Search results for: burden of proof
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1150

Search results for: burden of proof

1090 Assessing the Double Burden of Malnutrition in Moroccan Women: A Focus on Iron Deficiency and Weight Disorders

Authors: Fall Abdourahmane, Lazrak Meryem, El Hsaini Houda, El Ammari Laila, Gamih Hasnae, Yahyane Abdelhakim, Benjouad Abdelaziz, Aguenaou Hassan, El Kari Khalid

Abstract:

Introduction: The double burden of malnutrition (DBM), defined by the concurrent occurrence of undernutrition and overnutrition, represents a critical public health issue, particularly in low- and middle-income countries. In Morocco, 61.3% of women of reproductive age (WRA) are classified as overweight or obese, with 30.4% meeting the criteria for obesity. Furthermore, 34.4% of WRA are affected by anaemia, and 49.7% present with iron deficiency anaemia. Objective: The objective of this study is to assess the individual-level prevalence of the double burden of malnutrition (DBM) among Moroccan WRA, focusing on the simultaneous presence of iron deficiency anaemia and overweight/obesity. Methods: A national cross-sectional survey was carried out on a representative sample of 2090 Moroccan WRA. The data collected encompassed blood samples, anthropometric measurements and socio-economic factors. Haemoglobin levels were assessed using a Hemocue device, while ferritin and CRP levels were determined through immunoturbidimetric analysis. Results: The prevalence of overweight/obesity among WRA in Morocco was 60.2%, iron deficiency affected 30.6%, anaemia was found in 34.4%, and 50.0% had iron deficiency anaemia. The coexistence of overweight/obesity with anaemia was observed in 19.2% and with iron deficiency in 16.3%. Among overweight/obese women, 32.5% were anaemic, 28.4% had iron deficiency, and 47.6% had iron deficiency anaemia. The prevalence of DBM was higher in urban areas compared to rural settings. Conclusion: The DBM among women of WRA showed an emergent reality of the interconnection and the coexistence at individual level of the undernutrition and the overnutrition. Therefore, effective and dual actions that could simultaneously address the double dimension of the DBM have to be implemented for the policy solutions to be successful.

Keywords: the double burden of malnutrition, iron deficiency anemia, overweight, obesity

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1089 Interest Charges and Sustainability Challenges: The Case of OECD Countries

Authors: Aime Philombe Zapji Ymele

Abstract:

Servicing public debt is a significant budgetary burden. In the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth, and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation, and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interest charges, sustainability, public debt, interest rates

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1088 Interest Charges and Sustainability Challenges: The Case of OECD Countries

Authors: Zapji Ymele Aime Philombe

Abstract:

Servicing public debt is a significant budgetary burden in the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interests charges, public debt, sustainability, interest rates

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1087 Symptom Burden and Quality of Life in Advanced Lung Cancer Patients

Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

Abstract:

Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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1086 Associated Factors of Hypercholesterolemia, Hyperuricemia and Double Burden of Hypercuricémia-Hypercholesterolemia in Gout Patients: Hospital Based Study

Authors: Pierre Mintom, Armel Assiene Agamou, Leslie Toukem, William Dakam, Christine Fernande Nyangono Biyegue

Abstract:

Context: Hyperuricemia, the presence of high levels of uric acid in the blood, is a known precursor to the development of gout. Recent studies have suggested a strong association between hyperuricemia and disorders of lipoprotein metabolism, specifically hypercholesterolemia. Understanding the factors associated with these conditions in gout patients is essential for effective treatment and management. Research Aim: The objective of this study was to determine the prevalence of hyperuricemia, hypercholesterolemia, and the double burden of hyperuricemia-hypercholesterolemia in the gouty population. Additionally, the study aimed to identify the factors associated with these conditions. Methodology: The study utilized a database from a survey of 150 gouty patients recruited at the Laquintinie Hospital in Douala between August 2017 and February 2018. The database contained information on anthropometric parameters, biochemical markers, and the food and drugs consumed by the patients. Hyperuricemia and hypercholesterolemia were defined based on specific serum uric acid and total cholesterol thresholds, and the double burden was defined as the co-occurrence of hyperuricemia and hypercholesterolemia. Findings: The study found that the prevalence rates for hyperuricemia, hypercholesterolemia, and the double burden were 61.3%, 76%, and 50.7% respectively. Factors associated with these conditions included hypertriglyceridemia, atherogenicity index TC/HDL ratio, atherogenicity index LDL/HDL ratio, family history, and the consumption of specific foods and drinks. Theoretical Importance: The study highlights the strong association between hyperuricemia and dyslipidemia, providing important insights for guiding treatment strategies in gout patients. Additionally, it emphasizes the significance of nutritional education in managing these metabolic disorders, suggesting the need to address eating habits in gout patients. Data Collection and Analysis Procedures: Data was collected through surveys and medical records of gouty patients. Information on anthropometric parameters, biochemical markers, and dietary habits was recorded. Prevalence rates and associated factors were determined through statistical analysis, employing odds ratios to assess the risks. Question Addressed: The study aimed to address the prevalence rates and associated factors of hyperuricemia, hypercholesterolemia, and the double burden in gouty patients. It sought to understand the relationships between these conditions and determine their implications for treatment and nutritional education. Conclusion: Findings show that it’s exists an association between hyperuricemia and hypercholesterolemia in gout patients, thus creating a double burden. The findings underscore the importance of considering family history and eating habits in addressing the double burden of hyperuricemia-hypercholesterolemia. This study provides valuable insights for guiding treatment approaches and emphasizes the need for nutritional education in gout patients. This study specifically focussed on the sick population. A case–control study between gouty and non-gouty populations would be interesting to better compare and explain the results observed.

