Search results for: risk probability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6948

Search results for: risk probability

5658 Design and Analysis of Adaptive Type-I Progressive Hybrid Censoring Plan under Step Stress Partially Accelerated Life Testing Using Competing Risk

Authors: Ariful Islam, Showkat Ahmad Lone

Abstract:

Statistical distributions have long been employed in the assessment of semiconductor devices and product reliability. The power function-distribution is one of the most important distributions in the modern reliability practice and can be frequently preferred over mathematically more complex distributions, such as the Weibull and the lognormal, because of its simplicity. Moreover, it may exhibit a better fit for failure data and provide more appropriate information about reliability and hazard rates in some circumstances. This study deals with estimating information about failure times of items under step-stress partially accelerated life tests for competing risk based on adoptive type-I progressive hybrid censoring criteria. The life data of the units under test is assumed to follow Mukherjee-Islam distribution. The point and interval maximum-likelihood estimations are obtained for distribution parameters and tampering coefficient. The performances of the resulting estimators of the developed model parameters are evaluated and investigated by using a simulation algorithm.

Keywords: adoptive progressive hybrid censoring, competing risk, mukherjee-islam distribution, partially accelerated life testing, simulation study

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5657 Spatial Analysis of the Socio-Environmental Vulnerability in Medium-Sized Cities: Case Study of Municipality of Caraguatatuba SP-Brazil

Authors: Katia C. Bortoletto, Maria Isabel C. de Freitas, Rodrigo B. N. de Oliveira

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The environmental vulnerability studies are essential for priority actions to the reduction of disasters risk. The aim of this study is to analyze the socio-environmental vulnerability obtained through a Census survey, followed by both a statistical analysis (PCA/SPSS/IBM) and a spatial analysis by GIS (ArcGis/ESRI), taking as a case study the Municipality of Caraguatatuba-SP, Brazil. In the municipal development plan analysis the emphasis was given to the Special Zone of Social Interest (ZEIS), the Urban Expansion Zone (ZEU) and the Environmental Protection Zone (ZPA). For the mapping of the social and environmental vulnerabilities of the study area the exposure of people (criticality) and of the place (support capacity) facing disaster risk were obtained from the 2010 Census from the Brazilian Institute of Geography and Statistics (IBGE). Considering the criticality, the variables of greater influence were related to literate persons responsible for the household and literate persons with 5 or more years of age; persons with 60 years or more of age and income of the person responsible for the household. In the Support Capacity analysis, the predominant influence was on the good household infrastructure in districts with low population density and also the presence of neighborhoods with little urban infrastructure and inadequate housing. The results of the comparative analysis show that the areas with high and very high vulnerability classes cover the classes of the ZEIS and the ZPA, whose zoning includes: Areas occupied by low-income population, presence of children and young people, irregular occupations and land suitable to urbanization but underutilized. The presence of zones of urban sprawl (ZEU) in areas of high to very high socio-environmental vulnerability reflects the inadequate use of the urban land in relation to the spatial distribution of the population and the territorial infrastructure, which favors the increase of disaster risk. It can be concluded that the study allowed observing the convergence between the vulnerability analysis and the classified areas in urban zoning. The occupation of areas unsuitable for housing due to its characteristics of risk was confirmed, thus concluding that the methodologies applied are agile instruments to subsidize actions to the reduction disasters risk.

Keywords: socio-environmental vulnerability, urban zoning, reduction disasters risk, methodologies

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5656 Disadvantaged Adolescents and Educational Delay in South Africa: Impacts of Personal, Family, and School Characteristics

Authors: Rocio Herrero Romero, Lucie Cluver, James Hall, Janina Steinert

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Educational delay and non-completion are major policy concerns in South Africa. However, little research has focused on predictors for educational delay amongst adolescents in disadvantaged areas. This study has two aims: first, to use data integration approaches to compare the educational delay of 599 adolescents aged 16 to 18 from disadvantaged communities to national and provincial representative estimates in South Africa. Second, the paper also explores predictors for educational delay by comparing adolescents out of school (n=64) and at least one year behind (n=380), with adolescents in the age-appropriate grade or higher (n=155). Multinomial logistic regression models using self-report and administrative data were applied to look for significant associations of risk and protective factors. Significant risk factors for being behind (rather than in age-appropriate grade) were: male gender, past grade repetition, rural location and larger school size. Risk factors for being out of school (rather than in the age-appropriate grade) were: past grade repetition, having experienced problems concentrating at school, household poverty, and food insecurity. Significant protective factors for being in the age-appropriate grade (rather than out of school) were: living with biological parents or grandparents and access to school counselling. Attending school in wealthier communities was a significant protective factor for being in the age-appropriate grade (rather than behind). Our results suggest that both personal and contextual factors –family and school- predicted educational delay. This study provides new evidence to the significant effects of personal, family, and school characteristics on the educational outcomes of adolescents from disadvantaged communities in South Africa. This is the first longitudinal and quantitative study to systematically investigate risk and protective factors for post-compulsory educational outcomes amongst South African adolescents living in disadvantaged communities.

