Search results for: ecological risk index

Authors: Leela Lakshmi Sai Srinivas Parasa, Pushpavalli Naidu, Bhaskar Kambhampati

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Background: Obstructive Sleep Apnea (OSA) is a common but underdiagnosed sleep disorder characterized by repeated upper airway collapse during sleep. It frequently coexists with Type 2 Diabetes Mellitus (T2DM), a chronic metabolic condition with significant global and national health implications. The interplay between these conditions increases the risk of severe complications such as stroke, hypertension, and cardiovascular diseases. Understanding the prevalence of high-risk OSA in T2DM patients is essential for improving clinical outcomes and guiding public health interventions. Objective: This study aimed to assess the prevalence of high-risk OSA among T2DM patients using the Berlin questionnaire and to identify demographic and clinical predictors of risk. Methodology: This cross-sectional study of 100 patients with Type2 diabetes was undertaken at a tertiary care hospital in India for a period of 2 months. OSA was evaluated using the Berlin questionnaire. Diabetes mellitus was diagnosed according to WHO criteria as fasting blood sugar level > 7 mmol/L or random blood sugar >126 mg/dl on 2 separate occasions. Particulars of patients were recorded following which detailed history and physical examination were done. Data was analyzed using spss version 21. Results: The prevalence of high-risk OSA was 72% among the study population. The mean age was 54.9 +- 12.47 years. Age groups were divided into 3 groups (less than 50, 50-65, and greater than 65) The highest prevalence was observed in the 50-65 age group, accounting for 59.7% of high-risk cases. Gender distribution revealed a higher proportion of high-risk females (88.46%) compared to males (66.21%). Normal-weight individuals (BMI 18.5–24.9 kg/m²) represented 74.02% of high-risk OSA cases, while overweight individuals (BMI 25–29.9 kg/m²) accounted for 65.21%. Additionally, 90.9% of hypertensive patients were identified as high-risk for OSA. Conclusion: The study highlights a high prevalence of OSA risk among T2DM patients, especially those with hypertension and those in the middle-aged group. These findings emphasize the importance of routine OSA screening and tailored interventions for diabetic patients to reduce associated health risks. Proactive management can help mitigate the compounded effects of these two conditions, improving overall patient outcomes and reducing the burden on healthcare systems.

Keywords: obstructive sleep apnea, type 2 diabetes mellitus, berlin questionnaire, prevalence, hypertension

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Authors: Rady A., Elsheshai A., Elsawy M., Nagui R.

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Background and Aim: Metabolic syndrome affect around 20% of general population , authors have incriminated antipsychotics as serious risk factor that may provoke such derangement. The aim of our study is to assess metabolic syndrome in patients presenting psychotic features (delusions and hallucinations) whether schizophrenia or mood disorder and compare results in terms of drug naïf, on medication and healthy control. Subjects and Methods: The study recruited 40 schizophrenic patients, half of them drug naïf and the other half on antipsychotics, 40 patients with mood disorder with psychotic features, half of them drug naïf and the other half on medication, 20 healthy control. Exclusion criteria were put in order to exclude patients having already endocrine or metabolic disorders that my interfere with results obtain to minimize confusion bias. Metabolic syndrome assessed by measuring parameters including weight, body mass index, waist circumference, triglyceride level, HDL, fasting glucose, fasting insulin and insulin resistance Results: No difference was found when comparing drug naïf to those on medication in both schizophrenic and psychotic mood disorder arms, schizophrenic patients whether on medication or drug naïf should difference with control group for fasting glucose, schizophrenic patients on medication also showed difference in insulin resistance compared to control group. On the other hand, patients with psychotic mood disorder whether drug naïf or on medication showed difference from control group for fasting insulin level. Those on medication also differed from control for insulin resistance Conclusion: Our study didn’t reveal difference in metabolic syndrome among patients with psychotic features whether on medication or drug naïf. Only patients with Psychotic features on medication showed insulin resistance. Schizophrenic patients drug naïf or on medication tend to show higher fasting glucose while psychotic mood disorder whether drug naïf or on medication tend to show higher fasting insulin. This study suggest that presence of psychotic features themselves regardless being on medication or not carries a risk for insulin resistance and metabolic syndrome. Limitation: This study is limited by number of participants and larger numbers in future studies should be included in order to extrapolate results. Cohort longitudinal studies are needed in order to evaluate such hypothesis.

Keywords: schizophrenia, metabolic syndrome, psychosis, insulin, resistance

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Authors: Rajendra Kanojia

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Femoral components with inbuilt rotation require thicker flexion resection of the lateral femoral condyle and could potential risk to damage the popliteus tendon especially in the smaller Asian knees. We prospectively evaluated 10 patients with bilateral varus osteoarthritis knee to size the cuts and their location in relation to the popliteus tendon. Two different types of implant were used on either side, one side requires resection in 3° external rotation (group A) and other side femoral component with inbuilt external roation (group B). We had popliteus tendon injury in 3 knees all from group B. Risk of damaging the popliteus tendon was found higher in group B.

