Search results for: disease risk perception
9816 Credit Risk and Financial Stability
Authors: Zidane Abderrezzaq
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In contrast to recent successful developments in macro monetary policies, the modelling, measurement and management of systemic financial stability has remained problematical. Indeed, the focus of most effort has been on improving individual, rather than systemic, bank risk management; the Basel II objective has been to bring regulatory bank capital into line with the (sophisticated) banks’ assessment of their own economic capital. Even at the individual bank level there are concerns over appropriate diversification allowances, differing objectives of banks and regulators, the need for a buffer over regulatory minima, and the distinction between expected and unexpected losses (EL and UL). At the systemic level the quite complex and prescriptive content of Basel II raises dangers of ‘endogenous risk’ and procyclicality. Simulations suggest that this latter could be a serious problem. In an extension to the main analysis we study how liquidity effects interact with banking structure to produce a greater chance of systemic breakdown. We finally consider how the risk of contagion might depend on the degree of asymmetry (tiering) inherent in the structure of the banking system. A number of our results have important implications for public policy, which this paper also draws out.Keywords: systemic stability, financial regulation, credit risk, systemic risk
Procedia PDF Downloads 3659815 Using Deep Learning in Lyme Disease Diagnosis
Authors: Teja Koduru
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Untreated Lyme disease can lead to neurological, cardiac, and dermatological complications. Rapid diagnosis of the erythema migrans (EM) rash, a characteristic symptom of Lyme disease is therefore crucial to early diagnosis and treatment. In this study, we aim to utilize deep learning frameworks including Tensorflow and Keras to create deep convolutional neural networks (DCNN) to detect images of acute Lyme Disease from images of erythema migrans. This study uses a custom database of erythema migrans images of varying quality to train a DCNN capable of classifying images of EM rashes vs. non-EM rashes. Images from publicly available sources were mined to create an initial database. Machine-based removal of duplicate images was then performed, followed by a thorough examination of all images by a clinician. The resulting database was combined with images of confounding rashes and regular skin, resulting in a total of 683 images. This database was then used to create a DCNN with an accuracy of 93% when classifying images of rashes as EM vs. non EM. Finally, this model was converted into a web and mobile application to allow for rapid diagnosis of EM rashes by both patients and clinicians. This tool could be used for patient prescreening prior to treatment and lead to a lower mortality rate from Lyme disease.Keywords: Lyme, untreated Lyme, erythema migrans rash, EM rash
Procedia PDF Downloads 2299814 Interconnections between Chronic Jet Lag and Neurological Disorders
Authors: Suliman Khan, Rabeea Siddique, Mengzhou Xue
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Background: Patients with neurological disorders often display altered circadian rhythms. The disrupted circadian rhythms through chronic jetlag or shiftwork are thought to increase the risk and severity of human disease, including cancer, psychiatric, and related brain diseases. In this study, we investigated the impact of shiftwork or chronic jetlag (CJL) like conditions on mice’s brains. Transcriptome profiling based on RNA sequencing revealed that genes associated with serious neurological disorders were differentially expressed in the nucleus accumbens (NAc) and prefrontal cortex (PFC). According to the qPCR analysis, several key regulatory genes associated with neurological disorders were significantly altered in the NAc, PFC, hypothalamus, hippocampus, and striatum. Serotonin levels and the expression levels of serotonin transporters and receptors were significantly altered in mice treated with CJL. Overall, these results indicate that CJL may increase the risk of neurological disorders by disrupting the key regulatory genes, biological functions, serotonin, and corticosterone. These molecular linkages can further be studied to investigate the mechanism underlying CJL or shiftwork-mediated neurological disorders in order to develop treatment strategies.Keywords: chronic jetlag, molecular profiles, brain disorders, circadian rhythms
Procedia PDF Downloads 1099813 Investigating the Prevalence of HCV from Laboratory Centers in Tehran City - Iran by Electrochemiluminescence (ECL) and PCR Techniques
Authors: Zahra Rakhshan Masoudi, Sona Rostampour Yasouri
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Considering that the only way to save the lives of patients and healthy people who have suffered sudden accidents is blood transfusion, what is important is the presence of the known HCV virus as the most important cause of the disease after blood transfusion. HCV is one of the major global problems, and its transmission through blood causes life-threatening complications and extensive legal, social and economic consequences. On the one hand, unfortunately, there is still no effective vaccine available to prevent HCV. In Iran, the exact statistics of the prevalence of this disease have not yet been fully announced. The main purpose of this study is to investigate the prevalence rate and rapid diagnosis of HCV among those who refer to laboratory centers in Tehran. From spring to winter of 1401 (2022-2023), 2166 