Keywords: gout, hyperuricemia, hypercholesterolemia, double burden

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1085 Determinants of Stone Free Status After a Single Session of Flexible Ureteroscopy with Laser Lithotripsy for Renal Calculi

Authors: Mohamed Elkoushy, Sameer Munshi, Waseem Tayeb

Abstract:

Background: Flexible ureteroscopy (fURS) has dramatically improved the minimally invasive management of complex nephrolithiasis. fUR is increasingly being used as the first-line treatment for patients with renal stones. Stone-free status (SFS) is the primary goal in the management of patients with urolithiasis. However, substantial variations exist in the reported SFS following fURS. Objectives: This study determines the predictors of SFS after a single session of fURS with holmium laser lithotripsy (HLL) for renal calculi. Methods: A retrospective review of prospectively collected data was performed for all consecutive patients undergoing fURS and HLL for renal calculi at a tertiary care center. Patients with previous ipsilateral URS for the same stones were excluded. All patients underwent JJ ureteral stent insertion at the end of the procedure. SFS was defined as the presence of no residuals or ≤4-mm non-obstructing stone and was assessed by CT/KUB imaging after 3-4 weeks post-operatively. Multivariate logistic regression was used to detect possible predictors of SFS. Results: A total of 212 patients were included with a mean age of 52.3±8.3 years and a stone burden <20 mm (49.1%), 20-30 mm (41.0%) and >30 mm (9.9%). Overall SFS after a single session of fURS was 71.7%, 92% and 52% for stones less and larger than 20 mm, respectively. Patients with stones> 20 mm need retreatment with a mean number of 1.8 (1.3-2.7) fURS. SFS was significantly associated with male gender, stone bulk <20 mm (95.7% vs. 56.2%), non-lower pole stones, hydronephrotic kidney, low stone intensity, ureteral access sheath, and preoperative stenting. SFS was associated with a lower readmission rate (5.9% vs. 38.9%) and urinary tract infections (3.8% vs. 25.9%). In multivariate regression analysis, SFS maintains its significant association with low stone burden of <20 mm (OR: 5.21), stone intensity <600 HFU (OR: 2.87), and non-lower caliceal stones (OR: 3.84). Conclusion: Best results after a single-session fURS for renal stone were obtained for the stone burden of less than 20 mm and low stone attenuation. Lower calyceal stones may influence stone clearance and need a different approach than fURS, especially for higher stone burden.

Keywords: ureteroscopy, kidney stone, lithotripsy, stone-free, predictors

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1084 Burden of Cardiovascular Diseases in Dubrovnik- Neretva County 2018-2021

Authors: Tarnai Tena, Strinić Dean

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Chronic non-communicable diseases are today the leading cause of mortality, morbidity and mortality disability at the world level and in Croatia. Among them are the most represented precisely cardiovascular diseases (CVD), so today we are talking about their global card epidemic. From 2018 to 2021, cardiovascular diseases are the leading cause of death for both women and men in the Dubrovnik- Neretva County. With regard to the COVID-19 pandemic, which has taken over, without forgetting how much these patients are additionally affected, we are still talking about the primary cause of sickness and death in the population of this county and region. In this record, we present collected data processed according to gender and disease classification. We also bring a kind of overview because, for years, we have been following how the population of one of the origins of the Mediterranean diet has been struggling with cardiovascular diseases.