Keywords: popliteaus tendon injury, TKA, orthopaedic surgery, biomechanics and clinical applications

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Authors: Christopher G. Harris, Guy D. Eslick

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Purpose: Lobular carcinoma in situ (LCIS) is a known risk factor for breast cancer of unclear significance when detected in association with invasive carcinoma. This meta-analysis aims to determine the impact of LCIS on local recurrence risk for individuals with breast cancer treated with breast conservation therapy to help guide appropriate treatment strategies. Methods: We identified relevant studies from five electronic databases. Studies were deemed suitable for inclusion where they compared patients with invasive breast cancer and concurrent LCIS to those with breast cancer alone, all patients underwent breast conservation therapy (lumpectomy with adjuvant radiation therapy), and local recurrence was evaluated. Recurrence data were pooled by use of a random effects model. Results: From 1488 citations screened by our search, 8 studies were deemed suitable for inclusion. These studies comprised of 908 cases and 10638 controls. Median follow-up time was 90 months. There was a significantly increased overall risk of local breast cancer recurrence for individuals with LCIS in association with breast cancer following breast conservation therapy [pOR 1.87; 95% CI 1.14-3.04; p = 0.012]. The risk of local recurrence was non-significantly increased at 5 [pOR 1.09; 95% CI 0.48-2.48; p = 0.828] and 10 years [pOR 1.90; 95% CI 0.89-4.06; p = 0.096]. Conclusions: Individuals with LCIS in association with invasive breast cancer have an increased risk of local recurrence following breast conservation therapy. This supports consideration of aggressive local control of LCIS by way of completion mastectomy or re-excision for certain high-risk patients.

Keywords: breast cancer, breast conservation therapy, lobular carcinoma in situ, lobular neoplasia, local recurrence, meta-analysis

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Authors: Christina Y. P. Ting

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Migration is a global phenomenon with movements of migrants from developed and developing countries to the host societies. Migrants have changed the host countries’ demography – its population structure and also its ethnic cultural diversity. Acculturation of migrants in terms of their adoption of the host culture is seen as important to ensure that they ‘fit into’ their adopted country so as to participate in everyday public life. However, this research found that the increase of the China-born migrants’ post-migration consumption level had impact on Australia’s environment reflected not only because of their adoption of elements of the host culture, but also retention of aspects of Chinese culture – indicating that the influence of bi-culturalism was in operation. This research, which was based on the face-to-face interview with 61 China-born migrants in the suburb of Box Hill, Melbourne, investigated the pattern of change in the migrants’ consumption upon their settlement in Australia. Using an ecological footprint calculator, their post-migration footprints were found to be larger than pre-migration footprint. The uniquely-derived CALD (Culturally and Linguistically Diverse) Index was used to measure individuals’ strength of connectedness to ethnic culture. Multi-variant analysis was carried out to understand which independent factors that influence consumption best explain the change in footprint (which is the difference between pre-and post-migration footprints, as a dependent factor). These independent factors ranged from socio-economic and demographics to the cultural context, that is, the CALD Index and indicators of acculturation. The major findings from the analysis were: Chinese culture (as measured by the CALD Index) and indicators of acculturation such as length of residency and using English in communications besides the traditional factors such as age, income and education level made significant contributions to the large increase in the China-born group’s post-migration consumption level. This paper as part of a larger study found that younger migrants’ large change in their footprint were related to high income and low level of education. This group of migrants also practiced bi-cultural consumption in retaining ethnic culture and adopting the host culture. These findings have importantly highlighted that for a host society to tackle environmental crisis, governments need not only to understand the relationship between age and consumption behaviour, but also to understand and embrace the migrants’ ethnic cultures, which may act as bridges and/or fences in relationships. In conclusion, for governments to deal with national issues such as environmental crisis within a cultural diverse population, it necessitates an understanding of age and aspects of ethnic culture that may act as bridges and fences. This understanding can aid in putting in place policies that enable the co-existence of a hybrid of the ethnic and host cultures in order to create and maintain a harmonious and secured living environment for population groups.

Keywords: bicultural consumer, CALD index, consumption, ethnic culture, migrants

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Authors: Joseph Paul Chunga

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The investment universe is awash with a myriad of financial choices that investors have to opt for, which principally culminates into a duality between aggressive or conservative approaches. Howbeit, it is pertinent to emphasize that the investment vehicles with an aggressive approach tend to take on more risk than the latter group in an effort to generate higher future returns for their respective investors. This study examines the conditionality effect that such partiality in financing has on the High-Tech and Public Utility companies listed on the Shenzhen Stock Exchange (SSE). Specifically, it examines the significance of the relationship between capitalization ratios of Total Debt Ratio (TDR), Degree of Financial Leverage (DFL) and profitability ratios of Earnings per Share (EPS) and Returns on Equity (ROE) on the Financial Risk of the two industries. We employ a modified version of the Panel Regression Model used by Rahman (2017) to estimate the relationship. The study finds that there is a significant positive relationship between the capitalization ratios on the financial risk of Public Utility companies more than High-Tech companies and a substantial negative relationship between the profitability ratios and the financial risk of the former than the latter companies. This then spells an important insight for prospective investors with regards to the volatility of earnings of such companies.