blood samples were collected from laboratory centers in Tehran. Blood samples were evaluated for the presence of HCV by Electrochemiluminescence (ECL) and PCR techniques along with specific HCV primers. In general, 36 samples (1.6%) were tested positive by the mentioned techniques. The results indicated that the ECL technique is a sensitive and specific diagnostic method for detecting HCV in the early stages of the disease and can be very helpful and provide the possibility of starting the treatment steps to prevent the exacerbation of the disease earlier. Also, the results of PCR technique showed that PCR is an accurate, sensitive and fast method for definitive diagnosis of HCV. It seems that the incidence rate of this disease is increasing in Iran, and investigating the spread of the disease throughout Iran for a longer period of time in the continuation of our research can be helpful in the future to take the necessary measures to prevent the transmission of the disease to people and the rapid onset Treatment steps for patients with HCV should be carried out.Keywords: electrochemiluminescence, HCV, PCR, prevalence
Procedia PDF Downloads 589812 Universal Screening for GBS and Efficacy of GBS Intrapartum Antibiotic Prophylaxis [IAP] an Al Rahba Experience
Authors: Ritu Nambiar, Shazia Tariq, Sumaira Jamil, Farida Munawar, Imelda Israell
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GBS has emerged as a leading cause of neonatal infections worldwide and clinical trials have demonstrated that giving IAP was effective in reducing early onset GBS (EOGBS) disease of the newborn. There is no available data on the prevalence of GBS in the UAE, therefore, a retrospective chart analysis of our parturients were done to look at our prevalence. The aim of this study is: 1. To study the prevalence of GBS colonization of parturients at al Rahba Hospital following universal screening between 35-37 week. 2. To look at efficacy of GBS intrapartum antibiotic prophylaxis by NICU admission for EO GBS disease of the newborn. 1) The prevalence of GBS in our patient population is 24.15%. 2) Incidence of EO GBS disease of the newborn was 0.6%.Keywords: GBS Screening, universal intrapartum antibiotic prophylaxis, parturients, newborn
Procedia PDF Downloads 3799811 Ports and Airports: Gateways to Vector-Borne Diseases in Portugal Mainland
Authors: Maria C. Proença, Maria T. Rebelo, Maria J. Alves, Sofia Cunha
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Vector-borne diseases are transmitted to humans by mosquitos, sandflies, bugs, ticks, and other vectors. Some are re-transmitted between vectors, if the infected human has a new contact when his levels of infection are high. The vector is infected for lifetime and can transmit infectious diseases not only between humans but also from animals to humans. Some vector borne diseases are very disabling and globally account for more than one million deaths worldwide. The mosquitoes from the complex Culex pipiens sl. are the most abundant in Portugal, and we dispose in this moment of a data set from the surveillance program that has been carried on since 2006 across the country. All mosquitos’ species are included, but the large coverage of Culex pipiens sl. and its importance for public health make this vector an interesting candidate to assess risk of disease amplification. This work focus on ports and airports identified as key areas of high density of vectors. Mosquitoes being ectothermic organisms, the main factor for vector survival and pathogen development is temperature. Minima and maxima local air temperatures for each area of interest are averaged by month from data gathered on a daily basis at the national network of meteorological stations, and interpolated in a geographic information system (GIS). The range of temperatures ideal for several pathogens are known and this work shows how to use it with the meteorological data in each port and airport facility, to focus an efficient implementation of countermeasures and reduce simultaneously risk transmission and mitigation costs. The results show an increased alert with decreasing latitude, which corresponds to higher minimum and maximum temperatures and a lower amplitude range of the daily temperature.Keywords: human health, risk assessment, risk management, vector-borne diseases
Procedia PDF Downloads 4009810 The Effectiveness of Herbal Capsules Ethanol Extract of Celery (Apium graveolens L.) and Bulb of Garlic (Allium sativum L.) in Lowering Total Cholesterol Levels in Patients with Hypercholesterolemia
Authors: Anton Bahtiar, Lukas Tjandra Leksana, Fransiscus D. Suyatna
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Hypercholesterolemia is one of the major risk factors that can trigger the development of cardiovascular disease, especially coronary heart disease. One of the traditional drugs used for hypercholesterolemia is a combination of herbs celery (Apium graveolens) and garlic (Allium sativum). This study aimed to investigate the effects of the extract on lipid profile in hypercholesterolemic subjects. Subjects consisted of patients with traditional medicine clinic in Jakarta. Each subject received treatment capsules containing herbal extract and placebo capsules. On the 44 subjects, the lipid profile was examined blood levels of total cholesterol, HDL, LDL, and triglycerides. Paired two-tailed t-test was used for the difference between lipid profile of the therapy group and the placebo group. The changes in the lipid profile between the treatment groups and the placebo group for total cholesterol, HDL, LDL, and triglycerides was 14,82 ± 6,946;1.45 ± 2,945;6,98 ± 8,105;2,48 ± 6,504 mg/dL. The herbal extract decrease blood cholesterol and LDL levels significantly (P <0.05).Keywords: Allium sativum, Apium graveolens, hypercholesterolemia, cholesterol, HDL, LDL