Keywords: cardiovascular disease, burden, COVID-19, epidemiology, ishemic heart disease, cardiovascular medicine

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1083 A Tale of Seven Districts: Reviewing The Past, Present and Future of Patent Litigation Filings to Form a Two-Step Burden-Shifting Framework for 28 U.S.C. § 1404(a)

Authors: Timothy T. Hsieh

Abstract:

Current patent venue transfer laws under 28 U.S.C. § 1404(a) e.g., the Gilbert factors from Gulf Oil Corp. v. Gilbert, 330 U.S. 501 (1947) are too malleable in that they often lead to frequent mandamus orders from the U.S. Court of Appeals for the Federal Circuit (“Federal Circuit”) overturning district court rulings on venue transfer motions. Thus, this paper proposes a more robust two-step burden-shifting framework that replaces the eight Gilbert factors. Moreover, a brief history of venue transfer patterns in the seven most active federal patent district courts is covered, with special focus devoted to the venue transfer orders from Judge Alan D Albright of the U.S. District Court for the Western District of Texas. A comprehensive data summary of 45 case sets where the Federal Circuit ruled on writs of mandamus involving Judge Albright’s transfer orders is subsequently provided, with coverage summaries of certain cases including four precedential ones from the Federal Circuit. This proposed two-step burden shifting framework is then applied to these venue transfer cases, as well as Federal Circuit mandamus orders ruling on those decisions. Finally, alternative approaches to remedying the frequent reversals for venue transfer will be discussed, including potential legislative solutions, adjustments to common law framework approaches to venue transfer, deference to the inherent powers of Article III U.S. District Judge, and a unified federal patent district court. Overall, this paper seeks to offer a more robust and consistent three-step burden-shifting framework for venue transfer and for the Federal Circuit to follow in administering mandamus orders, which might change somewhat in light of Western District of Texas Chief Judge Orlando Garcia’s order on redistributing Judge Albright’s patent cases.

Keywords: Patent law, venue, judge Alan Albright, minimum contacts, western district of Texas

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1082 Impact of Treatment of Fragility Fractures Due to Osteoporosis as an Economic Burden Worldwide: A Systematic Review

Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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1081 Comprehensive Literature Review of the Humanistic Burden of Clostridium (Clostridiodes) difficile Infection

Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich

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Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.

Keywords: burden, Clostridiodes, difficile, humanistic, infection

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1080 Remote Sensing of Aerated Flows at Large Dams: Proof of Concept

Authors: Ahmed El Naggar, Homyan Saleh

Abstract:

Dams are crucial for flood control, water supply, and the creation of hydroelectric power. Every dam has a water conveyance system, such as a spillway, providing the safe discharge of catastrophic floods when necessary. Spillway design has historically been investigated in laboratory research owing to the absence of suitable full-scale flow monitoring equipment and safety problems. Prototype measurements of aerated flows are urgently needed to quantify projected scale effects and provide missing validation data for design guidelines and numerical simulations. In this work, an image-based investigation of free-surface flows on a tiered spillway was undertaken at the laboratory (fixed camera installation) and prototype size (drone video) (drone footage) (drone footage). The drone videos were generated using data from citizen science. Analyses permitted the measurement of the free-surface aeration inception point, air-water surface velocities, fluctuations, and residual energy at the chute's downstream end from a remote site. The prototype observations offered full-scale proof of concept, while laboratory results were efficiently confirmed against invasive phase-detection probe data. This paper stresses the efficacy of image-based analyses at prototype spillways. It highlights how citizen science data may enable academics better understand real-world air-water flow dynamics and offers a framework for a small collection of long-missing prototype data.

Keywords: remote sensing, aerated flows, large dams, proof of concept, dam spillways, air-water flows, prototype operation, remote sensing, inception point, optical flow, turbulence, residual energy

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1079 On the Cyclic Property of Groups of Prime Order

Authors: Ying Yi Wu

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The study of finite groups is a central topic in algebraic structures, and one of the most fundamental questions in this field is the classification of finite groups up to isomorphism. In this paper, we investigate the cyclic property of groups of prime order, which is a crucial result in the classification of finite abelian groups. We prove the following statement: If p is a prime, then every group G of order p is cyclic. Our proof utilizes the properties of group actions and the class equation, which provide a powerful tool for studying the structure of finite groups. In particular, we first show that any non-identity element of G generates a cyclic subgroup of G. Then, we establish the existence of an element of order p, which implies that G is generated by a single element. Finally, we demonstrate that any two generators of G are conjugate, which shows that G is a cyclic group. Our result has significant implications in the classification of finite groups, as it implies that any group of prime order is isomorphic to the cyclic group of the same order. Moreover, it provides a useful tool for understanding the structure of more complicated finite groups, as any finite abelian group can be decomposed into a direct product of cyclic groups. Our proof technique can also be extended to other areas of group theory, such as the classification of finite p-groups, where p is a prime. Therefore, our work has implications beyond the specific result we prove and can contribute to further research in algebraic structures.

Keywords: group theory, finite groups, cyclic groups, prime order, classification.