Keywords: disadvantaged communities, quantitative analysis, school delay, South Africa

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5655 Reliability Analysis of Construction Schedule Plan Based on Building Information Modelling

Authors: Lu Ren, You-Liang Fang, Yan-Gang Zhao

Abstract:

In recent years, the application of BIM (Building Information Modelling) to construction schedule plan has been the focus of more and more researchers. In order to assess the reasonable level of the BIM-based construction schedule plan, that is whether the schedule can be completed on time, some researchers have introduced reliability theory to evaluate. In the process of evaluation, the uncertain factors affecting the construction schedule plan are regarded as random variables, and probability distributions of the random variables are assumed to be normal distribution, which is determined using two parameters evaluated from the mean and standard deviation of statistical data. However, in practical engineering, most of the uncertain influence factors are not normal random variables. So the evaluation results of the construction schedule plan will be unreasonable under the assumption that probability distributions of random variables submitted to the normal distribution. Therefore, in order to get a more reasonable evaluation result, it is necessary to describe the distribution of random variables more comprehensively. For this purpose, cubic normal distribution is introduced in this paper to describe the distribution of arbitrary random variables, which is determined by the first four moments (mean, standard deviation, skewness and kurtosis). In this paper, building the BIM model firstly according to the design messages of the structure and making the construction schedule plan based on BIM, then the cubic normal distribution is used to describe the distribution of the random variables due to the collecting statistical data of the random factors influencing construction schedule plan. Next the reliability analysis of the construction schedule plan based on BIM can be carried out more reasonably. Finally, the more accurate evaluation results can be given providing reference for the implementation of the actual construction schedule plan. In the last part of this paper, the more efficiency and accuracy of the proposed methodology for the reliability analysis of the construction schedule plan based on BIM are conducted through practical engineering case.

Keywords: BIM, construction schedule plan, cubic normal distribution, reliability analysis

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5654 The Misuse of Free Cash and Earnings Management: An Analysis of the Extent to Which Board Tenure Mitigates Earnings Management

Authors: Michael McCann

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Managerial theories propose that, in joint stock companies, executives may be tempted to waste excess free cash on unprofitable projects to keep control of resources. In order to conceal their projects' poor performance, they may seek to engage in earnings management. On the one hand, managers may manipulate earnings upwards in order to post ‘good’ performances and safeguard their position. On the other, since managers pursuit of unrewarding investments are likely to lead to low long-term profitability, managers will use negative accruals to reduce current year’s earnings, smoothing earnings over time in order to conceal the negative effects. Agency models argue that boards of directors are delegated by shareholders to ensure that companies are governed properly. Part of that responsibility is ensuring the reliability of financial information. Analyses of the impact of board characteristics, particularly board independence on the misuse of free cash flow and earnings management finds conflicting evidence. However, existing characterizations of board independence do not account for such directors gaining firm-specific knowledge over time, influencing their monitoring ability. Further, there is little analysis of the influence of the relative experience of independent directors and executives on decisions surrounding the use of free cash. This paper contributes to this literature regarding the heterogeneous characteristics of boards by investigating the influence of independent director tenure on earnings management and the relative tenures of independent directors and Chief Executives. A balanced panel dataset comprising 51 companies across 11 annual periods from 2005 to 2015 is used for the analysis. In each annual period, firms were classified as conducting earnings management if they had discretionary accruals in the bottom quartile (downwards) and top quartile (upwards) of the distributed values for the sample. Logistical regressions were conducted to determine the marginal impact of independent board tenure and a number of control variables on the probability of conducting earnings management. The findings indicate that both absolute and relative measures of board independence and experience do not have a significant impact on the likelihood of earnings management. It is the level of free cash flow which is the major influence on the probability of earnings management. Higher free cash flow increases the probability of earnings management significantly. The research also investigates whether board monitoring of earnings management is contingent on the level of free cash flow. However, the results suggest that board monitoring is not amplified when free cash flow is higher. This suggests that the extent of earnings management in companies is determined by a range of company, industry and situation-specific factors.

Keywords: corporate governance, boards of directors, agency theory, earnings management

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5653 Link Between Intensity-trajectories Of Acute Postoperative Pain And Risk Of Chronicization After Breast And Thoracopulmonary Surgery

Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila

Abstract:

Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.

Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor

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5652 A Machine Learning Model for Dynamic Prediction of Chronic Kidney Disease Risk Using Laboratory Data, Non-Laboratory Data, and Metabolic Indices

Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

Abstract:

Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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5651 Robust ANOVA: An Illustrative Study in Horticultural Crop Research

Authors: Dinesh Inamadar, R. Venugopalan, K. Padmini

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An attempt has been made in the present communication to elucidate the efficacy of robust ANOVA methods to analyze horticultural field experimental data in the presence of outliers. Results obtained fortify the use of robust ANOVA methods as there was substantiate reduction in error mean square, and hence the probability of committing Type I error, as compared to the regular approach.

