Search results for: mortality bond

Authors: Tesfaye Tebeka Simur, Tian-Yu Peng, Yi-Feng Wang, Xiu-Wei Wu, Feng-Lian Zhang

Abstract:

A boryl radical-promoted dehydroxylative alkylation of 3-hydroxy-oxindole derivatives is achieved. The reaction starts from addition of 4-dimethylaminopyridine (DMAP)-boryl radical to the amide carbonyl oxygen atom, which induces a spin-center shift process to promote the C−O bond cleavage. The elimination of a hydroxide anion from a free hydroxy group is also accomplished. Capture of the generated carbon radical with alkenes furnishes a variety of C-3 alkylated oxindoles. This method features a simple operation and broad substrate scope.

Keywords: boryl radical, C-O, C-F, C=C, C=N bond activation, spin center shift

Procedia PDF Downloads 102

Authors: Lukman Abiodun Nafiu

Abstract:

This study examines the impact evaluation of vaccination against eight-child-killer diseases on under-five children mortality at Mbale District. It was driven by three specific objectives which are to determine the proportion of under-five children mortality due to the eight-child-killer diseases to the total under-five children mortality; establish the cause-effect relationship between the eight-child-killer diseases and under-five children mortality; as well as establish the dependence of under-five children mortality in the location at Mbale District. A community based cross-sectional and longitudinal (panel) study design involving both quantitative and qualitative (focus group discussion and in-depth interview) approaches was employed over a period of 36 months. Multi-stage cluster design involving Health Sub-District (HSD), Forms of Ownership (FOO) and Health Facilities Centres (HFC) as the first, second and third stages respectively was used. Data was collected regarding the eight-child-killer diseases namely: measles, pneumonia, pertussis (whooping cough), diphtheria, poliomyelitis (polio), tetanus, haemophilus influenza, rotavirus gastroenteritis and mortality regarding immunized and non-immunized children aged 0-59 months. We monitored the children over a period of 24 months. The study used a sample of 384 children out of all the registered children for each year at Mbale Referral Hospital and other Primary Health Care Centres (HCIV, HCIII and HCII) at Mbale District between 2015 and 2019. These children were followed from birth to their current state (living or dead). The data collected in this study was analysed using cross tabulation and the chi-square test. The study concluded that majority of mothers at Mbale district took their children for immunization and thus reducing the occurrence of under-five children mortality. Overall, 2.3%, 4.6%, 3.1%, 5.4%, 1.5%, 3.8%, 0.0% and 0.0% of under-five children had polio, tetanus, diphtheria, measles, pertussis, pneumonia, haemophilus influenzae and rotavirus gastroenteritis respectively across all the sub counties at Mbale district during the period considered. Also, different locations (sub counties) do not have significant influence on the occurrence of these eight-child-killer diseases among the under-five children at Mbale district. Therefore, the study recommended that government and agencies should continue to work together to implement measures of vaccination programs and increasing access to basic health care with a continuous improvement on the social interventions to progress child survival.

Keywords: Diseases, Mortality, Children, Vaccination

Procedia PDF Downloads 124

Authors: Asanga Gunawansa, Shenella Fonseka

Abstract:

On-demand bonds, also known as unconditional bonds, are commonplace in the construction industry as a means of safeguarding the employer from any potential non-performance by a contractor. On-demand bonds may be obtained from commercial banks, and they serve as an undertaking by the issuing bank to honour payment on demand without questioning and/or considering any dispute between the employer and the contractor in relation to the underlying contract. Thus, whether or not a breach had occurred under the underlying contract, which triggers the demand for encashment by the employer, is not a question the bank needs to be concerned with. As a result, an unconditional bond allows the beneficiary to claim the money almost without any condition. Thus, an unconditional bond is as good as cash-in-hand. In the past, establishing fraud on the part of the employer, of which the bank had knowledge, was the only ground on which a bank could dishonour a claim made under an on-demand bond. However, recent jurisprudence in common law countries shows that courts are beginning to consider unconscionable conduct on the part of the employer in claiming under an on-demand bond as a ground that contractors could rely on the prevent the banks from honouring such claims. This has created uncertainty in connection with on-demand bonds and their liquidity. This paper analyzes recent judicial decisions in four common law jurisdictions, namely, England, Singapore, Hong Kong, and Sri Lanka, to identify the scope of using the concept of “unconscionability” as a ground for preventing unreasonable claims for encashment of on-demand bonds. The objective of this paper is to argue that on-demand bonds have lost their effectiveness as “cash-in-hand” and that this is, in fact, an advantage and not an impediment to international commerce, as the purpose of such bonds should not be to provide for illegal and unconscionable conduct by the beneficiaries.

Keywords: fraud, performance guarantees, on-demand bonds, unconscionability

Procedia PDF Downloads 105

Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

Procedia PDF Downloads 484

Authors: Saiakhil Chilaka

Abstract:

Understanding the demographic factors that influence mortality from respiratory diseases like COVID-19, pneumonia, and influenza is crucial for informing public health policy. This study utilizes multivariable regression models to assess the relationship between state, sex, and age group on deaths from these diseases using U.S. data from 2020 to 2023. The analysis reveals that age and sex play significant roles in mortality, while state-level variations are minimal. Although the model’s low R-squared values indicate that additional factors are at play, this paper discusses how these findings, in light of recent research, can inform future public health policy, resource allocation, and intervention strategies.

Keywords: COVID-19, multivariable regression, public policy, data science

Procedia PDF Downloads 21

Authors: Zhou Shangcheng, Yi Sicen

Abstract:

Objective: To understand the mortality patterns of Zhangwan District in 2010 and provide the basis for the development of scientific and rational health policy. Methods: Data are collected from the Sixth Census of Zhangwan District and disease surveillance system. The statistical analysis include death difference between age, gender, region and time and the related factors. Methods developed for the Global Burden of Disease (GBD) Study by the World Bank and World Health Organization (WHO) were adapted and applied to Zhangwan District population health data. DALY rate per 1,000 was calculated for varied causes of death. SPSS 16 is used by statistic analysis. Results: From the data of death population of Zhangwan District we know the crude mortality rate was 6.03 ‰. There are significant differences of mortality rate in male and female population which was respectively 7.37 ‰ and 4.68 ‰. 0 age group population life expectancy in Zhangwan District in 2010 was 78.40 years old(Male 75.93, Female 81.03). The five leading causes of YLL in descending order were: cardiovascular diseases(42.63DALY/1000), malignant neoplasm (23.73DALY/1000), unintentional injuries (5.84DALY/1000), Respiratory diseases(5.43 DALY/1000), Respiratory infections (2.44DALY/1000). In addition, there are strong relation between the marital status , educational level and mortality in some to a certain extend. Conclusion Zhangwan District, as city level, is at lower mortality levels. The mortality of the total population of Zhangwan District has a downward trend and life expectancy is rising.

Keywords: sixth census, Zhangwan district, death level differences, influencing factors, cause of death

Procedia PDF Downloads 270

Authors: Chinelo Igwenagu

Abstract:

Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

Procedia PDF Downloads 422

Authors: Fernandes A. C. B. C. J., de Jesus V. C., Sepideh N., Vilela OFGG, Somarin K. K., França R., Pinheiro F. H. S. L.