Keywords: financial leverage, debt financing, conservative firms, aggressive firms

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Authors: Han-Wei Shih, Yao-Nan Wang, Ko-Tung Chang, Lung-Ming Fu

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A multi-channel cell growth real-time monitor and evaluation system using charge-coupled device (CCD) sensors with 40X lens integrating a NI LabVIEW image processing program is proposed and demonstrated. The LED light source control of monitor system is utilizing 8051 microprocessor integrated with NI LabVIEW software. In this study, the same concentration RAW264.7 cells growth rate and morphology in four different culture conditions (DMEM, LPS, G1, G2) were demonstrated. The real-time cells growth image was captured and analyzed by NI Vision Assistant every 10 minutes in the incubator. The image binarization technique was applied for calculating cell doubling time and cell division index. The cells doubling time and cells division index of four group with DMEM, LPS, LPS+G1, LPS+G2 are 12.3 hr,10.8 hr,14.0 hr,15.2 hr and 74.20%, 78.63%, 69.53%, 66.49%. The image magnification of multi-channel CCDs cell real-time monitoring system is about 100X~200X which compares with the traditional microscope.

Keywords: charge-coupled device (CCD), RAW264.7, doubling time, division index

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Authors: Wan-Ling Jiang, Hsin Chi, Jia-Lu Cheng, Ming-Fang Cheng

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Background: Investigating the risk factors for the fecal carriage of third-generation cephalosporin-resistant E.coli could contribute to further disease prevention. Previous research on third-generation cephalosporin-resistant prevalence in children in different regions of Taiwan is limited. This project aims to explore the risk factors and regional differences in the prevalence of third-generation cephalosporin-resistant and other antibiotic-resistant E. coli in the northern, southern, and eastern regions of Taiwan. Methods: We collected data from children aged 0 to 18 from community or outpatient clinics from July 2022 to May 2023 in southern, northern, and eastern Taiwan. The questionnaire was designed to survey the characteristics of participants and possible risk factors, such as clinical information, household environment, drinking water, and food habits. After collecting fecal samples and isolating stool culture with E.coli, antibiotic sensitivity tests and MLST typing were performed. Questionnaires were used to analyze the risk factors of third-generation cephalosporin-resistant E. coli in the three different regions of Taiwan. Results: In the total 246 stool samples, third-generation cephalosporin-resistant E.coli accounted for 37.4% (97/246) of all isolates. Among the three different regions of Taiwan, the highest prevalence of fecal carriage with third-generation cephalosporin-resistant E.coli was observed in southern Taiwan (42.7%), followed by northern Taiwan (35.5%) and eastern Taiwan (28.4%). Multi-drug resistant E. coli had prevalence rates of 51.9%, 66.3%, and 37.1% in the northern, southern, and eastern regions, respectively. MLST typing revealed that ST131 was the most prevalent type (11.8%). The prevalence of ST131 in northern, southern, and eastern Taiwan was 10.1%, 12.3%, and 13.2%, respectively. Risk factors analysis identified lower paternal education, overweight status, and non-vegetarian diet as statistical significance risk factors for third-generation cephalosporin-resistant E.coli. Conclusion: The fecal carriage rates of antibiotic-resistant E. coli among Taiwanese children were on the rise. This study found regional disparities in the prevalence of third-generation cephalosporin-resistant and multi-drug-resistant E. coli, with southern Taiwan having the highest prevalence. Lower paternal education, overweight, and non-vegetarian diet were the potential risk factors of third-generation cephalosporin-resistant E. coli in this study.

Keywords: Escherichia coli, fecal carriage, antimicrobial resistance, risk factors, prevalence

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Authors: Karl-Erich Lindenschmidt, Apurba Das, Joel Trudell, Keanne Russell

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In this presentation, we explore options for mitigating ice-jam flooding along the Athabasca River in western Canada. Not only flood hazard, expressed in this case as the probability of flood depths and extents being exceeded, but also flood risk, in which annual expected damages are calculated. Flood risk is calculated, which allows a cost-benefit analysis to be made so that decisions on the best mitigation options are not based solely on flood hazard but also on the costs related to flood damages and the benefits of mitigation. The river ice model is used to simulate extreme ice-jam flood events with which scenarios are run to determine flood exposure and damages in flood-prone areas along the river. We will concentrate on three mitigation options – the placement of a dike, artificial breakage of the ice cover along the river, the installation of an ice-control structure, and the construction of a reservoir. However, any mitigation option is not totally failsafe. For example, dikes can still be overtopped and breached, and ice jams may still occur in areas of the river where ice covers have been artificially broken up. Hence, for all options, it is recommended that zoning of building developments away from greater flood hazard areas be upheld. Flood mitigation can have a negative effect of giving inhabitants a false sense of security that flooding may not happen again, leading to zoning policies being relaxed. (Text adapted from Lindenschmidt [2022] "Ice Destabilization Study - Phase 2", submitted to the Regional Municipality of Wood Buffalo, Alberta, Canada)