Keywords: outliers, robust ANOVA, horticulture, cook distance, type I error

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5650 Female Frontline Health Workers in High-Risk Workplaces: Legal Protection in Bangladesh amid the Covid-19 Pandemic

Authors: Nabila Farhin, Israt Jahan

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Despite the feminisation of the global health force, women mostly engage in nursing, midwifery and community health workers (HWs), and the posts like surgeons, doctors, and specialists are generally male-dominated. It is also prominent in Bangladesh, where female HWs witness systematic workplace inequalities, discrimination, and underpayment. The Covid-19 pandemic put unsurmountable pressure on HWs as they had to serve in high-risk workplaces as frontliners. The already disadvantaged female HWs shouldered the same burden, were overworked without adequate occupational health and safety measures (OSH) and risked their lives. Acknowledging their vulnerable workplace conditions, the World Health Organization (WHO) and International Labour Organization (ILO) circulated a few specialised guidelines amid the peril. Bangladesh tried to adhere to international guidelines while formulating pandemic management strategies. In reality, the already weak and understaffed health sector collapsed with the patient influx and many HWs got infected and died in the line of duty, exposing the high-risk nature of the work. Unfortunately, the gender-segregated data of infected HWs are absent. This qualitative research investigates whether the existing laws of Bangladesh are adequate in protecting female HWs as frontliners in high-risk workplaces during the Covid-19 pandemic. The paper first examines international labour laws safeguarding female frontline HWs. It also analyses the specialised Covid-19 pandemic guidelines protecting their interests. Finally, the research investigates the compliance of Bangladesh as per international legal guidance during the pandemic. In doing so, it explores the domestic laws, professional guidelines for HWs and pandemic response strategies. The paper critically examines the primary sources like international and national statutes, rules, regulations and guidelines. Secondary sources like authoritative journal articles, books and newspaper reports are contextually analysed in line with the objective of the paper. The definition of HW is ambiguous in the labour laws of Bangladesh. It leads to confusion regarding the extent of legal protection rendered to female HWs at private hospitals in high-risk situations. The labour laws are not applicable in Public hospitals, as the employees follow the public service rules. Unfortunately, the country has no specialised law to protect HWs in high-risk workplaces, and the professional guidelines for HWs also remain inadequate in this regard. Even though the pandemic management strategies highlight some protective measures in high-risk situations, they only deal with HWs who are pregnant or have underlying health issues. No specialised protective guidelines can be found for female HWs as frontliners. Therefore, the laws are insufficient and failed to render adequate legal protection to female frontline HWs during the pandemic. The country also lacks comprehensive health legislation and uniform institutional and professional guidelines, preventing them from accessing grievance mechanisms. Hence, the female HWs felt victimised while duty-bound to serve in high-risk workplaces without adequate safeguards. Bangladesh should clarify the definition of HWs and standardise the service rules for providing medical care in high-risk workplaces. The research also recommends adequate health legislation and specialised legal protection to safeguard female HWs in future emergencies.

Keywords: female health workers (HWs), high-risk workplaces, Covid-19 pandemic, Bangladesh

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5649 The Capacity Building in the Natural Disaster Management of Thailand

Authors: Eakarat Boonreang

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The past two decades, Thailand faced the natural disasters, for instance, Gay typhoon in 1989, tsunami in 2004, and huge flood in 2011. The disaster management in Thailand was improved both structure and mechanism for cope with the natural disaster since 2007. However, the natural disaster management in Thailand has various problems, for examples, cooperation between related an organizations have not unity, inadequate resources, the natural disaster management of public sectors not proactive, people has not awareness the risk of the natural disaster, and communities did not participate in the natural disaster management. Objective of this study is to find the methods for capacity building in the natural disaster management of Thailand. The concept and information about the capacity building and the natural disaster management of Thailand were reviewed and analyzed by classifying and organizing data. The result found that the methods for capacity building in the natural disaster management of Thailand should be consist of 1)link operation and information in the natural disaster management between nation, province, local and community levels, 2)enhance competency and resources of public sectors which relate to the natural disaster management, 3)establish proactive natural disaster management both planning and implementation, 4)decentralize the natural disaster management to local government organizations, 5)construct public awareness in the natural disaster management to community, 6)support Community Based Disaster Risk Management (CBDRM) seriously, and 7)emphasis on participation in the natural disaster management of all stakeholders.

Keywords: capacity building, Community Based Disaster Risk Management (CBDRM), Natural Disaster Management, Thailand

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5648 Conformity and Differentiation in CSR Practices on Capital Market Performance: Empirical Evidence from Stock Liquidity and Price Crash Risk

Authors: Jie Zhang, Chaomin Zhang, Jihua Zhang, Haitong Li

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Using the theory of optimal distinctiveness, this study examines the effects of conformity and differentiation within corporate social responsibility (CSR) practices on capital market performance. Analysing data from Chinese A-share listed firms from 2007 to 2022, this paper demonstrates that when firms conform to the expected scope of CSR, such behaviour enhances investor attention and market acceptance, thereby boosting stock liquidity. Conversely, emphasising differentiation in CSR practices more effectively mitigates stock price crash risk by addressing principal–agent problems and decreasing information asymmetry. This paper also investigates how organisational and environmental factors moderate the relationship between conformity and differentiation in CSR practices and their impact on capital market performance. The results also show that the influence of conformity on stock liquidity is accentuated in smaller firms and environments with stringent legal oversight. By contrast, the benefits of differentiation in reducing stock price crash risk are amplified in firms with robust corporate governance and markets characterised by high uncertainty.