Procedia PDF Downloads 3269809 Prevalence, Level and Health Risk Assessment of Mycotoxins in the Fried Poultry Eggs from Jordan
Authors: Sharaf S. Omar
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In the current study, level and prevalence of deoxynivalenol (DON), aflatoxin B1 AFB1), zearalenone (ZEN), and ochratoxin A (OTA) in fried poultry eggs in Jordan was investigated. Poultry egg samples (n = 250) were collected. The level of DON, AFB1, ZEN and OTA in the white and yolk of poultry eggs was measured using LC-MS-MS. The health risk assessment was calculated using Margin of Exposures (MOEs) for AFB1 and OTA and hazard index (HI) for ZEN and DON. The highest prevalence in yolk and white of eggs was related to ZEN (96.56%) and OTA (97.44%), respectively. Also, the highest level in white and yolk was related to DON (1.07µg/kg) and DON (1.65 µg/kg), respectively. Level of DON in the yolk of eggs was significantly higher than white of eggs (P-value < 0.05). Risk assessment indicated that exposed population are at high risk of AFB1 (MOEs < 10,000) in fried poultry eggs.Keywords: mycotoxins 2, aflatoxin b1, risk assessment, poultry egg
Procedia PDF Downloads 1059808 Association of Musculoskeletal and Radiological Features with Clinical and Serological Findings in Systemic Sclerosis: A Single-Centre Registry Study
Authors: Rezvan Hosseinian
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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.Keywords: disease subsets, hand radiography, joint erosion, sclerosis
Procedia PDF Downloads 739807 Risk and Vulnerability Assessment of Agriculture on Climate Change: Bangnampriao District, Thailand
Authors: Charuvan Kasemsap
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This research was studied in Bangnampriao District, Chachernsao Province, Thailand. The primary data relating to flooding, drought, and saline intrusion problem on agriculture were collected by surveying, focus group, and in-depth interview with agricultural officers, technical officers of irrigation department, and local government leader of Bangnampriao District. The likelihood and consequence of risk were determined the risk index by risk assessment matrix. In addition, the risk index and the total coping capacity scores were investigated the vulnerability index by vulnerability matrix. It was found that the high-risk drought and saline intrusion was dramatically along Bang Pakong River owing to the end destination of Chao Phraya Irrigation system of Central Thailand. This leads yearly the damage of rice paddy, mango tree, orchard, and fish pond. Therefore, some agriculture avoids rice growing during January to May, and also pumps fresh water from a canal into individual storage pond. However, Bangnampriao District will be strongly affected by the impacts of climate change. Monthly precipitations are expected to decrease in number; dry seasons are expected to be more in number and longer in duration. Thus, the risk and vulnerability of agriculture are also increasing. Adaptation strategies need to be put in place in order to enhance the resilience of the agriculture.Keywords: agriculture, bangnampriao, climate change, risk assessment
Procedia PDF Downloads 4249806 Impact of Diabetes Mellitus Type 2 on Clinical In-Stent Restenosis in First Elective Percutaneous Coronary Intervention Patients
Authors: Leonard Simoni, Ilir Alimehmeti, Ervina Shirka, Endri Hasimi, Ndricim Kallashi, Verona Beka, Suerta Kabili, Artan Goda
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Background: Diabetes Mellitus type 2, small vessel calibre, stented length of vessel, complex lesion morphology, and prior bypass surgery have resulted risk factors for In-Stent Restenosis (ISR). However, there are some contradictory results about body mass index (BMI) as a risk factor for ISR. Purpose: We want to identify clinical, lesional and procedural factors that can predict clinical ISR in our patients. Methods: Were enrolled 759 patients who underwent first-time elective PCI with Bare Metal Stents (BMS) from September 2011 to December 2013 in our Department of Cardiology and followed them for at least 1.5 years with a median of 862 days (2 years and 4 months). Only the patients re-admitted with ischemic heart disease underwent control coronary angiography but no routine angiographic control was performed. Patients were categorized in ISR and non-ISR groups and compared between them. Multivariate analysis - Binary Logistic Regression: Forward Conditional Method was used to identify independent predictive risk factors. P was considered statistically significant when <0.05. Results: ISR compared to non-ISR individuals had a significantly lower BMI (25.7±3.3 vs. 26.9±3.7, p=0.004), higher risk anatomy (LM + 3-vessel CAD) (23% vs. 14%, p=0.03), higher number of stents/person used (2.1±1.1 vs. 1.75±0.96, p=0.004), greater length of stents/person used (39.3±21.6 vs. 33.3±18.5, p=0.01), and a lower use of clopidogrel and ASA (together) (95% vs. 99%, p=0.012). They also had a higher, although not statistically significant, prevalence of Diabetes Mellitus (42% vs. 32%, p=0.072) and a greater number of treated vessels (1.36±0.5 vs. 1.26±0.5, p=0.08). In the multivariate analysis, Diabetes Mellitus type 2 and multiple stents used were independent predictors risk factors for In-Stent Restenosis, OR 1.66 [1.03-2.68], p=0.039, and OR 1.44 [1.16-1.78,] p=0.001, respectively. On the other side higher BMI and use of clopidogrel and ASA together resulted protective factors OR 0.88 [0.81-0.95], p=0.001 and OR 0.2 [0.06-0.72] p=0.013, respectively. Conclusion: Diabetes Mellitus and multiple stents are strong predictive risk factors, whereas the use of clopidogrel and ASA together are protective factors for clinical In-Stent Restenosis. Paradoxically High BMI is a protective factor for In-stent Restenosis, probably related to a larger diameter of vessels and consequently a larger diameter of stents implanted in these patients. Further studies are needed to clarify this finding.Keywords: body mass index, diabetes mellitus, in-stent restenosis, percutaneous coronary intervention