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1078 Formal Asymptotic Stability Guarantees, Analysis, and Evaluation of Nonlinear Controlled Unmanned Aerial Vehicle for Trajectory Tracking

Authors: Soheib Fergani

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This paper concerns with the formal asymptotic stability guarantees, analysis and evaluation of a nonlinear controlled unmanned aerial vehicles (uav) for trajectory tracking purpose. As the system has been recognised as an under-actuated non linear system, the control strategy has been oriented towards a hierarchical control. The dynamics of the system and the mission purpose make it mandatory to provide an absolute proof of the vehicle stability during the maneuvers. For this sake, this work establishes the complete theoretical proof for an implementable control oriented strategy that asymptotically stabilizes (GAS and LISS) the system and has never been provided in previous works. The considered model is reorganized into two partly decoupled sub-systems. The concidered control strategy is presented into two stages: the first sub-system is controlled by a nonlinear backstepping controller that generates the desired control inputs to stabilize the second sub-system. This methodology is then applied to a harware in the loop uav simulator (SiMoDrones) that reproduces the realistic behaviour of the uav in an indoor environment has been performed to show the efficiency of the proposed strategy.

Keywords: UAV application, trajectory tracking, backstepping, sliding mode control, input to state stability, stability evaluation

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1077 Foreign Human Capital as a Fiscal Burden on the UK's Exchequer: An Intellectual Capital Perspective

Authors: Tasawar Nawaz

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Migration has once again become a lively topic in Europe and UK, in particular. A burgeoning concern in the public debate, however, is driven by the fear that migrants are fiscal burden because they drain public resources by drawing on the generous social transfers introduced in Europe to prevent social exclusion. This study challenges these beliefs by gathering empirical evidence through a qualitative research approach on the subject matter. The analysis suggests that UK provides a rich social and economic environment for intellectual profiles especially, human intellectual capital of migrants to flourish and add value to the exchequer. Contrary to the beliefs held by politicians and general public, the empirical evidence suggests that migrants add higher fiscal contribution by working longer hours, paying consistent taxes, and bringing skills which UK may lack thus, are not fiscal burdens on the UK exchequer.

Keywords: austerity, European union, human intellectual capital, migrants, social welfare, United Kingdom

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1076 Correlation between Early Government Interventions in the Northeastern United States and COVID-19 Outcomes

Authors: Joel Mintz, Kyle Huntley, Waseem Wahood, Samuel Raine, Farzanna Haffizulla

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The effect of different state government interventions on COVID-19 health outcomes is currently unknown. Stay at home (SAH) orders, all non-essential business closures and school closures in the Northeastern US were examined. A linear correlation between the peak number of new daily COVID-19 positive tests, hospitalizations and deaths per capita and the elapsed time between government issued guidance and a fixed number of COVID-19 deaths in each state was performed. Earlier government interventions were correlated with lower peak healthcare burden. Statewide closures of schools and non-essential businesses showed significantly greater (p<.001) correlation to peak COVID-19 disease burden as compared to a statewide SAH. The implications of these findings require further study to determine the effectiveness of these interventions.

Keywords: Coronavirus, epidemiology, government intervention, public health, social distancing

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1075 Method for Identification of Through Defects of Polymer Films Applied onto Metal Parts

Authors: Yu A. Pluttsova , O. V. Vakhnina , K. B. Zhogova

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Nowadays, many devices operate under conditions of enhanced humidity, temperature drops, fog, and vibration. To ensure long-term and uninterruptable equipment operation under adverse conditions, one applies moisture-proof films on products and electronics components, which helps to prevent corrosion, short circuit, allowing a significant increase in device lifecycle. The reliability of such moisture-proof films is mainly determined by their coating uniformity without gaps and cracks. Unprotected product edges, as well as pores in films, can cause device failure during operation. The work objective was to develop an effective, affordable, and profit-proved method for determining the presence of through defects of protective polymer films on the surface of parts made of iron and its alloys. As a diagnostic reagent, one proposed water solution of potassium ferricyanide (III) in hydrochloric acid, this changes the color from yellow to blue according to the reactions; Feº → Fe²⁺ and 4Fe²⁺ + 3[Fe³⁺(CN)₆]³⁻ → Fe ³⁺4[Fe²⁺(CN)₆]₃. There was developed the principle scheme of technological process for determining the presence of polymer films through defects on the surface of parts made of iron and its alloys. There were studied solutions with different diagnostic reagent compositions in water: from 0,1 to 25 mass fractions, %, of potassium ferricyanide (III), and from 5 to 25 mass fractions, %, of hydrochloride acid. The optimal component ratio was chosen. The developed method consists in submerging a part covered with a film into a vessel with a diagnostic reagent. In the polymer film through defect zone, the part material (ferrum) interacts with potassium ferricyanide (III), the color changes to blue. Pilot samples were tested by the developed method for the presence of through defects in the moisture-proof coating. It was revealed that all the studied parts had through defects of the polymer film coating. Thus, the claimed method efficiently reveals polymer film coating through defects on parts made of iron or its alloys, being affordable and profit-proved.