Keywords: corporate social responsibility, social responsibility practices, capital market performance, optimal distinctiveness

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5647 Relationship between Different Heart Rate Control Levels and Risk of Heart Failure Rehospitalization in Patients with Persistent Atrial Fibrillation: A Retrospective Cohort Study

Authors: Yongrong Liu, Xin Tang

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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

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5646 Cancer of the Cervix Caused by HPV (Human papillomavirus) in Algerian Population

Authors: Sara Mouffouk, Fatma Belaid, Asma Hechani, Chaima Mouffouk

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Cancer of the cervix caused by HPV (human papillomavirus ) is for many years a real public health problem, it is ranked 2nd deadly female cancer kills more than 270 000 women each year worldwide. In Algeria, the mortality of cervical cancer decreases with the impact, but the prognosis of these cancers remains bleak: The 5-year relative survival is 60 %. The mode of transmission is usually sexuel. Our study was undertaken to show the link between HPV and cervical cancer and the importance of Pap smear screening in this type of pathology. On the total sample, 76.11 % showed abnormal cervical smears of which 13% have mild cases and hormonal reaction Change, and 44% represent inflammatory smears and normal cases 35%, while long seven years from 2005 to 2012. Thus, 43% of abnormal smear results between ASCUS, AGUS, low and high grade carcinoma and adenocarcinoma and 57 % of other cases of unknown origin. The average age of women at risk of developing adenocarcinoma is 45-50 with a 67% to 33% of the same risk in women of age group 41-45 years although the percentage of cases of HPV infected patients was 2% in the past seven years. We found that with increasing age, the risk is argued. Due to several factors such as multiparty can reduced the resistance of the uterine epithelium and even as the multi that promotes contamination HPV causes repeated infections with HPV.

Keywords: cervical cancer, human papillomavirus (HPV) screening, prevention, vaccines

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5645 Evaluation of Environmental and Social Management System of Green Climate Fund's Accredited Entities: A Qualitative Approach Applied to Environmental and Social System

Authors: Sima Majnooni

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This paper discusses the Green Climate Fund's environmental and social management framework (GCF). The environmental and social management framework ensures the accredited entity considers the GCF's accreditation standards and effectively implements each of the GCF-funded projects. The GCF requires all accredited entities to meet basic transparency and accountability standards as well as environmental and social safeguards (ESMS). In doing so, the accredited entity sets up different independent units. One of these units is called the Grievance Mechanism. When allegations of environmental and social harms are raised in association with GCF-funded activities, affected parties can contact the entity’s grievance unit. One of the most challenging things about the accredited entity's grievance unit is the lack of available information and resources on the entities' websites. Many AEs have anti-corruption or anti-money laundering unit, but they do not have the environmental and social unit for affected people. This paper will argue the effectiveness of environmental and social grievance mechanisms of AEs by using a qualitative approach to indicate how many of AEs have a poor or an effective GRM. Some ESMSs seem highly effective. On the other hand, other mechanisms lack basic requirements such as a clear, transparent, uniform procedure and a definitive timetable. We have looked at each AE mechanism not only in light of how the website goes into detail regarding the process of grievance mechanism but also in light of their risk category. Many mechanisms appear inadequate for the lower level risk category entities (C) and, even surprisingly, for many higher-risk categories (A). We found; in most cases, the grievance mechanism of AEs seems vague.

Keywords: grievance mechanism, vague environmental and social policies, green climate fund, international climate finance, lower and higher risk category

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5644 Canada Deuterium Uranium Updated Fire Probabilistic Risk Assessment Model for Canadian Nuclear Plants

Authors: Hossam Shalabi, George Hadjisophocleous

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The Canadian Nuclear Power Plants (NPPs) use some portions of NUREG/CR-6850 in carrying out Fire Probabilistic Risk Assessment (PRA). An assessment for the applicability of NUREG/CR-6850 to CANDU reactors was performed and a CANDU Fire PRA was introduced. There are 19 operating CANDU reactors in Canada at five sites (Bruce A, Bruce B, Darlington, Pickering and Point Lepreau). A fire load density survey was done for all Fire Safe Shutdown Analysis (FSSA) fire zones in all CANDU sites in Canada. National Fire Protection Association (NFPA) Standard 557 proposes that a fire load survey must be conducted by either the weighing method or the inventory method or a combination of both. The combination method results in the most accurate values for fire loads. An updated CANDU Fire PRA model is demonstrated in this paper that includes the fuel survey in all Canadian CANDU stations. A qualitative screening step for the CANDU fire PRA is illustrated in this paper to include any fire events that can damage any part of the emergency power supply in addition to FSSA cables.