Procedia PDF Downloads 1959805 Association of Musculoskeletal and Radiological Features with Clinical and Serological Findings in Systemic Sclerosis: A Single-Centre Registry Study
Authors: Nasrin Azarbani
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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal
Procedia PDF Downloads 589804 A Transformer-Based Question Answering Framework for Software Contract Risk Assessment
Authors: Qisheng Hu, Jianglei Han, Yue Yang, My Hoa Ha
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When a company is considering purchasing software for commercial use, contract risk assessment is critical to identify risks to mitigate the potential adverse business impact, e.g., security, financial and regulatory risks. Contract risk assessment requires reviewers with specialized knowledge and time to evaluate the legal documents manually. Specifically, validating contracts for a software vendor requires the following steps: manual screening, interpreting legal documents, and extracting risk-prone segments. To automate the process, we proposed a framework to assist legal contract document risk identification, leveraging pre-trained deep learning models and natural language processing techniques. Given a set of pre-defined risk evaluation problems, our framework utilizes the pre-trained transformer-based models for question-answering to identify risk-prone sections in a contract. Furthermore, the question-answering model encodes the concatenated question-contract text and predicts the start and end position for clause extraction. Due to the limited labelled dataset for training, we leveraged transfer learning by fine-tuning the models with the CUAD dataset to enhance the model. On a dataset comprising 287 contract documents and 2000 labelled samples, our best model achieved an F1 score of 0.687.Keywords: contract risk assessment, NLP, transfer learning, question answering
Procedia PDF Downloads 1219803 Nonparametric Estimation of Risk-Neutral Densities via Empirical Esscher Transform
Authors: Manoel Pereira, Alvaro Veiga, Camila Epprecht, Renato Costa
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This paper introduces an empirical version of the Esscher transform for risk-neutral option pricing. Traditional parametric methods require the formulation of an explicit risk-neutral model and are operational only for a few probability distributions for the returns of the underlying. In our proposal, we make only mild assumptions on the pricing kernel and there is no need for the formulation of the risk-neutral model for the returns. First, we simulate sample paths for the returns under the physical distribution. Then, based on the empirical Esscher transform, the sample is reweighted, giving rise to a risk-neutralized sample from which derivative prices can be obtained by a weighted sum of the options pay-offs in each path. We compare our proposal with some traditional parametric pricing methods in four experiments with artificial and real data.Keywords: esscher transform, generalized autoregressive Conditional Heteroscedastic (GARCH), nonparametric option pricing
Procedia PDF Downloads 4829802 Parents' Perception on the Use of Mobile Technology by Young Children
Authors: Jason Gan
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Technology has been around for many years, those that play a crucial part of our lives have evolved quick and fast, from televisions to computers and now mobile technology has also become a part of our lives. However in Singapore a nation with a strong reliance and following in technology, how are young children (0 to 8 years old) coping with these high technology equipment especially mobile technology and why and what are parents doing to manage this trend in the nation. This study aims to uncover some of the parents’ perception behind the use of mobile technology by their children.Keywords: technology, preschoolers, ICT and Singapore, early childhood
Procedia PDF Downloads 4279801 Portfolio Restructuring of Banks: The Impact on Performance and Risk
Authors: Hannes Koester
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Driven by difficult market conditions and increasing regulations, many banks are making the strategic decision to restructure their portfolio by divesting several business segments. Using a unique dataset of 727 portfolio restructuring announcements by 161 international listed banks over the period 1999 to 2015, we investigate the impact of restructuring measurements on the stock performance as well as on the banks’ profitability and risk. Employing the event study methodology, we detect positive stock market reactions on the announcement of restructuring measurements. These positive stock market reactions indicate that shareholders reward banks’ specialization activities. However, the results of the system GMM regressions show a negative relation between restructuring measurements and banks’ return on assets and a positive relation towards the individual and systemic risk of banks. These empirical results indicate that there is no guarantee that portfolio restructurings will result in a more profitable and less risky institution.Keywords: bank performance, bank risk, divestiture, restructuring, systemic risk