Abstract:

Objective: The purpose of this study was to look at the effect of pre-treatment of enamel with pumice and/or 37% phosphoric acid on the shear bond strength (SBS) of orthodontic tubes bonded to enamel while simultaneously evaluating the efficacy of orthodontic tubes bonded by self-etch primer (SEP). Materials and Methods: 39 of the crown halves were divided into 3 groups at random. Group, I was the control group utilizing both prophy paste and the conventional double etching pre-treatment method. Group II excluded the use of prophy paste prior to double etching. Group III excluded the use of both prophy paste and double etching and only utilized SEP. Bond strength of the orthodontic tubes was measured by SBS. One way ANOVA and Tukey’s HSD test were used to compare SBS values between the three groups. The statistical significance was set to p<0.05. Results: The difference in SBS values of groups I (36.672 ± 9.315 Mpa), II (34.242 ± 9.986 Mpa), and III (39.055 ± 5.565) were not statistically significant (P<0.05). Conclusion: This study suggested that the use of prophy paste or pre-acid etch of the enamel surface did not provide a statistically significant difference in SBS between the three groups.

Keywords: shear bond strength, orthodontic bracket, self-etch primer, pumice, prophy

Procedia PDF Downloads 178

Authors: Noureddine Adjlane, Nizar Haddad

Abstract:

Deformed Wing Virus (DWV) is considered as the most prevalent virus that dangerous the honeybee health worldwide today. In this study we aimed to evaluate the impact of the virus on honeybees (Apis mellifera intermissa) mortality in Algeria and we conducted the study on samples collected from the central area in the country. We used PCR for the diagnoses of the (DWV) in the diagnosis. The results had shown a high infestation in the sampled colonies and it represented 42% of the total sample. In this study, we found a clear role of both Varroa destructor mite and DWV on hive mortality in the experimented apiary. Further studies need to be conducted in order to give soled recommendations to the beekeepers, decision makers and stockholders of the Algerian beekeeping sector.

Keywords: honey bee, DWV, Varroa destructor, mortality, prevalence, infestation

Procedia PDF Downloads 455

Authors: Al Romano, Jeryl C. Hije, Mechaela Marie O. Tabiolo

Abstract:

The decline in water quality is a major factor in aquatic disease outbreaks and can lead to significant mortality among aquatic organisms. Understanding the relationship between dissolved oxygen (DO) and water temperature is crucial, as these variables directly impact the health, behavior, and survival of fish populations. This study investigated how DO levels, water temperature, and atmospheric temperature interact in Sampaloc Lake to assess the risk of fish mortality. By employing a combination of linear regression models and machine learning techniques, researchers developed predictive models to forecast DO concentrations at various depths. The results indicate that while DO levels generally decrease with depth, the predicted concentrations are sufficient to support the survival of common fish species in Sampaloc Lake during March, April, and May 2025.

Keywords: aquaculture, dissolved oxygen, water temperature, regression analysis, machine learning, fish mass mortality, early warning system

Procedia PDF Downloads 35

Authors: K. A. Adeleke

Abstract:

Often in epidemiological research, introducing stratified Cox model can account for the existence of interactions of some inherent factors with some major/noticeable factors. This research work aimed at modelling correlated variables in infant mortality with the existence of some inherent factors affecting the infant survival function. An alternative semiparametric Stratified Cox model is proposed with a view to take care of multilevel factors that have interactions with others. This, however, was used as a tool to model infant mortality data from Nigeria Demographic and Health Survey (NDHS) with some multilevel factors (Tetanus, Polio, and Breastfeeding) having correlation with main factors (Sex, Size, and Mode of Delivery). Asymptotic properties of the estimators are also studied via simulation. The tested model via data showed good fit and performed differently depending on the levels of the interaction of the strata variable Z*. An evidence that the baseline hazard functions and regression coefficients are not the same from stratum to stratum provides a gain in information as against the usage of Cox model. Simulation result showed that the present method produced better estimates in terms of bias, lower standard errors, and or mean square errors.