Keywords: fire safety, CANDU, nuclear, fuel densities, FDS, qualitative analysis, fire probabilistic risk assessment

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5643 Public Private Partnership for Infrastructure Projects: Mapping the Key Risks

Authors: Julinda Keçi

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In many countries, governments have been promoting the involvement of private sector entities to enter into long-term agreements for the development and delivery of large infrastructure projects, with a focus on overcoming the limitations upon public fund of the traditional approach. The involvement of private sector through public-private partnerships (PPP) brings in new capital investments, value for money and additional risks to handle. Worldwide research studies have shown that an objective, systematic, reliable and user-oriented risk assessment process and an optimal allocation mechanism among different stakeholders is crucial to the successful completion. In this framework this paper, which is the first stage of a research study, aims to identify the main risks for the delivery of PPP projects. A review of cross-countries research projects and case studies was performed to map the key risks affecting PPP infrastructure delivery. The matrix of mapping offers a summary of the frequency of factors, clustered in eleven categories: Construction, Design, Economic, Legal, Market, Natural, Operation, Political, Project finance, Project selection and Relationship. Results will highlight the most critical risk factors, and will hopefully assist the project managers in directing the managerial attention in the further stages of risk allocation.

Keywords: construction, infrastructure, public private partnerships, risks

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5642 Design of a Fuzzy Expert System for the Impact of Diabetes Mellitus on Cardiac and Renal Impediments

Authors: E. Rama Devi Jothilingam

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Diabetes mellitus is now one of the most common non communicable diseases globally. India leads the world with largest number of diabetic subjects earning the title "diabetes capital of the world". In order to reduce the mortality rate, a fuzzy expert system is designed to predict the severity of cardiac and renal problems of diabetic patients using fuzzy logic. Since uncertainty is inherent in medicine, fuzzy logic is used in this research work to remove the inherent fuzziness of linguistic concepts and uncertain status in diabetes mellitus which is the prime cause for the cardiac arrest and renal failure. In this work, the controllable risk factors "blood sugar, insulin, ketones, lipids, obesity, blood pressure and protein/creatinine ratio" are considered as input parameters and the "the stages of cardiac" (SOC)" and the stages of renal" (SORD) are considered as the output parameters. The triangular membership functions are used to model the input and output parameters. The rule base is constructed for the proposed expert system based on the knowledge from the medical experts. Mamdani inference engine is used to infer the information based on the rule base to take major decision in diagnosis. Mean of maximum is used to get a non fuzzy control action that best represent possibility distribution of an inferred fuzzy control action. The proposed system also classifies the patients with high risk and low risk using fuzzy c means clustering techniques so that the patients with high risk are treated immediately. The system is validated with Matlab and is used as a tracking system with accuracy and robustness.

Keywords: Diabetes mellitus, fuzzy expert system, Mamdani, MATLAB

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5641 Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Tunisia: Risk and Protective Factor

Authors: Ahmed Sami Hammami, Mohamed Jellazi

Abstract:

Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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5640 Detection of Resistive Faults in Medium Voltage Overhead Feeders

Authors: Mubarak Suliman, Mohamed Hassan

Abstract:

Detection of downed conductors occurring with high fault resistance (reaching kilo-ohms) has always been a challenge, especially in countries like Saudi Arabia, on which earth resistivity is very high in general (reaching more than 1000 Ω-meter). The new approaches for the detection of resistive and high impedance faults are based on the analysis of the fault current waveform. These methods are still under research and development, and they are currently lacking security and dependability. The other approach is communication-based solutions which depends on voltage measurement at the end of overhead line branches and communicate the measured signals to substation feeder relay or a central control center. However, such a detection method is costly and depends on the availability of communication medium and infrastructure. The main objective of this research is to utilize the available standard protection schemes to increase the probability of detection of downed conductors occurring with a low magnitude of fault currents and at the same time avoiding unwanted tripping in healthy conditions and feeders. By specifying the operating region of the faulty feeder, use of tripping curve for discrimination between faulty and healthy feeders, and with proper selection of core balance current transformer (CBCT) and voltage transformers with fewer measurement errors, it is possible to set the pick-up of sensitive earth fault current to minimum values of few amps (i.e., Pick-up Settings = 3 A or 4 A, …) for the detection of earth faults with fault resistance more than (1 - 2 kΩ) for 13.8kV overhead network and more than (3-4) kΩ fault resistance in 33kV overhead network. By implementation of the outcomes of this study, the probability of detection of downed conductors is increased by the utilization of existing schemes (i.e., Directional Sensitive Earth Fault Protection).