Keywords: diagnostic reagent, metal parts, polimer films, through defects

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1074 Sports and Exercise Medicine: A Public Health Tool in Combating and Preventing the Side Effects of a Sedentary Lifestyle

Authors: Shireen Ibish

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Physical inactivity and unhealthy diets have contributed to a global burden of disease with increased relation to non-communicable diseases, increased risk of colon and breast cancer, high prevalence of depression, reduced quality of life and early death. The World Health Organisation’s facts on Obesity show a tripling in prevalence across the European Region since the 1980s. This has lead to a huge public health burden, being responsible for and 10-13% of deaths (fourth largest cause of global mortality) and 2-8% of health costs in the Region. In the UK alone, the present cost of physical inactivity has been estimated to be £8.2 billion. In 2002 a paper published in the International Journal of Epidemiology on ‘sedentary’ lifestyle, put into figures the increasingly worrying statistics across European countries. “Percentages of sedentary lifestyles across European countries ranged between 43.3% (Sweden) and 87.8% (Portugal)”. This was especially so amongst obese subjects, less- educated people, and smokers. While in the UK’s “50% of adult population in the UK is predicted to be obese by 2050.” Sports and Exercise Medicine, as a specialty, has a lot to offer in targeting this globally increasing epidemic. The worrying figures and the increasing knowledge of combating and preventing this issue have lead to increased awareness amongst the medical profession and more targeted interventions to reduce the burden of disease. “The public health element of the specialty is critical – this is not simply a specialty for the management of elite athletes’ medical conditions – it is central to the promotion of exercise as a means of disease prevention, to enhance well-being and in the management of disease.” WHO advised on creating National policies, encouraging and providing opportunities for greater physical activity, and improve the affordability, availability and accessibility of healthy foods. In the UK various different movements have been established to target this problem. The Motivate2Move, Move Eat Treat and guidelines advising specialties on targeting and encouraging exercise in the population (Sport and Exercise Medicine A Fresh Approach).

Keywords: sedentary lifestyle, obesity, public health burden, medicine

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1073 Moral Rights: Judicial Evidence Insufficiency in the Determination of the Truth and Reasoning in Brazilian Morally Charged Cases

Authors: Rainner Roweder

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Theme: The present paper aims to analyze the specificity of the judicial evidence linked to the subjects of dignity and personality rights, otherwise known as moral rights, in the determination of the truth and formation of the judicial reasoning in cases concerning these areas. This research is about the way courts in Brazilian domestic law search for truth and handles evidence in cases involving moral rights that are abundant and important in Brazil. The main object of the paper is to analyze the effectiveness of the evidence in the formation of judicial conviction in matters related to morally controverted rights, based on the Brazilian, and as a comparison, the Latin American legal systems. In short, the rights of dignity and personality are moral. However, the evidential legal system expects a rational demonstration of moral rights that generate judicial conviction or persuasion. Moral, in turn, tends to be difficult or impossible to demonstrate in court, generating the problem considered in this paper, that is, the study of the moral demonstration problem as proof in court. In this sense, the more linked to moral, the more difficult to be demonstrated in court that right is, expanding the field of judicial discretion, generating legal uncertainty. More specifically, the new personality rights, such as gender, and their possibility of alteration, further amplify the problem being essentially an intimate manner, which does not exist in the objective, rational evidential system, as normally occurs in other categories, such as contracts. Therefore, evidencing this legal category in court, with the level of security required by the law, is a herculean task. It becomes virtually impossible to use the same evidentiary system when judging the rights researched here; therefore, it generates the need for a new design of the evidential task regarding the rights of the personality, a central effort of the present paper. Methodology: Concerning the methodology, the Method used in the Investigation phase was Inductive, with the use of the comparative law method; in the data treatment phase, the Inductive Method was also used. Doctrine, Legislative, and jurisprudential comparison was the technique research used. Results: In addition to the peculiar characteristics of personality rights that are not found in other rights, part of them are essentially linked to morale and are not objectively verifiable by design, and it is necessary to use specific argumentative theories for their secure confirmation, such as interdisciplinary support. The traditional pragmatic theory of proof, for having an obvious objective character, when applied in the rights linked to the morale, aggravates decisionism and generates legal insecurity, being necessary its reconstruction for morally charged cases, with the possible use of the “predictive theory” ( and predictive facts) through algorithms in data collection and treatment.

Keywords: moral rights, proof, pragmatic proof theory, insufficiency, Brazil

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1072 An Intelligent Baby Care System Based on IoT and Deep Learning Techniques

Authors: Chinlun Lai, Lunjyh Jiang

Abstract:

Due to the heavy burden and pressure of caring for infants, an integrated automatic baby watching system based on IoT smart sensing and deep learning machine vision techniques is proposed in this paper. By monitoring infant body conditions such as heartbeat, breathing, body temperature, sleeping posture, as well as the surrounding conditions such as dangerous/sharp objects, light, noise, humidity and temperature, the proposed system can analyze and predict the obvious/potential dangerous conditions according to observed data and then adopt suitable actions in real time to protect the infant from harm. Thus, reducing the burden of the caregiver and improving safety efficiency of the caring work. The experimental results show that the proposed system works successfully for the infant care work and thus can be implemented in various life fields practically.