Procedia PDF Downloads 3069800 Advanced Techniques in Robotic Mitral Valve Repair
Authors: Abraham J. Rizkalla, Tristan D. Yan
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Purpose: Durable mitral valve repair is preferred to a replacement, avoiding the need for anticoagulation or re-intervention, with a reduced risk of endocarditis. Robotic mitral repair has been gaining favour globally as a safe, effective, and reproducible method of minimally invasive valve repair. In this work, we showcase the use of the Davinci© Xi robotic platform to perform several advanced techniques, working synergistically to achieve successful mitral repair in advanced mitral disease. Techniques: We present the case of a Barlow type mitral valve disease with a tall and redundant posterior leaflet resulting in severe mitral regurgitation and systolic anterior motion. Firstly, quadrangular resection of P2 is performed to remove the excess and redundant leaflet. Secondly, a sliding leaflet plasty of P1 and P3 is used to reconstruct the posterior leaflet. To anchor the newly formed posterior leaflet to the papillary muscle, CV-4 Goretex neochordae are fashioned using the innovative string, ruler, and bulldog technique. Finally, mitral valve annuloplasty and closure of a patent foramen ovale complete the repair. Results: There was no significant residual mitral regurgitation and complete resolution of the systolic anterior motion of the mitral valve on post operative transoesophageal echocardiography. Conclusion: This work highlights the robotic approach to complex repair techniques for advanced mitral valve disease. Familiarity with resection and sliding plasty, neochord implantation, and annuloplasty allows the modern cardiac surgeon to achieve a minimally-invasive and durable mitral valve repair when faced with complex mitral valve pathology.Keywords: robotic mitral valve repair, Barlow's valve, sliding plasty, neochord, annuloplasty, quadrangular resection
Procedia PDF Downloads 799799 Antibiotic Prescribing Pattern and Associated Risk Factors Promoting Antibiotic Resistance, a Cross Sectional Study in a Regional Hospital in Ghana
Authors: Nicholas Agyepong, Paul Gyan
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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.Keywords: antibiotic, antimicrobial resistance, prescription, prescribers
Procedia PDF Downloads 329798 Perceived Risks in Business-to-Consumer Online Contracts: An Empirical Study in Saudi Arabia
Authors: Shaya Alshahrani
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Perceived risks play a major role in consumer intentions, behaviors, attitudes, and decisions about online shopping in the KSA. This paper investigates the influence of six perceived risk dimensions on Saudi consumers: product risk, information risk, financial risk, privacy and security risk, delivery risk, and terms and conditions risk empirically. To ensure the success of this study, a random survey was distributed to reflect the consumers’ perceived risk and to enable the generalization of the results. Data were collected from 323 respondents in the Kingdom of Saudi Arabia (KSA): 50 who had never shopped online and 273 who had done so. The results indicated that all six risks influenced the respondents’ perceptions of online shopping. The non-online shoppers perceived financial and delivery risks as the most significant barriers to online shopping. This was followed closely by performance, information, and privacy and security risks. Terms and conditions were perceived as less significant. The online consumers considered delivery and performance risks to be the most significant influences on internet shopping. This was followed closely by information and terms and conditions. Financial and privacy and security risks were perceived as less significant. This paper argues that introducing adequate legal solutions to addressing related problems arising from this study is an urgent need. This may enhance consumer trust in the KSA online market, increase consumers’ intentions regarding online shopping, and improve consumer protection.Keywords: perceived risk, online contracts, Saudi Arabia, consumer protection
Procedia PDF Downloads 1399797 Comparison between Deterministic and Probabilistic Stability Analysis, Featuring Consequent Risk Assessment
Authors: Isabela Moreira Queiroz
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Slope stability analyses are largely carried out by deterministic methods and evaluated through a single security factor. Although it is known that the geotechnical parameters can present great dispersal, such analyses are considered fixed and known. The probabilistic methods, in turn, incorporate the variability of input key parameters (random variables), resulting in a range of values of safety factors, thus enabling the determination of the probability of failure, which is an essential parameter in the calculation of the risk (probability multiplied by the consequence of the event). Among the probabilistic methods, there are three frequently used methods in geotechnical society: FOSM (First-Order, Second-Moment), Rosenblueth (Point Estimates) and Monte Carlo. This paper presents a comparison between the results from deterministic and probabilistic analyses (FOSM method, Monte Carlo and Rosenblueth) applied to a hypothetical slope. The end was held to evaluate the behavior of the slope and consequent risk analysis, which is used to calculate the risk and analyze their mitigation and control solutions. It can be observed that the results obtained by the three probabilistic methods were quite close. It should be noticed that the calculation of the risk makes it possible to list the priority to the implementation of mitigation measures. Therefore, it is recommended to do a good assessment of the geological-geotechnical model incorporating the uncertainty in viability, design, construction, operation and closure by means of risk management.Keywords: probabilistic methods, risk assessment, risk management, slope stability