Keywords: sensitive earth fault, zero sequence current, grounded system, resistive fault detection, healthy feeder

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5639 Effect of Co-Infection With Intestinal Parasites on COVID-19 Severity: A Prospective Observational Cohort Study

Authors: Teklay Gebrecherkos, Dawit Wolday, Muhamud Abdulkader

Abstract:

Background: COVID-19 symptomatology in Africa appears significantly less serious than in the industrialized world. Our hypothesis for this phenomenon, being a different, more activated immune system due to parasite infections contributes to reduced COVID-19 outcome. We investigated this hypothesis in an endemic area in sub sub-saharan Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites, between July 2020 and March 2021. The primary outcome was the proportion of patients with severe COVID-19. SARS-CoV-2 infection was confirmed by RT-PCR on samples obtained from nasopharyngeal swabs, while direct microscopic examination, modified Ritchie concentration, and Kato-Katz methods were used to identify parasites and ova from a fresh stool sample. Ordinal logistic regression models were used to estimate the association between parasite infection and COVID-19 severity. Models were adjusted for sex, age, residence, education level, occupation, body mass index, and comorbidities. Data were analyzed using STATA version 14. P-value <0.05 was considered statistically significant. Results: A total of 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37•8%) had an intestinal parasitic infection. Only 27/255 (10•6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51•8%) non-severe COVID-19 patients appeared parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (AOR) of 0•14 (95% CI 0•09–0•24; p<0•0001) for all parasites, AOR 0•20 ([95% CI 0•11–0•38]; p<0•0001) for protozoa, and AOR 0•13 ([95% CI 0•07–0•26]; p<0•0001) for helminths. When stratified by species, co-infection with Entamoeba spp., Hymenolopis nana, and Schistosoma mansoni implied a lower probability of developing severe COVID-19. There were 11 deaths (1•5%), and all were among patients without parasites (p=0•009). Conclusions: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19.

Keywords: COVID-19, SARS-COV-2, intestinal parasite, RT-PCR, co-infection

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5638 Financial Market Turmoil and Performance of Islamic Equity Indices

Authors: Abul Shamsuddin

Abstract:

The Islamic stock market indices are constructed by screening out stocks that are incompatible with Islam’s prohibition of interest and certain lines of business. This study examines the effects of Islamic screening on the risk-return characteristics of Islamic vis-a-vis mainstream equity portfolios. We use data on Dow Jones Islamic market indices and FTSE Global Islamic indices over 1993-2013. We observe that Islamic equity indices outperform their mainstream counterparts in both raw and risk-adjusted returns. In addition, Islamic equity indices are more resilient to turbulence in international markets than that of their mainstream counterparts. The findings are robust across a variety of portfolio performance measures.

Keywords: Dow Jones Islamic market index, FTSE global Islamic index, ethical investment, finance

Procedia PDF Downloads 352
5637 Functional Connectivity Signatures of Polygenic Depression Risk in Youth

Authors: Louise Moles, Steve Riley, Sarah D. Lichenstein, Marzieh Babaeianjelodar, Robert Kohler, Annie Cheng, Corey Horien Abigail Greene, Wenjing Luo, Jonathan Ahern, Bohan Xu, Yize Zhao, Chun Chieh Fan, R. Todd Constable, Sarah W. Yip

Abstract:

Background: Risks for depression are myriad and include both genetic and brain-based factors. However, relationships between these systems are poorly understood, limiting understanding of disease etiology, particularly at the developmental level. Methods: We use a data-driven machine learning approach connectome-based predictive modeling (CPM) to identify functional connectivity signatures associated with polygenic risk scores for depression (DEP-PRS) among youth from the Adolescent Brain and Cognitive Development (ABCD) study across diverse brain states, i.e., during resting state, during affective working memory, during response inhibition, during reward processing. Results: Using 10-fold cross-validation with 100 iterations and permutation testing, CPM identified connectivity signatures of DEP-PRS across all examined brain states (rho’s=0.20-0.27, p’s<.001). Across brain states, DEP-PRS was positively predicted by increased connectivity between frontoparietal and salience networks, increased motor-sensory network connectivity, decreased salience to subcortical connectivity, and decreased subcortical to motor-sensory connectivity. Subsampling analyses demonstrated that model accuracies were robust across random subsamples of N’s=1,000, N’s=500, and N’s=250 but became unstable at N’s=100. Conclusions: These data, for the first time, identify neural networks of polygenic depression risk in a large sample of youth before the onset of significant clinical impairment. Identified networks may be considered potential treatment targets or vulnerability markers for depression risk.

Keywords: genetics, functional connectivity, pre-adolescents, depression

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5636 Male Versatile Sexual Offenders in Taiwan

Authors: Huang Yueh Chen, Sheng Ang Shen

Abstract:

Purpose: Sexual assault has always been a highly anticipated crime in Taiwan. People assume that the career of sexual offenders tends to be highly specialized. This study hopes to analyze the crime career and risk factors of offenders by means of another classification. Methods: A total of 145 sexual offenders were sentenced on the parole or expiration date from 2009 to 2011, through analysis of official existing documents such as ‘Re-infringement risk assessment report’ and ‘case assessment report’. Results: The section ‘Various Types of Crimes ‘ of criminal career is analyzed. The highest number of ‘ versatile sexual offender’ followed by ‘adult sexual offender’ is about 2.5, representing more than 1.5 kinds of non-sex crimes besides sexual crimes. Different specialized sexual offenders have had extensive experience in the ‘Sexual Assault Experiences in Children and School’, ‘Static 99 Levels’, ‘Pre-Commuted Substance Use’, ‘Excited Deviant Sexual Behavior’, ‘Various Types of Crimes,’ and ‘Sexual Crime in Forerunner’ , ‘Type of Index Crime’ and other projects to achieve significant differences. Conclusions: Resources continue to be devoted to specialized offenders, the character of first-time sexual offender depends on further research and makes the public aware of the different assumptions of diversified offenders from traditional professional offenses that reduce unnecessary panic in society.