Keywords: baby care system, Internet of Things, deep learning, machine vision

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1071 Consumers' Awareness, Knowledge, and Perception towards Goods and Services Tax in India

Authors: Harjinder Kaur

Abstract:

GST was implemented by government with the expectation to reform the taxation system of India. So this study basically seeks to understand the consumers’ awareness, knowledge and perception about the implementation of GST. To conduct this study, 100 respondents of all demographic profile were randomly selected from the Punjab region of India. To investigate the relationship between demographic profile and level of awareness and knowledge about GST, one way ANOVA test was used and it is found that there is a significant relationship between gender, age and qualification and level of awareness and knowledge. Furthermore, due to the lack of information on GST, the respondents had a high negative perception. The study also reveals that the implementation of GST has resulted in higher prices for goods and services and thus this tax may cause burden to people. Also after implementation of GST financial issues such as inflation, rising cost of living, economic instability have impacted many Indian consumers in terms of their spending. But at the same time it is also perceived that GST is designed to remove the burden of many indirect taxes and aims to develop the more efficient tax system which increases the revenue of country.

Keywords: goods and service tax, consumers awareness, knowledge, perception

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1070 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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1069 Optimality of Shapley Value Mechanism under Sybil Strategies

Authors: Bruno Mazorra Roig

Abstract:

In the realm of cost-sharing mechanisms, the vulnerability to Sybil strategies, where agents can create fake identities to manipulate outcomes, has not yet been studied. In this paper, we delve into the intricacies of different cost-sharing mechanisms proposed in the literature, highlighting its non-Sybil-resistance nature. Furthermore, we prove that under mild conditions, a Sybil-proof cost-sharing mechanism for public excludable goods is at least (n/2 + 1)−approximate. This finding reveals an exponential increase in the worst-case social cost in environments where agents are restricted from using Sybil strategies. We introduce the concept of Sybil Welfare Invariant mechanisms, where a mechanism maintains its worst-case welfare under Sybil strategies for every set of prior beliefs with full support even when the mechanism is not Sybil-proof. Finally, we prove that the Shapley value mechanism for public excludable goods holds this property and so deduce that the worst-case social cost of this mechanism is the nth harmonic number Hn under the equilibrium of the game with Sybil strategies, matching the worst-case social cost bound for cost-sharing mechanisms. This finding carries important implications for decentralized autonomous organizations (DAOs), indicating that they are capable of funding public excludable goods efficiently, even when the total number of agents is unknown.

Keywords: game theory, mechanism design, cost sharing, false-name proofness

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1068 Building a Blockchain-based Internet of Things

Authors: Rob van den Dam

Abstract:

Today’s Internet of Things (IoT) comprises more than a billion intelligent devices, connected via wired/wireless communications. The expected proliferation of hundreds of billions more places us at the threshold of a transformation sweeping across the communications industry. Yet, we found that the IoT architecture and solutions that currently work for billions of devices won’t necessarily scale to tomorrow’s hundreds of billions of devices because of high cost, lack of privacy, not future-proof, lack of functional value and broken business models. As the IoT scales exponentially, decentralized networks have the potential to reduce infrastructure and maintenance costs to manufacturers. Decentralization also promises increased robustness by removing single points of failure that could exist in traditional centralized networks. By shifting the power in the network from the center to the edges, devices gain greater autonomy and can become points of transactions and economic value creation for owners and users. To validate the underlying technology vision, IBM jointly developed with Samsung Electronics the autonomous decentralized peer-to- peer proof-of-concept (PoC). The primary objective of this PoC was to establish a foundation on which to demonstrate several capabilities that are fundamental to building a decentralized IoT. Though many commercial systems in the future will exist as hybrid centralized-decentralized models, the PoC demonstrated a fully distributed proof. The PoC (a) validated the future vision for decentralized systems to extensively augment today’s centralized solutions, (b) demonstrated foundational IoT tasks without the use of centralized control, (c) proved that empowered devices can engage autonomously in marketplace transactions. The PoC opens the door for the communications and electronics industry to further explore the challenges and opportunities of potential hybrid models that can address the complexity and variety of requirements posed by the internet that continues to scale. Contents: (a) The new approach for an IoT that will be secure and scalable, (b) The three foundational technologies that are key for the future IoT, (c) The related business models and user experiences, (d) How such an IoT will create an 'Economy of Things', (e) The role of users, devices, and industries in the IoT future, (f) The winners in the IoT economy.