Keywords: stratified Cox, semiparametric model, infant mortality, multilevel factors, cofounding variables

Procedia PDF Downloads 557

Authors: Ashirgul Kozhagulova, Ainash Shabdirova, Galym Tokazhanov, Minh Nguyen

Abstract:

The synthetic rocks have been advantageous over the natural rocks in terms of availability and the consistent studying the impact of a particular parameter. The artificial rocks can be fabricated using variety of techniques such as mixing sand and Portland cement or gypsum, firing the mixture of sand and fine powder of borosilicate glass or by in-situ precipitation of calcite solution. In this study, sodium silicate solution has been used as the cementing agent for the quartz sand. The molded soft cylindrical sandstone samples are placed in the gas-tight pressure vessel, where the hardening of the material takes place as the chemical reaction between carbon dioxide and the silicate solution progresses. The vessel allows uniform disperse of carbon dioxide and control over the ambient gas pressure. Current paper shows how the bonding material is initially distributed in the intergranular space and the surface of the sand particles by the usage of Electron Microscopy and the Energy Dispersive Spectroscopy. During the study, the strength of the cement bond as a function of temperature is observed. The impact of cementing agent dosage on the micro and macro characteristics of the sandstone is investigated. The analysis of the cement bond at micro level helps to trace the changes to particles bonding damage after a potential yielding. Shearing behavior and compressional response have been examined resulting in the estimation of the shearing resistance and cohesion force of the sandstone. These are considered to be main input values to the mathematical prediction models of sand production from weak clastic oil reservoir formations.

Keywords: artificial sanstone, cement bond, microstructure, SEM, triaxial shearing

Procedia PDF Downloads 167

Authors: Shuwen Wu, Zhi LI

Abstract:

Atomically dispersed Fe‒N₄ catalysts are proven as promising alternatives to commercial Pt/C for the oxygen reduction reaction. Most reported Fe‒N₄ catalysts suffer from inferior O‒O bond-breaking capability due to superoxo-like O₂ adsorption, though the isolated dual-atomic metal sites strategy is extensively adopted. Atomic Fe clusters hold greater promise for promoting O‒O bond cleavage by forming peroxo-like O₂ adsorption. However, the excessively strong binding strength between Fe clusters and oxygenated intermediates sacrifices the activity. Here, we first report a Fex/Cu‒N@CF catalyst with atomic Fe clusters functionalized by adjacent single Cu‒N₄ sites anchoring on a porous carbon nanofiber membrane. The theoretical calculation indicates that the single Cu‒N₄ sites can modulate the electronic configuration of Fe clusters to reduce O₂* protonation reaction free energy, which ultimately enhances the electrocatalytic performance. Particularly, the Cu‒N₄ sites can increase the overlaps between the d orbitals of Fe and p orbitals of O to accelerate O‒O cleavage in OOH*. As a result, this unique atomic catalyst exhibits a half potential (E1/2) of 0.944 V in an alkaline medium exceeding that of commercial Pt/C, whereas acidic performance E1/2 = 0.815 V is comparable to Pt/C. This work shows the great potential of single atoms for improvements in atomic cluster catalysts.

Keywords: Hierarchical porous fibers, atomic Fe clusters, Cu single atoms, oxygen reduction reaction; O-O bond cleavage

Procedia PDF Downloads 116

Authors: M. Budakoglu, M. Karaman, D. Kiran, Z. Doner, B. Zeytuncu, B. Tanç, M. Kumral

Abstract:

Lake Acıgöl is one of the large saline lacustrine environment in Turkey. Eleven trace metals (Cr, Mn, Fe, Al, Co, Ni, Cu, Zn, Cd, Pb and As) in 9 surface and subsurface sediment samples from the Lake Acıgöl were analyzed with the bulk and sequential extraction analysis methods by ICP-MS to obtain the metal distribution patterns in this extreme environment. Five stepped sequential extraction technique (1- exchangeable, 2- bond to carbonates, 3- bond to iron and manganese oxides/hydroxides, 4- bond to organic matter and sulphides, and 5- residual fraction incorporated into clay and silicate mineral lattices) was used to characterize the various forms of metals in the <63μ size sediments. The metal contents (ppm) and their percentages for each extraction step were reported and compared with the results obtained from the total digestion. Results indicate that sum of the four fraction are in good agreement with the total digestion results of Ni, Cd, As, Zn, Cu and Fe with the satisfactory recoveries (94.04–109.0%) and the method used is reliable and repeatable for these elements. It was found that there were high correlations between Fe vs. Ni loads in the fraction of F2 and F4 with R2= 0,91 and 0,81, respectively. Comparison of totally 135 chemical analysis results in three sampling location and for 5 fraction between Fe-Co, Co-Ni and Fe-Ni element couples were presented elevated correlations with R2=0,98, 0,92 and 0,91, respectively.