Keywords: versatile sexual offender, specialized sexual offender, criminal career, risk factor

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5635 Development of a Predictive Model to Prevent Financial Crisis

Authors: Tengqin Han

Abstract:

Delinquency has been a crucial factor in economics throughout the years. Commonly seen in credit card and mortgage, it played one of the crucial roles in causing the most recent financial crisis in 2008. In each case, a delinquency is a sign of the loaner being unable to pay off the debt, and thus may cause a lost of property in the end. Individually, one case of delinquency seems unimportant compared to the entire credit system. China, as an emerging economic entity, the national strength and economic strength has grown rapidly, and the gross domestic product (GDP) growth rate has remained as high as 8% in the past decades. However, potential risks exist behind the appearance of prosperity. Among the risks, the credit system is the most significant one. Due to long term and a large amount of balance of the mortgage, it is critical to monitor the risk during the performance period. In this project, about 300,000 mortgage account data are analyzed in order to develop a predictive model to predict the probability of delinquency. Through univariate analysis, the data is cleaned up, and through bivariate analysis, the variables with strong predictive power are detected. The project is divided into two parts. In the first part, the analysis data of 2005 are split into 2 parts, 60% for model development, and 40% for in-time model validation. The KS of model development is 31, and the KS for in-time validation is 31, indicating the model is stable. In addition, the model is further validation by out-of-time validation, which uses 40% of 2006 data, and KS is 33. This indicates the model is still stable and robust. In the second part, the model is improved by the addition of macroeconomic economic indexes, including GDP, consumer price index, unemployment rate, inflation rate, etc. The data of 2005 to 2010 is used for model development and validation. Compared with the base model (without microeconomic variables), KS is increased from 41 to 44, indicating that the macroeconomic variables can be used to improve the separation power of the model, and make the prediction more accurate.

Keywords: delinquency, mortgage, model development, model validation

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5634 Review of Correlation between Tacrolimus Pharmacotherapy and Infection after Organ Transplantation

Authors: Zahra Tolou-Ghamari

Abstract:

Introduction: After allogeneic organ transplantation, in order to lower the rate of rejectiontacrolimus is given. In fact, infection is reported as the most complication of tacrolimus that might be associated with higher susceptibility by its’ long term use. Aim: This study aims to review the association between the occurrence of infections after organ transplantation following the administration of tacrolims. Materials and Methods: Scientific literature on the pharmacotherapy of tacrolimus after organ transplantation and infections were searched using PUBMED.Gov (https://pubmed.ncbi.nlm.nih.gov/), Web of Science, and Scopus. Results: In order to prevent acute and chronic rejection, the potent immunosuppressive drug tacrolimus administered as a calcineurin inhibitor after organ transplantation. Its’ most frequent infectious complication is reported as urinary tract infection. Virulent strain of recombinant Literiamonocytogenes, in addition to an increase in bacterial burden in the liver and spleen tissues, was reported in the animal experimental study. The consequence of aggressive events and recipients total area under the cureve exposure to immunosuppressive could be as considered as surrogate markers for individual infection’s risk evaluation. Conclusion: Transplant surgery and duration of hospital stay could determinate the risk of infection during the first month of organ transplantation. Despite administration of antiviral drugs, opportunistic infection such as cytomegalovirus could increase the risk of infection during month 1 to year after transplantation.

Keywords: transplant, infection, tacrolimus, kidney

Procedia PDF Downloads 125
5633 Playing Safely: An Exploration of Irish Parental Attitudes Towards Risky Play and Its Impact on Play Opportunities for Children

Authors: Fiona Armstrong, David Gaul, Michael Barrett, Lorraine D'Arcy

Abstract:

Playing is an instinctive and universal human behavior, is a child’s way of learning and an outlet for their innate need of activity. Risky play can be defined as any play that is thrilling or exciting involving the risk of injury. The benefits of risky play have been acknowledged as helping children to explore and conquer fears, develop confidence, reduce anxiety, and develop risk-management skills. Studies indicate that children learn sound judgment by assessing and confronting risks in relation to their own capabilities through exposure to carefully managed play experiences. Risky play has been associated with danger and increased risk of injury, with families focusing on risk aversion and protecting children from the risks inherent in the modern world. Despite children needing cultural, social, emotional, physical, and geographical space to play, the opportunity for children to play is diminishing. Aim: This study explores play behaviors and risky play in an Irish context by investigating parental attitudes to risky play. Methodology: This is a mixed methods study involving the State of Play survey and semi-structured interviews exploring parental attitudes to risky play. Data will be quantitatively analyzed using descriptive and inferential statistics using IBM SPSS and qualitatively analyzed via thematic analysis using NVivo. Conclusion: The information gathered could advise stakeholders regarding the creation and provision of developmentally appropriate, challenging, stimulating, adaptable, accessible, and safe as necessary outdoor play areas. This research can inform parents, planners, architects, and authorities involved in creating environments for play and contribute to policy development.