Keywords: IoT, internet, wired, wireless

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1067 Integrating Efficient Anammox with Enhanced Biological Phosphorus Removal Process Through Flocs Management for Sustainable Ultra-deep Nutrients Removal from Municipal Wastewater

Authors: Qiongpeng Dan, Xiyao Li, Qiong Zhang, Yongzhen Peng

Abstract:

The nutrients removal from wastewater is of great significance for global wastewater recycling and sustainable reuse. Traditional nitrogen and phosphorus removal processes are very dependent on the input of aeration and carbon sources, which makes it difficult to meet the low-carbon goal of energy saving and emission reduction. This study reported a proof-of-concept demonstration of integrating anammox and enhanced biological phosphorus removal (EBPR) by flocs management in a single-stage hybrid bioreactor (biofilms and flocs) for simultaneous nitrogen and phosphorus removal (SNPR). Excellent removal efficiencies of nitrogen (97.7±1.3%) and phosphorus (97.4±0.7%) were obtained in low C/N ratio (3.0±0.5) municipal wastewater treatment. Interestingly, with the loss of flocs, anammox bacteria (Ca. Brocadia) was highly enriched in biofilms, with relative and absolute abundances reaching up to 12.5% and 8.3×1010 copies/g dry sludge, respectively. The anammox contribution to nitrogen removal also rose from 32.6±9.8% to 53.4±4.2%. Endogenous denitrification by flocs was proven to be the main contributor to both nitrite and nitrate reduction, and flocs loss significantly promoted nitrite flow towards anammox, facilitating AnAOB enrichment. Moreover, controlling the floc's solid retention time at around 8 days could maintain a low poly-phosphorus level of 0.02±0.001 mg P/mg VSS in the flocs, effectively addressing the additional phosphorus removal burden imposed by the enrichment of phosphorus-accumulating organisms in biofilms. This study provides an update on developing a simple and feasible strategy for integrating anammox and EBPR for SNPR in mainstream municipal wastewater.

Keywords: anammox process, enhanced biological phosphorus removal, municipal wastewater, sustainable nutrients removal

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1066 The Untreated Burden of Parkinson’s Disease: A Patient Perspective

Authors: John Acord, Ankita Batla, Kiran Khepar, Maude Schmidt, Charlotte Allen, Russ Bradford

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Objectives: Despite the availability oftreatment options, Parkinson’s disease (PD) continues to impact heavily on a patient’s quality of life (QoL), as many symptoms that bother the patient remain unexplored and untreated in clinical settings. The aims of this research were to understand the burden of PDsymptoms from a patient perspective, particularly those which are the most persistent and debilitating, and to determine if current treatments and treatment algorithms adequately focus on their resolution. Methods: A13-question, online, patient-reported survey was created based on the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)and symptoms listed on Parkinson’s Disease Patient Advocacy Groups websites, and then validated by 10 Parkinson’s patients. In the survey, patients were asked to choose both their most common and their most bothersome symptoms, whether they had received treatment for those and, if so, had it been effective in resolving those symptoms. Results: The most bothersome symptoms reported by the 111 participants who completed the survey were sleep problems (61%), feeling tired (56%), slowness of movements (54%), and pain in some parts of the body (49%). However, while 86% of patients reported receiving dopamine or dopamine like drugs to treat their PD, far fewer reported receiving targeted therapies for additional symptoms. For example, of the patients who reported having sleep problems, only 33% received some form of treatment for this symptom. This was also true for feeling tired (30% received treatment for this symptom), slowness of movements (62% received treatment for this symptom), and pain in some parts of the body (61% received treatment for this symptom). Additionally, 65% of patients reported that the symptoms they experienced were not adequately controlled by the treatments they received, and 9% reported that their current treatments had no effect on their symptoms whatsoever. Conclusion: The survey outcomes highlight that the majority of patients involved in the study received treatment focused on their disease, however, symptom-based treatments were less well represented. Consequently, patient-reported symptoms such as sleep problems and feeling tired tended to receive more fragmented intervention than ‘classical’ PD symptoms, such as slowness of movement, even though they were reported as being amongst the most bothersome symptoms for patients. This research highlights the need to explore symptom burden from the patient’s perspective and offer Customised treatment/support for both motor and non-motor symptoms maximize patients’ quality of life.

Keywords: survey, patient reported symptom burden, unmet needs, parkinson's disease

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1065 The Mediterranean Migration Crisis: The North East Hotspot Policy

Authors: Loizos A. Hadjivasiliou, May Chehab

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Confronted with the human tragedy unfolding in the Mediterranean during the 2011-2016 period, the European Union introduced for the first time the “hotspot approach”, the establishment of facilities for initial reception, identification registration, and fingerprinting of asylum seekers and migrants arriving in the EU by sea, at the frontline Member States. However, the lack of a comprehensive collective policy on migration management and border security left the Mediterranean Member States, mainly Italy, Greece, and Cyprus, struggling to overcome these challenges. The current study sheds light on the implementation of the hotspot approach as the frontispiece of the European response to the migration challenges, which, limited to the operational and financial support of the hosting member states, leads to heterogeneous burden-sharing. Within this framework, it highlights the fact that the implementation of the hotspots as a panacea carries the risk of transforming the Mediterranean member states into giant hotspots with unpredictable consequences for the future of the Schengen area.