Keywords: ice jam, flood hazard, flood risk river ice modelling, flood risk

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Authors: Yas Barzegaar, Atrin Barzegar

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The aim of this research is to develop an intelligent system to analyze the risk level of wheat flour product manufacturing system. The model consists of five Fuzzy Inference Systems in two different layers to analyse the risk of a wheat flour product manufacturing system. The first layer of the model consists of four Fuzzy Inference Systems with three criteria. The output of each one of the Physical, Chemical, Biological and Environmental Failures will be the input of the final manufacturing systems. The proposed model based on Mamdani Fuzzy Inference Systems gives a performance ranking of wheat flour products manufacturing systems. The first step is obtaining data to identify the failure modes from expert’s opinions. The second step is the fuzzification process to convert crisp input to a fuzzy set., then the IF-then fuzzy rule applied through inference engine, and in the final step, the defuzzification process is applied to convert the fuzzy output into real numbers.

Keywords: failure modes, fuzzy rules, fuzzy inference system, risk assessment

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Authors: Dong Wook Lee, Seung Hyun Kim

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Geological structure formed by volcanic activities shows polymorphic characteristics due to repeated cooling and hardening of lava. The Jeju region is showing polymorphic characteristics in which clinker layers are irregularly distributed along with vesicular basalt due to volcanic activities. Accordingly, resident damages and environmental disputes occur frequently in the Jeju region due to blasting. The purpose of this study is to develop a blast vibration equation considering the polymorphic characteristics of basaltic ground in Jeju. The blast vibration equation consists of a functional formula of the blasting vibration constant K that changes according to ground characteristics, and attenuation index n. The case study results in Jeju showed that if there are clinker layers, attenuation index n showed a distribution of -1.11~-1.87, whereas if there are no clinker layers, n was -2.79. Moreover, if there are no clinker layers, the frequency of blast vibration showed a high frequency band from 30Hz to 100Hz, while in rocks with clinker layers it showed a low frequency band from 10Hz to 20Hz.

Keywords: blast vibration equation, basaltic ground, clinker layer, blasting vibration constant, attenuation index

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Authors: Shotiros Protong

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The incidents of sudden landslides in Thailand during the past decade have occurred frequently and more severely. It is necessary to focus on the principal parameters used for analysis such as land cover land use, rainfall values, characteristic of soil and digital elevation model (DEM). The combination of intense rainfall and severe monsoons is increasing due to global climate change. Landslide occurrences rapidly increase during intense rainfall especially in the rainy season in Thailand which usually starts around mid-May and ends in the middle of October. The rain-triggered landslide hazard analysis is the focus of this research. The combination of geotechnical and hydrological data are used to determine permeability, conductivity, bedding orientation, overburden and presence of loose blocks. The regional landslide hazard mapping is developed using the Slope Stability Index SINMAP model supported on Arc GIS software version 10.1. Geological and land use data are used to define the probability of landslide occurrences in terms of geotechnical data. The geological data can indicate the shear strength and the angle of friction values for soils above given rock types, which leads to the general applicability of the approach for landslide hazard analysis. To address the research objectives, the methods are described in this study: setup and calibration of the SINMAP model, sensitivity of the SINMAP model, geotechnical laboratory, landslide assessment at present calibration and landslide assessment under future climate simulation scenario A2 and B2. In terms of hydrological data, the millimetres/twenty-four hours of average rainfall data are used to assess the rain triggered landslide hazard analysis in slope stability mapping. During 1954-2012 period, is used for the baseline of rainfall data at the present calibration. The climate change in Thailand, the future of climate scenarios are simulated by spatial and temporal scales. The precipitation impact is need to predict for the climate future, Statistical Downscaling Model (SDSM) version 4.2, is used to assess the simulation scenario of future change between latitude 16o 26’ and 18o 37’ north and between longitude 98o 52’ and 103o 05’ east by SDSM software. The research allows the mapping of risk parameters for landslide dynamics, and indicates the spatial and time trends of landslide occurrences. Thus, regional landslide hazard mapping under present-day climatic conditions from 1954 to 2012 and simulations of climate change based on GCM scenarios A2 and B2 from 2013 to 2099 related to the threshold rainfall values for the selected the study area in Uttaradit province in the northern part of Thailand. Finally, the landslide hazard mapping will be compared and shown by areas (km2 ) in both the present and the future under climate simulation scenarios A2 and B2 in Uttaradit province.