Keywords: Lake Acigol, sequancial extraction, recent lake sediment, geochemical speciation of heavy metals

Procedia PDF Downloads 412

Authors: R. Manjula, Kaustav Bagchi, Sushant Ramesh, Anush Baskaran

Abstract:

In the past century, the emergence of information technology has had a significant positive impact on human life. While companies tend to be more involved in the completion of projects, the turn of the century has seen importance being given to investment in information security policies. These policies are essential to protect important data from adversaries, and thus following these policies has become one of the most important attributes revolving around information security models. In this research, we have focussed on the factors affecting information security policy compliance in two models : The theory of planned behaviour and the integration of the social bond theory and the involvement theory into a single model. Finally, we have given a proposal of where these theories would be successful.

Keywords: information technology, information security, involvement theory, policies, social bond theory

Procedia PDF Downloads 370

Authors: Ulli Heinlein, Thomas Freimann

Abstract:

Pre-applied bonded membranes are used as positive-side waterproofing on concrete basements, are installed before the concrete work, and achieve a tear-resistant and waterproof bond with the subsequently placed fresh concrete. This bond increases redundancy compared to lose waterproofing membranes by preventing lateral water migrations in the event of damage. So far, the membranes have been tested in the laboratory, but it is not yet known how they behave on construction sites in the presence of dirt, soil, cement paste or moisture. This article, therefore, conducts investigations on six construction sites using 18 test slabs where the pre-applied bonded membranes are selectively contaminated or wetted. Subsequently, cores are taken, and the influence of the contaminations on the adhesive tensile strength and waterproof bond is tested. Pre-applied bonded membranes with smooth or granular but closed surfaces show no sensitivity to wetness, whereas open-pored membranes with nonwovens do not tolerate standing water. Contaminations decline the performance of all pre-applied bonded membranes since a separating layer is formed between the bonding layer and the concrete. The influence depends on the thickness of the contamination and its mechanical properties.

Keywords: waterproofing, positive-side waterproofing, basement, pre-applied bonded waterproofing membrane, In-situ testing, lateral water migrations

Procedia PDF Downloads 186

Authors: Christos Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Konstantina Panouria, Tamta Sirbilatze, Ifigenia Apostolou, Vaggelis Lambas, Christina Kordali, Georgios Mavras

Abstract:

Objectives: Malnutrition in hospitalized patients is related to increased morbidity and mortality. The purpose of our study was to compare various nutritional scores in order to detect the most suitable one for assessing the nutritional status of elderly, hospitalized patients and correlate them with mortality and extension of admission duration, due to patients’ critical condition. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). Sensitivity, specificity, positive and negative predictive values and ROC curves were assessed after adjustment for the cause of current admission, a known prognostic factor according to previously applied multivariate models. Primary endpoints were mortality (from admission until 6 months afterwards) and duration of hospitalization, compared to national guidelines for closed consolidated medical expenses. Results: Concerning mortality, MNA (short-form and full) and SNAQ had similar, low sensitivity (25.8%, 25.8% and 35.5% respectively) while MUST had higher sensitivity (48.4%). In contrast, all the questionnaires had high specificity (94%-97.5%). Short-form MNA and sNAQ had the best positive predictive value (72.7% and 78.6% respectively) whereas all the questionnaires had similar negative predictive value (83.2%-87.5%). MUST had the highest ROC curve (0.83) in contrast to the rest questionnaires (0.73-0.77). With regard to extension of admission duration, all four scores had relatively low sensitivity (48.7%-56.7%), specificity (68.4%-77.6%), positive predictive value (63.1%-69.6%), negative predictive value (61%-63%) and ROC curve (0.67-0.69). Conclusion: MUST questionnaire is more advantageous in predicting mortality due to its higher sensitivity and ROC curve. None of the nutritional scores is suitable for prediction of extended hospitalization.