Keywords: asylum, burden sharing, hotspots, migration management policy, Schengen area

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1064 Consortium Blockchain-based Model for Data Management Applications in the Healthcare Sector

Authors: Teo Hao Jing, Shane Ho Ken Wae, Lee Jin Yu, Burra Venkata Durga Kumar

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Current distributed healthcare systems face the challenge of interoperability of health data. Storing electronic health records (EHR) in local databases causes them to be fragmented. This problem is aggravated as patients visit multiple healthcare providers in their lifetime. Existing solutions are unable to solve this issue and have caused burdens to healthcare specialists and patients alike. Blockchain technology was found to be able to increase the interoperability of health data by implementing digital access rules, enabling uniformed patient identity, and providing data aggregation. Consortium blockchain was found to have high read throughputs, is more trustworthy, more secure against external disruptions and accommodates transactions without fees. Therefore, this paper proposes a blockchain-based model for data management applications. In this model, a consortium blockchain is implemented by using a delegated proof of stake (DPoS) as its consensus mechanism. This blockchain allows collaboration between users from different organizations such as hospitals and medical bureaus. Patients serve as the owner of their information, where users from other parties require authorization from the patient to view their information. Hospitals upload the hash value of patients’ generated data to the blockchain, whereas the encrypted information is stored in a distributed cloud storage.

Keywords: blockchain technology, data management applications, healthcare, interoperability, delegated proof of stake

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1063 Assessing the Disability-Free Life Expectancy and Decomposition of Its Difference: A Gender Perspective on India over the Decade 2001-2011

Authors: Kajori Banerjee, Laxmi Kant Dwivedi

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“Health transition” is defined to be “a process through which high levels of mortality, morbidity and disability are reduced to low levels by influencing cultural, social and behavioural factors”. Life expectancy in India has been on the rise and parallel the burden of disease and disability has also risen noticeably. Borrowing data from Indian Census (2001, 2011), this study identifies the gender-wise burden of disability by calculating disability free life expectancy (DFLE) and life lived with disability (LWD). Sullivan’s method of calculating DFLE using proportion of disabled is used for this purpose. The change in person years lived with disability in the decade 2001-11 is further decomposed using Arriaga’s method into mortality and disability effects (ME and DE) to check the magnitude and direction of contribution of mortality and disability. Nationally, along with DFLE, LWD has amplified too. Despite having the highest life expectancy and DFLE, LWD in Kerala, was highest for both sexes in 2001. But in 2011, the LWD was highest among the males of Orissa and females of Rajasthan. For the overall population, DE is positive for the prime working age groups of 20-40years indicating that there has been an increase in the disability proportion holding mortality constant for 2001-2011. Females exhibit higher positive DE implying greater loss of healthy years due to disability than males. The findings call for an immediate attention to the causes of rising disability burden among the working population, especially females, as this might heavily effect the availability of quality labour force and its relative economic output in the Indian labour market. This also hints at the degrading quality of the elongated life and needs to be given the required attention to enhance the quality of life lead in the Nation.

Keywords: disability-free life expectancy, disability effect, life expectancy, mortality effect

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1062 Life Cycle Assessment: Drinking Glass Systems

Authors: Devina Jain

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The choice between single-use drinking glasses and reusable glasses is of major concern to our lifestyles, and hence, the environment. This study is aimed at comparing three systems - a disposable paper cup, a disposable cup and a reusable stainless steel cup or glass - with respect to their effect on the environment to find out which one is more advantageous for reducing the impact on the environment. Life Cycle Assessment was conducted using modeling software, Umberto NXT Universal (Version 7.1). For the purpose of this study, the cradle to grave approach was considered. Results showed that cleaning is of a very strong influence on the environmental burden by these drinking systems, with a contribution of up to 90 to 100%. Thus, the burden is determined by the way in which the utensils are washed, and how much water is consumed. It maybe seems like a small, insignificant daily practice. In the short term, it would seem that paper and plastic cups are a better idea, since they are easy to acquire and do not need to be stored, but in the long run, we can say that steel cups will have less of an environmental impact. However, if the frequency of use and the number of glasses employed per use are of significance to decide the appropriateness of the usage, it is better to use disposable cups and glasses.

Keywords: disposable glass, life cycle assessment, paper, plastic, reusable glass, stainless steel

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1061 A Method for solving Legendre's Conjecture

Authors: Hashem Sazegar

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Legendre’s conjecture states that there is a prime number between n^2 and (n + 1)^2 for every positive integer n. In this paper we prove that every composite number between n2 and (n + 1)2 can be written u^2 − v^2 or u^2 − v^2 + u − v that u > 0 and v ≥ 0. Using these result as well as induction and residues (modq) we prove Legendre’s conjecture.

Keywords: bertrand-chebyshev theorem, landau’s problems, goldbach’s conjecture, twin prime, ramanujan proof

Procedia PDF Downloads 360