of two factories, using simple random sampling. The use of HPDs was gathered by the self-record form, examined and confirmed by the researcher team. Hearing loss was assessed by the audiometric screening at the regional Samut Prakan hospital. If an average threshold level exceeds 25 dBA at high frequency (4 and 6 Hz) in each ear, participants would be lost of hearing. Data were collected from October to December, 2016. All participants were examined by the same examiners for the validity. An Audiometric testing was performed with the participants who have been exposed to high noise levels at least 14 hours from workplace. Results: Sixty participants (64.5%) had secondary level of education. The average mean score of percent time of using HPDs was 60.5% (SD = 25.34). Sixty-seven participants (72.0%) had abnormal hearing which they have still needed to increase lower percent time of using HPDs (Mean = 37.01, SD = 23.81) than those having normal hearing (Mean = 45.77, SD = 28.44). However, there was no difference in the mean average of percent time of using HPDs between these two groups.Conclusion: The findings of this study have confirmed that the steel industrial workers still need to be motivated to use HPDs regularly. Future research should pay more attentions for creating a meaningful innovation to steel industrial workers.

Keywords: hearing protection devices, noise induced hearing loss, audiometric testing, steel industry

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170 A Focused, High-Intensity Spread-Spectrum Ultrasound Solution to Prevent Biofouling

Authors: Alan T. Sassler

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Biofouling is a significant issue for ships, especially those based in warm water ports. Biofouling damages hull coatings, degrades platform hydrodynamics, blocks cooling water intakes, and returns, reduces platform range and speed, and increases fuel consumption. Although platforms are protected to some degree by antifouling paints, these paints are much less effective on stationary platforms, and problematic biofouling can occur on antifouling paint-protected stationary platforms in some environments in as little as a matter of weeks. Remediation hull cleaning operations are possible, but they are very expensive, sometimes result in damage to the vessel’s paint or hull and are generally not completely effective. Ultrasound with sufficient intensity focused on specific frequency ranges can be used to prevent the growth of biofouling organisms. The use of ultrasound to prevent biofouling isn't new, but systems to date have focused on protecting platforms by shaking the hull using internally mounted transducers similar to those used in ultrasonic cleaning machines. While potentially effective, this methodology doesn't scale well to large platforms, and there are significant costs associated with installing and maintaining these systems, which dwarf the initial purchase price. An alternative approach has been developed, which uses highly directional pier-mounted transducers to project high-intensity spread-spectrum ultrasonic energy into the water column focused near the surface. This focused energy has been shown to prevent biofouling at ranges of up to 50 meters from the source. Spreading the energy out over a multi-kilohertz band makes the system both more effective and more environmentally friendly. This system has been shown to be both effective and inexpensive in small-scale testing and is now being characterized on a larger scale in selected marinas. To date, test results have been collected in Florida marinas suggesting that this approach can be used to keep ensonified areas of thousands of square meters free from biofouling, although care must be taken to minimize shaded areas.

Keywords: biofouling, ultrasonic, environmentally friendly antifoulant, marine protection, antifouling

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169 Assessment of Sperm Aneuploidy Using Advanced Sperm Fish Technique in Infertile Patients

Authors: Archana. S, Usha Rani. G, Anand Balakrishnan, Sanjana.R, Solomon F, Vijayalakshmi. J

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Background: There is evidence that male factors contribute to the infertility of up to 50% of couples, who are evaluated and treated for infertility using advanced assisted reproductive technologies. Genetic abnormalities, including sperm chromosome aneuploidy as well as structural aberrations, are one of the major causes of male infertility. Recent advances in technology expedite the evaluation of sperm aneuploidy. The purpose of the study was to de-termine the prevalence of sperm aneuploidy in infertile males and the degree of association between DNA fragmentation and sperm aneuploidy. Methods: In this study, 75 infertile men were included, and they were divided into four abnormal groups (Oligospermia, Terato-spermia, Asthenospermia and Oligoasthenoteratospermia (OAT)). Men with children who were normozoospermia served as the control group. The Fluorescence in situ hybridization (FISH) method was used to test for sperm aneuploidy, and the Sperm Chromatin Dispersion Assay (SCDA) was used to measure the fragmentation of sperm DNA. Spearman's correla-tion coefficient was used to evaluate the relationship between sperm aneuploidy and sperm DNA fragmentation along with age. P < 0.05 was regarded as significant. Results: 75 partic-ipants' ages varied from 28 to 48 years old (35.5±5.1). The percentage of spermatozoa bear-ing X and Y was determined to be statistically significant (p-value < 0.05) and was found to be 48.92% and 51.18% of CEP X X 1 – nucish (CEP XX 1) [100] and CEP Y X 1 – nucish (CEP Y X 1) [100]. When compared to the rate of DNA fragmentation, it was discovered that infertile males had a greater frequency of sperm aneuploidy. Asthenospermia and OAT groups in sex chromosomal aneuploidy were significantly correlated (p<0.05). Conclusion: Sperm FISH and SCDA assay results showed increased sperm aneuploidy frequency, and DNA fragmentation index in infertile men compared with fertile men. There is a significant relationship observed between sperm aneuploidy and DNA fragmentation in OAT patients. When evaluating male variables and idiopathic infertility, the sperm FISH screening method can be used as a valuable diagnostic tool.

Keywords: ale infertility, dfi (dna fragmentation assay) (scd-sperm chromatin dispersion).art (artificial reproductive technology), trisomy, aneuploidy, fish (fluorescence in-situ hybridization), oat (oligoasthoteratospermia)

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168 Τhe Importance of Previous Examination Results, in Futural Differential Diagnostic Procedures and Especially in the Era of Covid-19

Authors: Angelis P. Barlampas

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Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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167 Disease Trajectories in Relation to Poor Sleep Health in the UK Biobank

Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

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Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.

Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank

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166 Phenotypical and Genotypical Diagnosis of Cystic Fibrosis in 26 Cases from East and South Algeria

Authors: Yahia Massinissa, Yahia Mouloud

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Cystic fibrosis (CF), the most common lethal genetic disease in the Europe population, is caused by mutations in the transmembrane conductance regulator gene (CFTR). It affects most organs including an epithelial tissue, base of hydroelectrolytic transepithelial transport, notably that aerial ways, the pancreas, the biliary ways, the intestine, sweat glands and the genital tractus. The gene whose anomalies are responsible of the cystic fibrosis codes for a protein Cl channel named CFTR (cystic fibrosis transmembrane conductance regulator) that exercises multiple functions in the cell, one of the most important in control of sodium and chlorine through epithelia. The deficient function translates itself notably by an abnormal production of viscous secretion that obstructs the execrator channels of this target organ: one observes then a dilatation, an inflammation and an atrophy of these organs. It also translates itself by an increase of the concentration in sodium and in chloride in sweat, to the basis of the sweat test. In order to do a phenotypical and genotypical diagnosis at a part of the Algerian population, our survey has been carried on 16 patients with evocative symptoms of the cystic fibrosis at that the clinical context has been confirmed by a sweat test. However, anomalies of the CFTR gene have been determined by electrophoresis in gel of polyacrylamide of the PCR products (polymerase chain reaction), after enzymatic digestion, then visualized to the ultraviolet (UV) after action of the ethidium bromide. All mutations detected at the time of our survey have already been identified at patients attained by this pathology in other populations of the world. However, the important number of found mutation with regard to the one of the studied patients testifies that the origin of this big clinical variability that characterizes the illness in the consequences of an enormous diversity of molecular defects of the CFTR gene.

Keywords: cystic fibrosis, CFTR gene, polymorphism, algerian population, sweat test, genotypical diagnosis

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165 Optimization of a High-Growth Investment Portfolio for the South African Market Using Predictive Analytics

Authors: Mia Françoise

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This report aims to develop a strategy for assisting short-term investors to benefit from the current economic climate in South Africa by utilizing technical analysis techniques and predictive analytics. As part of this research, value investing and technical analysis principles will be combined to maximize returns for South African investors while optimizing volatility. As an emerging market, South Africa offers many opportunities for high growth in sectors where other developed countries cannot grow at the same rate. Investing in South African companies with significant growth potential can be extremely rewarding. Although the risk involved is more significant in countries with less developed markets and infrastructure, there is more room for growth in these countries. According to recent research, the offshore market is expected to outperform the local market over the long term; however, short-term investments in the local market will likely be more profitable, as the Johannesburg Stock Exchange is predicted to outperform the S&P500 over the short term. The instabilities in the economy contribute to increased market volatility, which can benefit investors if appropriately utilized. Price prediction and portfolio optimization comprise the two primary components of this methodology. As part of this process, statistics and other predictive modeling techniques will be used to predict the future performance of stocks listed on the Johannesburg Stock Exchange. Following predictive data analysis, Modern Portfolio Theory, based on Markowitz's Mean-Variance Theorem, will be applied to optimize the allocation of assets within an investment portfolio. By combining different assets within an investment portfolio, this optimization method produces a portfolio with an optimal ratio of expected risk to expected return. This methodology aims to provide a short-term investment with a stock portfolio that offers the best risk-to-return profile for stocks listed on the JSE by combining price prediction and portfolio optimization.

Keywords: financial stocks, optimized asset allocation, prediction modelling, South Africa

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164 Reduced Lung Volume: A Possible Cause of Stuttering

Authors: Shantanu Arya, Sachin Sakhuja, Gunjan Mehta, Sanjay Munjal

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Stuttering may be defined as a speech disorder affecting the fluency domain of speech and characterized by covert features like word substitution, omittance and circumlocution and overt features like prolongation of sound, syllables and blocks etc. Many etiologies have been postulated to explain stuttering based on various experiments and research. Moreover, Breathlessness has also been reported by many individuals with stuttering for which breathing exercises are generally advised. However, no studies reporting objective evaluation of the pulmonary capacity and further objective assessment of the efficacy of breathing exercises have been conducted. Pulmonary Function Test which evaluates parameters like Forced Vital Capacity, Peak Expiratory Flow Rate, Forced expiratory flow Rate can be used to study the pulmonary behavior of individuals with stuttering. The study aimed: a) To identify speech motor & physiologic behaviours associated with stuttering by administering PFT. b) To recognize possible reasons for an association between speech motor behaviour & stuttering severity. In this regard, PFT tests were administered on individuals who reported signs and symptoms of stuttering and showed abnormal scores on Stuttering Severity Index. Parameters like Forced Vital Capacity, Forced Expiratory Volume, Peak Expiratory Flow Rate (L/min), Forced Expiratory Flow Rate (L/min) were evaluated and correlated with scores of Stuttering Severity Index. Results showed significant decrease in the parameters (lower than normal scores) in individuals with established stuttering. Strong correlation was also found between degree of stuttering and the degree of decrease in the pulmonary volumes. Thus, it is evident that fluent speech requires strong support of lung pressure and requisite volumes. Further research in demonstrating the efficacy of abdominal breathing exercises in this regard is needed.

Keywords: forced expiratory flow rate, forced expiratory volume, forced vital capacity, peak expiratory flow rate, stuttering

Procedia PDF Downloads 247