Procedia PDF Downloads 3759796 Patients' Quality of Life and Caregivers' Burden of Parkinson's Disease
Authors: Kingston Rajiah, Mari Kannan Maharajan, Si Jen Yeen, Sara Lew
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Parkinson’s disease (PD) is a progressive neurodegenerative disorder with evolving layers of complexity. Both motor and non-motor symptoms of PD may affect patients’ quality of life (QoL). Life expectancy for an individual with Parkinson’s disease depends on the level of care the individual has access to, can have a direct impact on length of life. Therefore, improvement of the QoL is a significant part of therapeutic plans. Patients with PD, especially those who are in advanced stages, are in great need of assistance, mostly from their family members or caregivers in terms of medical, emotional, and social support. The role of a caregiver becomes increasingly important with the progression of PD, the severity of motor impairment and increasing age of the patient. The nature and symptoms associated with PD can place significant stresses on the caregivers’ burden. As the prevalence of PD is estimated to more than double by 2030, it is important to recognize and alleviate the burden experienced by caregivers. This study focused on the impact of the clinical features on the QoL of PD patients, and of their caregivers. This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr Staging of Parkinson's Disease were used to assess the severity and Parkinson's disease activities of daily living scale were used to assess the disability of Parkinson’s disease patients. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. At least one of the clinical features affected PD patients’ QoL, and at least one of the QoL domains affected the caregivers’ burden. Clinical features ‘Saliva and Drooling’, and ‘Dyskinesia’ explained 29% of variance in QoL of PD patients. The QoL domains ‘stigma’, along with ‘emotional wellbeing’ explained 48.6% of variance in caregivers’ burden. Clinical features such as saliva, drooling and dyskinesia affected the QoL of PD patients. The PD patients’ QoL domains such as ‘stigma’ and ‘emotional well-being’ influenced their caregivers’ burden.Keywords: carers, quality of life, clinical features, Malaysia
Procedia PDF Downloads 2369795 Assessing the Risk of Condensation and Moisture Accumulation in Solid Walls: Comparing Different Internal Wall Insulation Options
Authors: David Glew, Felix Thomas, Matthew Brooke-Peat
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Improving the thermal performance of homes is seen as an essential step in achieving climate change, fuel security, fuel poverty targets. One of the most effective thermal retrofits is to insulate solid walls. However, it has been observed that applying insulation to the internal face of solid walls reduces the surface temperature of the inner wall leaf, which may introduce condensation risk and may interrupt seasonal moisture accumulation and dissipation. This research quantifies the extent to which the risk of condensation and moisture accumulation in the wall increases (which can increase the risk of timber rot) following the installation of six different types of internal wall insulation. In so doing, it compares how risk is affected by both the thermal resistance, thickness, and breathability of the insulation. Thermal bridging, surface temperatures, condensation risk, and moisture accumulation are evaluated using hygrothermal simulation software before and after the thermal upgrades. The research finds that installing internal wall insulation will always introduce some risk of condensation and moisture. However, it identifies that risks were present prior to insulation and that breathable materials and insulation with lower resistance have lower risks than alternative insulation options. The implications of this may be that building standards that encourage the enhanced thermal performance of solid walls may be introducing moisture risks into homes.Keywords: condensation risk, hygrothermal simulation, internal wall insulation, thermal bridging
Procedia PDF Downloads 1559794 The Importance of the Fluctuation in Blood Sugar and Blood Pressure of Insulin-Dependent Diabetic Patients with Chronic Kidney Disease
Authors: Hitoshi Minakuchi, Izumi Takei, Shu Wakino, Koichi Hayashi, Hiroshi Itoh
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Objectives: Among type 2 diabetics, patients with CKD(chronic kidney disease), insulin resistance, impaired glyconeogenesis in kidney and reduced degradation of insulin are recognized, and we observed different fluctuational patterns of blood sugar between CKD patients and non-CKD patients. On the other hand, non-dipper type blood pressure change is the risk of organ damage and mortality. We performed cross-sectional study to elucidate the characteristic of the fluctuation of blood glucose and blood pressure at insulin-treated diabetic patients with chronic kidney disease. Methods: From March 2011 to April 2013, at the Ichikawa General Hospital of Tokyo Dental College, we recruited 20 outpatients. All participants are insulin-treated type 2 diabetes with CKD. We collected serum samples, urine samples for several hormone measurements, and performed CGMS(Continuous glucose