Keywords: duration of admission, malnutrition, nutritional assessment scores, prognostic factors for mortality

Procedia PDF Downloads 346

Authors: Mandeep Kaur, Jitendra K. Bera

Abstract:

The search for atom-economical and green synthetic methods for the synthesis of functionalized molecules has attracted much attention. Metal ligand cooperation (MLC) plays a pivotal role in organometallic catalysis to activate C−H, H−H, O−H, N−H and B−H bonds through reversible bond breaking and bond making process. Towards this goal, a bifunctional N─heterocyclic carbene (NHC) based pyridyl-functionalized amide ligand precursor, and corresponding dearomatized iridium complex was synthesized. The NMR and UV/Vis acid titration study have been done to prove the proton response nature of the iridium complex. Further, the dearomatized iridium complex explored as a catalyst on the platform of MLC via dearomatzation/aromatization mode of action towards atom economical α and β─alkylation of ketones and secondary alcohols by using primary alcohols through hydrogen borrowing methodology. The key features of the catalysis are high turnover frequency (TOF) values, low catalyst loading, low base loading and no waste product. The greener syntheses of quinoline, lactone derivatives and selective alkylation of drug molecules like pregnenolone and testosterone were also achieved successfully. Another structurally similar iridium complex was also synthesized with modified ligand precursor where a pendant amide unit was absent. The inactivity of this analogue iridium complex towards catalysis authenticated the participation of proton responsive imido sidearm of the ligand to accelerate the catalytic reaction. The mechanistic investigation through control experiments, NMR and deuterated labeling study, authenticate the borrowing hydrogen strategy.

Keywords: C-C bond formation, hydrogen borrowing, metal ligand cooperation (MLC), n-heterocyclic carbene

Procedia PDF Downloads 180

Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

Abstract:

Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

Procedia PDF Downloads 307

Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

Abstract:

Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

Procedia PDF Downloads 184

Authors: Asiye Aydilek, Harun Aydilek

Abstract:

We investigate the costs of various suboptimal allocations in housing, consumption, bond and stock holdings of a retiree in a setting with recursive utility, considering the extensive empirical evidence that investors make suboptimal decisions in different ways. We find that suboptimal stock holdings impose only modest costs on the retiree. This may have a merit in explaining the limited stock investment in the data. The cost of suboptimal bond holdings is higher than that of stocks, but still small. This may partially explain why many more people hold bonds compared to stocks. We find that positive deviations from the optimal level are less costly relative to the negative ones in suboptimal housing allocations. This may help us to clarify why the elderly are over consuming housing, as seen in the housing data. The cost of suboptimal consumption is quite high and the highest of all. Our paper suggests that, in terms of welfare, the decisions of how much of liquid wealth to use for consumption and for saving are more important than the decision about the composition of liquid savings. Suboptimal stock holdings are twice more costly in power utility and suboptimal bond holdings are twenty times more costly in recursive utility. Recursive utility is superior to power utility in terms of rationalizing many people's preference for bonds instead of stocks in investment.