Keywords: landslide hazard, GIS, slope stability index (SINMAP), landslides, Thailand

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Authors: Yazhou Zhou, Yong Huang, Guoqin Ge

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In the process of human social development, the coupling and coordinated development among the ecological environment(E), production(P), and living functions(L) is of great significance for sustainable development. This study uses an improved coupling coordination degree model (CCDM) to discover the coordination conflict between E and human settlement environment. The main work of this study is as follows: (1) It is found that in the process of urbanization development of Ya 'an city from 2014 to 2018, the degree of coupling (DOC) value between E, P, and L is high, but the coupling coordination degree (CCD) of the three is low, especially the DOC value of E and the other two has the biggest decline. (2) A more objective weight value is obtained, which can avoid the analysis error caused by subjective judgment weight value.

Keywords: ecological environment, coupling coordination degree, neural network, sustainable development

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Authors: Zina Benouaret, Djamil Aissani

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In this work, we introduce the qualitative and quantitative concept of the strong stability method in the risk process modeling two lines of business of the same insurance company or an insurance and re-insurance companies that divide between them both claims and premiums with a certain proportion. The approach proposed is based on the identification of the ruin probability associate to the model considered, with a stationary distribution of a Markov random process called a reversed process. Our objective, after clarifying the condition and the perturbation domain of parameters, is to obtain the stability inequality of the ruin probability which is applied to estimate the approximation error of a model with disturbance parameters by the considered model. In the stability bound obtained, all constants are explicitly written.

Keywords: Markov chain, risk models, ruin probabilities, strong stability analysis

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Authors: Kornelius Ronald Demu, Dewi Retno Sari Saputro, Purnami Widyaningsih

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Human Development Index (HDI) is a standard measurement for a country's human development. Several factors may have influenced it, such as life expectancy, gross domestic product (GDP) based on the province's annual expenditure, the number of poor people, and the percentage of an illiterate people. The scatter plot between HDI and the influenced factors show that the plot does not follow a specific pattern or form. Therefore, the HDI's data in Indonesia can be applied with a nonparametric regression model. The estimation of the regression curve in the nonparametric regression model is flexible because it follows the shape of the data pattern. One of the nonparametric regression's method is a truncated spline. Truncated spline regression is one of the nonparametric approach, which is a modification of the segmented polynomial functions. The estimator of a truncated spline regression model was affected by the selection of the optimal knots point. Knot points is a focus point of spline truncated functions. The optimal knots point was determined by the minimum value of generalized cross validation (GCV). In this article were applied the data of Human Development Index with a truncated spline nonparametric regression model. The results of this research were obtained the best-truncated spline regression model to the HDI's data in Indonesia with the combination of optimal knots point 5-5-5-4. Life expectancy and the percentage of an illiterate people were the significant factors depend to the HDI in Indonesia. The coefficient of determination is 94.54%. This means the regression model is good enough to applied on the data of HDI in Indonesia.

Keywords: generalized cross validation (GCV), Human Development Index (HDI), knots point, nonparametric regression, truncated spline

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Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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Authors: Iyanujesu Adereti, Tajudeen Basiru, Ayodamola Olanipekun

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Background: Substance abuse among adolescents is of public health concern globally. Despite being the most abused by adolescents, there are limited studies on the prevalence of alcohol use and cigarette smoking among adolescents in Mauritius. Objectives: To determine the prevalence of cigarette smoking, alcohol use and associated correlates among school-going adolescents in Mauritius. Methodology: Data obtained from 2017 WHO Global School-based Student Health Survey (GSHS) survey of 3,012 school-going adolescents in Mauritius was analyzed using STATA. Descriptive statistics were used to obtain prevalence. Bivariate and multivariate logistic regression analysis was used to evaluate predictors of cigarette smoking and alcohol use. Results: Prevalence of alcohol consumption and cigarette smoking were 26.0% and 17.1%, respectively. Smoking and alcohol use was more prevalent among males, younger adolescents, and those in higher school grades (p-value <.000). In multivariable logistic regression, male gender was associated with a higher risk of cigarette smoking (adjusted Odds Ratio (aOR) [95%Confidence Interval (CI)]= 1.51[1.06-2.14]) but lower risk of alcohol use (aOR[95%CI]= 0.69[0.53-0.90]) while older age (mid and late adolescence) and parental smoking were found to be associated with increased risk of alcohol use (aOR[95%CI]= 1.94[1.34-2.99] and 1.36[1.05-1.78] respectively). Marijuana use, truancy, being in a fight and suicide ideation were associated with increased odds of alcohol use (aOR[95%CI]= 3.82[3.39-6.09]; 2.15[1.62-2.87]; 1.83[1.34-2.49] and 1.93[1.38-2.69] respectively) and cigarette smoking (aOR[95%CI]= 17.28[10.4 - 28.51]; 1.73[1.21-2. 49]; 1.67[1.14-2.45] and 2.17[1.43-3.28] respectively) while involvement in sexual activity was associated with reduced risk of alcohol use (aOR[95%CI]= 0.50[0.37-0.68]) and cigarette smoking (aOR[95%CI]= 0.47[0.33-0.69]). Parental support and parental monitoring were uniquely associated with lower risk of cigarette smoking (aOR[95%CI]= 0.69[0.47-0.99] and 0.62[0.43-0.91] respectively). Conclusion: The high prevalence of alcohol use and cigarette smoking in this study shows the need for the government of Mauritius to enhance policies that will help address this issue putting into accounts the various risk and protective factors.