measurement system), ABPM (ambulatory blood pressure monitoring), brain computed tomography, carotid artery thickness, ankle brachial index, PWV, CVR-R, and analyzed these data statistically. Results: Among all 20 participants, hypoglycemia was decided blood glucose 70mg/dl by CGMS of 9 participants (45.0%). The event of hypoglycemia was recognized lower eGFR (29.8±6.2ml/min:41.3±8.5ml/min, P<0.05), lower HbA1c (6.44±0.57%:7.53±0.49%), higher PWV (1858±97.3cm/s:1665±109.2cm/s), higher serum glucagon (194.2±34.8pg/ml:117.0±37.1pg/ml), higher free cortisol of urine (53.8±12.8μg/day:34.8±7.1μg/day), and higher metanephrin of urine (0.162±0.031mg/day:0.076±0.029mg/day). Non-dipper type blood pressure change in ABPM was detected 8 among 9 participants with hypoglycemia (88.9%), 4 among 11 participants (36.4%) without hypoglycemia. Multiplex logistic-regression analysis revealed that the event of hypoglycemia is the independent factor of non-dipper type blood pressure change. Conclusions: Among insulin-treated type 2 diabetic patients with CKD, the events of hypoglycemia were frequently detected, and can associate with the organ derangements through the medium of non-dipper type blood pressure change.Keywords: chronic kidney disease, hypoglycemia, non-dipper type blood pressure change, diabetic patients
Procedia PDF Downloads 4049793 Conscription or Constriction: Perception of Students on the Reinforcement of Compulsory Military Service
Authors: Krista Mae F. Ramos, Lance Micaiah C. Dauz, Gylza Nicole D. Bautista, Rua R. Galang, Jeric Xyrus G. Karganilla
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With the recent proclamation of the possible reinforcement of Compulsory Military Service in the Philippines, debates and societal talks rose and circulated as opinions and perceptions regarding the topic continue to clash. This study aims to determine the perception of the youth on its reimplementation and identify various advantages and disadvantages based on their perspective. The responses were gathered through a virtual call interview, underwent the process of thematization, and were categorized into different themes. Results reflect that the students perceive compulsory military service as a necessity for national defense but requires a long time that can hinder their education and needs a strong foundation to be implemented and sustained. The participants acknowledged that the practice would instill discipline, patriotism, and nationalism, develop an individual’s physical abilities, provide skills and knowledge and improve a person’s self-defense. However, there are also concerns regarding the prominent military shaping and abuse, their loss of freedom of choice, and the chances of health deterioration.Keywords: compulsory, military, service, reinforcement, perception
Procedia PDF Downloads 1509792 The Influence of Interior Decoration on Customer's Perception of Hotels in Uyo, Akwa Ibom State Nigeria
Authors: O. B. Enemuo, A. A. Onubuogu
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This work evaluated the influence of interior of decoration on customer perception of hotels in Uyo Akwa Ibom State. Specifically the study identified the various interior decoration used in hotels in the study area, determined the interior decoration used in hotels that appeal to the customer more, ascertained the influence of interior decoration on the level of patronage in the hotel in the study area and suggested ways of improving the interior decoration of hotels in the study area for sustainability. The study was guided by four research questions and two hypotheses. It adopted survey research design; structured questionnaire was used for data collection. The samples for the study were four hundred (400) staff and managers from the various hotels in the study area. Data generated were analyzed using mean and standard deviation analyses of variance (ANOVA) derived from regression analyses to test the hypotheses. The result of the finding showed that satisfactory interior decoration has a positive influence on the sustainability of the hospitality establishments in Uyo. The hypothesis showed that there was a significant relationship between the gender perception on the influence of interior decoration in the hotel and significant relationship between the gender perceptions on the influence of interior decoration in the hotels. From the finding, it was recommended that the hotels should design interior decorative service delivery system which has an impact on customer satisfaction in the hospitality industry and practiced healthy decorative environment and increased customer satisfaction.Keywords: influence, interior decoration, customer’s perception, hotels
Procedia PDF Downloads 2859791 Risk Assessment and Management Using Machine Learning Models
Authors: Lagnajeet Mohanty, Mohnish Mishra, Pratham Tapdiya, Himanshu Sekhar Nayak, Swetapadma Singh
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In the era of global interconnectedness, effective risk assessment and management are critical for organizational resilience. This review explores the integration of machine learning (ML) into risk processes, examining its transformative potential and the challenges it presents. The literature reveals ML's success in sectors like consumer credit, demonstrating enhanced predictive accuracy, adaptability, and potential cost savings. However, ethical considerations, interpretability issues, and the demand for skilled practitioners pose limitations. Looking forward, the study identifies future research scopes, including refining ethical frameworks, advancing interpretability techniques, and fostering interdisciplinary collaborations. The synthesis of limitations and future directions highlights the dynamic landscape of ML in risk management, urging stakeholders to navigate challenges innovatively. This abstract encapsulates the evolving discourse on ML's role in shaping proactive and effective risk management strategies in our interconnected and unpredictable global landscape.Keywords: machine learning, risk assessment, ethical considerations, financial inclusion