Keywords: child development, parental attitudes, play opportunities, risky play

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5632 The Culex Pipiens Niche: Assessment with Climatic and Physiographic Variables via a Geographic Information System

Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, João Casaca

Abstract:

Using a geographic information system (GIS), the relations between a georeferenced data set of Culex pipiens sl. mosquitoes collected in Portugal mainland during seven years (2006-2012) and meteorological and physiographic parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures), daily total rainfall, altitude, land use/land cover and proximity to water bodies are evaluated. Focus is on the mosquito females; the characterization of its habitat is the key for the planning of chirurgical non-aggressive prophylactic countermeasures to avoid ambient degradation. The GIS allow for the spatial determination of the zones were the mosquito mean captures has been above average; using the meteorological values at these coordinates, the limits of each parameter are identified/computed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the thresholds obtained for each parameter. The intersection of the maps obtained for each month show the evolution of the area favorable to the species through the mosquito season, which is from May to October at these latitudes. In parallel, mean and above average captures were related to the physiographic parameters. Three levels of risk could be identified for each parameter, using above average captures as an index. The results were applied to the suitability meteorological maps of each month. The Culex pipiens critical niche is delimited, reflecting the critical areas and the level of risk for transmission of the pathogens to which they are competent vectors (West Nile virus, iridoviruses, rheoviruses and parvoviruses).

Keywords: Culex pipiens, ecological niche, risk assessment, risk management

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5631 Geosynthetic Tubes in Coastal Structures a Better Substitute for Shorter Planning Horizon: A Case Study

Authors: A. Pietro Rimoldi, B. Anilkumar Gopinath, C. Minimol Korulla

Abstract:

Coastal engineering structure is conventionally designed for a shorter planning horizon usually 20 years. These structures are subjected to different offshore climatic externalities like waves, tides, tsunamis etc. during the design life period. The probability of occurrence of these different offshore climatic externalities varies. The impact frequently caused by these externalities on the structures is of concern because it has a significant bearing on the capital /operating cost of the project. There can also be repeated short time occurrence of these externalities in the assumed planning horizon which can cause heavy damage to the conventional coastal structure which are mainly made of rock. A replacement of the damaged portion to prevent complete collapse is time consuming and expensive when dealing with hard rock structures. But if coastal structures are made of Geo-synthetic containment systems such replacement is quickly possible in the time period between two successive occurrences. In order to have a better knowledge and to enhance the predictive capacity of these occurrences, this study estimates risk of encounter within the design life period of various externalities based on the concept of exponential distribution. This gives an idea of the frequency of occurrences which in turn gives an indication of whether replacement is necessary and if so at what time interval such replacements have to be effected. To validate this theoretical finding, a pilot project has been taken up in the field so that the impact of the externalities can be studied both for a hard rock and a Geosynthetic tube structure. The paper brings out the salient feature of a case study which pertains to a project in which Geosynthetic tubes have been used for reformation of a seawall adjacent to a conventional rock structure in Alappuzha coast, Kerala, India. The effectiveness of the Geosystem in combatting the impact of the short-term externalities has been brought out.

Keywords: climatic externalities, exponential distribution, geosystems, planning horizon

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5630 The Risk of Post-stroke Pneumonia and Its One-Year Disability in Taiwan

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

Abstract:

Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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5629 Effect on Tolerability and Adverse Events in Participants Receiving Naltrexone/Bupropion and Antidepressant Medication, Including SSRIs, in a Large Randomized Double-Blind Study

Authors: Kye Gilder, Kevin Shan, Amy Halseth, Steve Smith

Abstract:

This study assessed the effect of prolonged-release naltrexone 32 mg/bupropion 360 mg (NB) on cardiovascular (CV) events in overweight/obese participants at elevated CV risk. Participants must lose ≥2% body weight at 16 wks, without a sustained increase in blood pressure, to continue drug. Only serious adverse events (SAE) and adverse events leading to discontinuation of study drug (AELDSD) were collected. The study was terminated early after second interim analysis with 50% of all CV events. Data on CV endpoints has been published. Current analyses focused on AEs in participants on antidepressants at baseline, as these individuals were excluded from Phase 3 trials. Intent-to-treat (ITT) population (placebo [PBO] N=4450, NB N=4455) was 54.5% female, 83.5% white, mean age of 61 yrs, mean BMI 37.3 kg/m2, 22.8% with a history of depression, 23.1% on antidepressants, including 15.4% on an SSRI. SAEs in participants receiving antidepressants was similar between NB (10.7%) and PBO (9.9%) and also similar to overall population (9.5% NB, 8.1% PBO). SAEs in those on SSRIs were similar, 10.1% NB and PBO 9.4%. For those on SSRIs or other antidepressants, AELDSDs were similar to overall population and were primarily GI disorders. Obesity increases the risk of developing depression. For participants taking NB and antidepressants, including SSRIs, there is a similar AE profile as the overall population and data revealed no evidence of an additional health risk with combined use.

Keywords: antidepressant, Contrave, Mysimba, obesity, pharmacotherapy

Procedia PDF Downloads 256