Keywords: adolescent health, alcohol use, cigarette smoking, global school-based student health survey

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Authors: Claire Xu, Welton Wang, Manasvi Pinnaka, Anqi Pan, Michael Han

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Hospitalizations account for one-third of the total health care spending in the US. Early risk detection and intervention can reduce this high cost and increase the satisfaction of both patients and physicians. Due to the lack of awareness of the potential arising risks in home environment, the opportunities for patients to seek early actions of clinical visits are dramatically reduced. This research aims to offer a highly personalized remote patients monitoring and risk assessment AI framework to identify the potentially preventable hospitalization for both acute as well as chronic diseases. A hybrid-AI framework is trained with data from clinical setting, patients surveys, as well as online databases. 20+ risk factors are analyzed ranging from activities, biometric info, demographic info, socio-economic info, hospitalization history, medication info, lifestyle info, etc. The AI model yields high performance of 87% accuracy and 88 sensitivity with 20+ features. This hybrid-AI framework is proven to be effective in identifying the potentially preventable hospitalization. Further, the high indicative features are identified by the models which guide us to a healthy lifestyle and early intervention suggestions.

Keywords: hospitalization prevention, machine learning, remote patient monitoring, risk prediction

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Authors: Savitri Siddanagoudra, Shantala Herlekar, Priya Arjunwadekar

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Background: The physiological response to water drinking in healthy subjects is an integrated response with an increase in sympathetic vasoconstrictor activity with induced bradycardia. Obesity is a modern pandemic, implicated in the pathogenesis of cardiovascular disease. In autonomic failure patients, water drinking has been shown the increased high blood pressure and bradycardia. Acute effects of ice water ingestion on blood pressure (BP) in relation to body mass index (BMI) is not addressed in literature. Objectives: Objective of this study is to evaluate BP before and after ingestion of cold water in all the three groups. Methods and Material: 60 healthy subjects between the age group of 18-24 yrs were selected and assigned into 3 groups based on BMI. BMI less than and equal to 25 kg/m2 is selected as Normal BMI group ,between 25- 29 kg/m2 as Overweight and BMI more than and equal to 30 kg/m2 as Obese. Procedure: Basal and after ingestion of 250 ml of cold water (7 0C ± 0.5 0C)BP was recorded in all the 3 groups. Results: Basal and after ice water ingestion BP increased statistically in all 3 groups. Conclusion: On acute ingestion of ice water overweight, obese may have more sympathoexcitaion compared to normal subjects.

Keywords: blood pressure, body mass index, ice water, symathoexcitation

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Authors: Naren Bag, S. Bhattacharyya, Partha P. Gopmandal

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In this study, we have analyzed the transport of analytes under a two dimensional steady incompressible flow of power-law fluids through rectangular nanochannel. A mathematical model based on the Cauchy momentum-Nernst-Planck-Poisson equations is considered to study the combined effect of mixed electroosmotic (EO) and pressure driven (PD) flow. The coupled governing equations are solved numerically by finite volume method. We have studied extensively the effect of key parameters, e.g., flow behavior index, concentration of the electrolyte, surface potential, imposed pressure gradient and imposed electric field strength on the net average flow across the channel. In addition to study the effect of mixed EOF and PD on the analyte distribution across the channel, we consider a nonlinear model based on general convective-diffusion-electromigration equation. We have also presented the retention factor for various values of electrolyte concentration and flow behavior index.

Keywords: electric double layer, finite volume method, flow behavior index, mixed electroosmotic/pressure driven flow, non-Newtonian power-law fluids, numerical simulation

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Authors: M. J. Matulino, Carissa Ganong, Mark Mills, Jazmine Harry

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Large Woody Debris (LWD), defined as wooden debris with a diameter of at least 10 cm and a length of 2 m, serves as a crucial resource and habitat for aquatic organisms. While research on the ecological impacts of LWD has been conducted in temperate streams, LWD's influence on tropical stream biodiversity remains understudied, making this investigation particularly valuable for future conservation efforts. The Sura River in La Selva Biological Station includes both LWD and open channel sites. We sampled paired LWD and open-channel sites using minnow traps, Promar traps, and dip nets. Vertebrates were identified as species, while macroinvertebrates were identified to order level. We quantified abundance, richness, and Shannon diversity at each. We captured a total of 467 individuals, including 2 turtles, 17 fishes, 1 freshwater crab, 39 shrimp, and 408 other macroinvertebrates. Total abundance was significantly higher in LWD sites. Species richness was marginally higher in LWD sites, but the Shannon diversity index did not differ significantly with habitat. Shrimp (Macrobrachium olfersi) length was significantly higher in LWD areas. Increased food resources and microhabitat availability could contribute to higher abundance, richness, and organismal size in LWD environments. This study fills a critical gap by investigating LWD effects in a tropical environment, providing valuable insights for conservation efforts and the preservation of aquatic biodiversity.