Procedia PDF Downloads 559790 Step Method for Solving Nonlinear Two Delays Differential Equation in Parkinson’s Disease
Authors: H. N. Agiza, M. A. Sohaly, M. A. Elfouly
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Parkinson's disease (PD) is a heterogeneous disorder with common age of onset, symptoms, and progression levels. In this paper we will solve analytically the PD model as a non-linear delay differential equation using the steps method. The step method transforms a system of delay differential equations (DDEs) into systems of ordinary differential equations (ODEs). On some numerical examples, the analytical solution will be difficult. So we will approximate the analytical solution using Picard method and Taylor method to ODEs.Keywords: Parkinson's disease, step method, delay differential equation, two delays
Procedia PDF Downloads 1959789 Stem Cell Augmentation Therapy for Cardiovascular Risk in Ankylosing Spondylitis: STATIN-as Study
Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan
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Objective: Bone marrow derived stem cells, endothelial progenitor cells (EPCs), protect against atherosclerotic vascular damage. However, EPCs are depleted in AS and contribute to the enhanced cardiovascular risk. Statins have a protective effect in CAD and diabetes by enhancing the proliferation, migration and survival of EPCs. Therapeutic potential of augmenting EPCs to treat the heightened cardiovascular risk of AS has not yet been exploited. We aimed to investigate the effect of rosuvastatin on EPCs population and inflammation in AS. Methods: 30 AS patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=15) and placebo (n=15) as an adjunct to existing stable anti-rheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures (BASDAI, BASFI, CRP and ESR), pro-inflammatory cytokines (TNF-α, IL-6 and IL-1) and lipids were measured at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin. At 6 months, BASDAI, BASFI, ESR, CRP, TNF-α, and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and BASDAI, CRP and IL-6 after rosuvastatin treatment. Conclusion: First study to show that rosuvastatin augments EPCs population in AS. This defines a novel mechanism of rosuvastatin treatment in AS: the augmentation of EPCs with improvement in proinflammatory cytokines and inflammatory disease activity. The augmentation of EPCs by rosuvastatin may provide a novel strategy to prevent cardiovascular events in AS.Keywords: ankylosing spondylitis, Endothelial Progenitor Cells, inflammation, pro-inflammatory cytokines, rosuvastatin
Procedia PDF Downloads 3459788 Integrated Management of Diseases of Vegetables and Flower Crops Grown in Protected Condition under Organic Production System
Authors: Shripad Kulkarni
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Plant disease is an impairment of the normal state of a plant that interrupts or modifies its vital functions. Disease occurs on different parts of plants and cause heavy losses. Diagnosis of Problem is very important before planning any management practice and this can be done based on appearance of the crop, examination of the root and examination of the soil. There are various types of diseases such as biotic (transmissible) which accounts for ~30% whereas , abiotic (not transmissible) diseases are the major one with ~70% incidence. Plant diseases caused by different groups of organism’s belonging fungi, bacteria, viruses, nematodes and few others have remained important in causing significant losses in different crops indicating the urgent need of their integrated management. Various factors favor disease development and different steps and methods are involved in management of diseases under protected condition. Management of diseases through botanicals and bioagents by modifying root and aerial environment, vector management along with care to be taken while managing the disease are analysed.Keywords: organic production system, diseases, bioagents and polyhouse, agriculture
Procedia PDF Downloads 3979787 Traditional Chinese Medicine Treatment for Coronary Heart Disease: a Meta-Analysis
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Traditional Chinese medicine has been used in the treatment of coronary heart disease (CHD) for centuries, and in recent years, the research data on the efficacy of traditional Chinese medicine through clinical trials has gradually increased to explore its real efficacy and internal pharmacology. However, due to the complexity of traditional Chinese medicine prescriptions, the efficacy of each component is difficult to clarify, and pharmacological research is challenging. This study aims to systematically review and clarify the clinical efficacy of traditional Chinese medicine in the treatment of coronary heart disease through a meta-analysis. Based on PubMed, CNKI database, Wanfang data, and other databases, eleven randomized controlled trials and 1091 CHD subjects were included. Two researchers conducted a systematic review of the papers and conducted a meta-analysis supporting the positive therapeutic effect of traditional Chinese medicine in the treatment of CHD.Keywords: coronary heart disease, Chinese medicine, treatment, meta-analysis
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