Keywords: large woody debris (LWD), aquatic organisms, ecological impacts, tropical stream biodiversity, conservation efforts

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Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.

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Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.

Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)

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Authors: Choppala Pratheek, Vineet Ahuja

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Background: Crohn's disease (CD) recurrence following surgery is a common challenge, and current detection methods rely on risk factors identified in Western populations. This study aimed to investigate the risk factors and rates of postoperative CD recurrence in a tuberculosis-endemic region like India. Retrospective data was collected from a structured database from a specialty IBD clinic by reviewing case files from January 2005 to December 2021. Inclusion criteria involved CD patients diagnosed based on the ECCO-ESGAR consensus guidelines, who had undergone at least one intestinal resection and had a minimum follow-up period of one year at the IBD clinic. Results: A total of 90 patients were followed up for a median period of 45 months (IQR, 20.75 - 72.00). Out of the 90 patients, 61 received ATT prior to surgery, with a mean delay in diagnosis of 2.5 years, although statistically non-significant (P=0.078). Clinical recurrence occurred in 50% of patients, with the cumulative rate increasing from 13.3% at one year to 40% at three years. Among 63 patients who underwent endoscopy, 65.7% showed evidence of endoscopic recurrence, with the cumulative rate increasing from 31.7% at one year to 55.5% at four years. Smoking was identified as a significant risk factor for early endoscopic recurrence (P=0.001) by Cox regression analysis, but no other risk factors were identified. Initiating post-operative medications prior to clinical recurrence delayed its onset (P=0.004). Subgroup analysis indicated that endoscopic monitoring aided in the early identification of recurrence (P=0.001). The findings contribute to enhancing post-operative CD management strategies in such regions where the disease burden is escalating.

Keywords: crohns, post operative, tuberculosis-endemic, risk factors

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Authors: Etleva Hamzaraj, Eva Kica, Anila Paparisto, Pranvera Lazo

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Worldwide demographic developments of recent decades have been associated with negative environmental consequences. For this reason, there is a growing interest in assessing the state of natural ecosystems or assessing human impact on them. In this respect, this study aims to evaluate the change in water quality of the Mat River for a period of about ten years to highlight human impact. In one year, period of study, several biological and environmental parameters are determined to evaluate river water quality, and the data collected are compared with those of a similar study in 2007. Samples are collected every month in five stations evenly distributed along the river. Total coliform bacteria, the number of heterotrophic bacteria in water, and benthic macroinvertebrates are used as biological parameters of water quality. The most probable number index is used for evaluation of total coliform bacteria in water, while the number of heterotrophic bacteria is determined by counting colonies on plates with Plate Count Agar, cultivated with 0.1 ml sample after series dilutions. Benthic macroinvertebrates are analyzed by the number of individuals per taxa, the value of biotic index, EPT Richness Index value and tolerance value. Environmental parameters like pH, temperature, and electrical conductivity are measured onsite. As expected, the bacterial load was higher near urban areas, and the pollution increased with the course of the river. The maximum concentration of fecal coliforms was 1100 MPN/100 ml in summer and near the most urbanized area of the river. The data collected during this study show that after about ten years, there is a change in water quality of Mat River. According to a similar study carried out in 2007, the water of Mat River was of ‘excellent’ quality. But, according to this study, the water was classified as of ‘excellent’ quality only in one sampling site, near river source, while in all other stations was of ‘good’ quality. This result is based on biological and environmental parameters measured. The human impact on the quality of water of Mat River is more than evident.

Keywords: water quality, coliform bacteria, MPN index, benthic macroinvertebrates, biotic index

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Authors: Moise A. E., State G., Tudorache M., Custură I., Enea D. N., Osman (Defta) A., Drăgotoiu D.

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This scientific paper explores risk management strategies in the food supply chain, with a focus on chicken raw materials, in the context of a company sourcing from the EU and non-EU. The aim of the paper is to adapt the requirements of international standards (IFS, BRC, QS, ITW, FSSC, ISO), proposing efficient methods to identify and remediate non-conformities and corrective and preventive actions. Defining the supply flow and acceptance steps promotes collaboration with suppliers to ensure the quality and safety of raw materials. To assess the risks of suppliers and raw materials, objective criteria are developed and vulnerabilities in the supply chain are analyzed, including the risk of fraud. Active monitoring of international alerts through RASFF helps to identify emerging risks quickly, and regular analysis of international trends and company performance enables continuous adaptation of risk management strategies. Implementing these measures strengthens food safety and consumer confidence in the final products supplied.

Keywords: food supply chain, international standards, quality and safety of raw materials, RASFF

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Authors: Sergey Podluzhnyy

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One of the most important tasks of investment and pension fund management is building decision support system which helps to make right decision on corporate bond portfolio formation. Today there are several basic methods of bond portfolio management. They are duration management, immunization and convexity management. Identified methods have serious disadvantage: they do not take into account credit risk or insolvency risk of issuer. So, identified methods can be applied only for management and evaluation of high-quality sovereign bonds. Applying article proposes mathematical model for building an optimal in case of risk and yield corporate bond portfolio. Proposed model takes into account the default probability in formula of assessment of bonds which results to more correct evaluation of bonds prices. Moreover, applied model provides tools for visualization of the efficient frontier of corporate bonds portfolio taking into account the exposure to credit risk, which will increase the quality of the investment decisions of portfolio managers.

Keywords: corporate bond portfolio, default probability, effective boundary, portfolio optimization task

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Authors: Abdul Kadir, L. Meily Kurniawidjaja

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Batik Madura workers are exposed to many Musculoskeletal Disorders risk factors, particularly Low Back Pain (LBP). This study was conducted as an early detection of ergonomic risk level on Workers Industrial Sentra Batik Madura in Dusun Banyumas, Klampar Subdistrict, Proppo Pamekasan, Madura, East Java. This study includes 12 workers who 11 workers had pain in the upper and lower part of the neck, back, wrist right hand, also 10 workers had pain in the right shoulder. This is a descriptive observational study with cross-sectional approach. Qualitative research by observing workers activity such as draw and putting the wax motif, fabric dyeing, fabric painting, discoloration, washing, and drying. The results are workers have identified ergonomic hazards such as awkward postures, twisting movements, repetitive, and static work postures. Using the method of REBA and QEC, the results get a very high-risk level of activity in each of Madura batik making process is the draw and putting the wax motif, coloring, painting, discoloration, washing, and drying. The level of risk can be reduced by improvement of work equipment include the provision of seats, strut fabric, high settings furnaces, drums, coloring basin, and washing tub.

Keywords: activities of Madura's batik, ergonomic risk level, equipment, QEC (Quick Exposure Checklist), REBA (Rapid Entire Body Assessment)

Procedia PDF Downloads 194

Authors: Alper Serdar Anli

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Analysis of temporal variation of reference evapotranspiration (ET0) is important in arid and semi-arid regions where water resources are limited. In this study, temporal variation of reference evapotranspiration (ET0) and meteorological drought analysis through SPEI (Standardized Precipitation Evapotranspiration Index) method have been carried out in provinces of Central Anatolia Region, Turkey. Reference evapotranspiration of concerning provinces in the region has been estimated using Penman-Monteith method and one calendar year has been split up four periods as r1, r2, r3 and r4. Temporal variation of reference evapotranspiration according to four periods has been analyzed through parametric Dickey-Fuller test and non-parametric Mann-Whitney U test. As a result, significant increasing trends for reference evapotranspiration have been detected and according to SPEI method used for estimating meteorological drought in provinces, mild drought has been experienced in general, and however there have been also a significant amount of events where moderate and severely droughts occurred.

Keywords: central Anatolia region, drought index, Penman-Monteith, reference evapotranspiration, temporal variation

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Authors: Mustafa Gok, Sair Kahraman, Mustafa Fener

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In rock engineering applications, determining uniaxial compressive strength (UCS), Brazilian tensile strength (BTS), and basic index properties such as density, porosity, and water absorption is crucial for the design of both underground and surface structures. However, obtaining reliable samples for direct testing, especially from rocks that weather quickly and have low strength, is often challenging. In such cases, indirect methods provide a practical alternative to estimate the physical and mechanical properties of these rocks. In this study, tuff samples collected from the Cappadocia region (Nevşehir) in Turkey were subjected to indirect testing methods. Over 100 tests were conducted, using needle penetrometer index (NPI), point load strength index (PLI), and disc shear index (BPI) to estimate the uniaxial compressive strength (UCS), Brazilian tensile strength (BTS), density, and water absorption index of the tuffs. The relationships between the results of these indirect tests and the target physical properties were evaluated using simple and multiple regression analyses. The findings of this research reveal strong correlations between the indirect methods and the mechanical properties of the tuffs. Both uniaxial compressive strength and Brazilian tensile strength could be accurately predicted using NPI, PLI, and BPI values. The regression models developed in this study allow for rapid, cost-effective assessments of tuff strength in cases where direct testing is impractical. These results are particularly valuable for geological engineering applications, where time and resource constraints exist. This study highlights the significance of using indirect methods as reliable predictors of the mechanical behavior of weak rocks like tuffs. Further research is recommended to explore the application of these methods to other rock types with similar characteristics. Further research is required to compare the results with those of established direct test methods.

Keywords: brazilian tensile strength, disc shear strength, indirect methods, tuffs, uniaxial compressive strength

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