Keywords: housing, recursive utility, retirement, suboptimal decisions, welfare cost

Procedia PDF Downloads 317

Authors: Ashenafi Beyene Fanta, Daniel Makina

Abstract:

Economic theory predicts that finance promotes economic growth. Although the finance-growth link is among the most researched areas in financial economics, our understanding of the link between the two is still incomplete. This is caused by, among others, wrong econometric specifications, using weak proxies of financial development, and inability to address the endogeneity problem. Studies on the finance growth link in South Africa consistently report economic growth driving financial development. Early studies found that economic growth drives financial development in South Africa, and recent studies have confirmed this using different econometric models. However, the monetary aggregate (i.e. M2) utilized used in these studies is considered a weak proxy for financial development. Furthermore, the fact that the models employed do not address the endogeneity problem in the finance-growth link casts doubt on the validity of the conclusions. For this reason, the current study examines the finance growth link in South Africa using data for the period 1990 to 2011 by employing a generalized method of moments (GMM) technique that is capable of addressing endogeneity, simultaneity and omitted variable bias problems. Unlike previous cross country and country case studies that have also used the same technique, our contribution is that we account for the development of bond markets and non-bank financial institutions rather than being limited to stock market and banking sector development. We find that bond market development affects economic growth in South Africa, and no similar effect is observed for the bank and non-bank financial intermediaries and the stock market. Our findings show that examination of individual elements of the financial system is important in understanding the unique effect of each on growth. The observation that bond markets rather than private credit and stock market development promotes economic growth in South Africa induces an intriguing question as to what unique roles bond markets play that the intermediaries and equity markets are unable to play. Crucially, our results support observations in the literature that using appropriate measures of financial development is critical for policy advice. They also support the suggestion that individual elements of the financial system need to be studied separately to consider their unique roles in advancing economic growth. We believe that our understanding of the channels through which bond market contribute to growth would be a fertile ground for future research.

Keywords: bond market, finance, financial sector, growth

Procedia PDF Downloads 422

Authors: Despina Giannadaki, Jos Lelieveld, Andrea Pozzer, John Evans

Abstract:

Outdoor air pollution by fine particles ranks among the top ten global health risk factors that can lead to premature mortality. Epidemiological cohort studies, mainly conducted in United States and Europe, have shown that the long-term exposure to PM2.5 (particles with an aerodynamic diameter less than 2.5μm) is associated with increased mortality from cardiovascular, respiratory diseases and lung cancer. Fine particulates can cause health impacts even at very low concentrations. Previously, no concentration level has been defined below which health damage can be fully prevented. The World Health Organization ambient air quality guidelines suggest an annual mean PM2.5 concentration limit of 10μg/m3. Populations in large parts of the world, especially in East and Southeast Asia, and in the Middle East, are exposed to high levels of fine particulate pollution that by far exceeds the World Health Organization guidelines. The aim of this work is to evaluate the implementation of recent air quality standards for PM2.5 in the EU, the US and other countries worldwide and estimate what measures will be needed to substantially reduce premature mortality. We investigated premature mortality attributed to fine particulate matter (PM2.5) under adults ≥ 30yrs and children < 5yrs, applying a high-resolution global atmospheric chemistry model combined with epidemiological concentration-response functions. The latter are based on the methodology of the Global Burden of Disease for 2010, assuming a ‘safe’ annual mean PM2.5 threshold of 7.3μg/m3. We estimate the global premature mortality by PM2.5 at 3.15 million/year in 2010. China is the leading country with about 1.33 million, followed by India with 575 thousand and Pakistan with 105 thousand. For the European Union (EU) we estimate 173 thousand and the United States (US) 52 thousand in 2010. Based on sensitivity calculations we tested the gains from PM2.5 control by applying the air quality guidelines (AQG) and standards of the World Health Organization (WHO), the EU, the US and other countries. To estimate potential reductions in mortality rates we take into consideration the deaths that cannot be avoided after the implementation of PM2.5 upper limits, due to the contribution of natural sources to total PM2.5 and therefore to mortality (mainly airborne desert dust). The annual mean EU limit of 25μg/m3 would reduce global premature mortality by 18%, while within the EU the effect is negligible, indicating that the standard is largely met and that stricter limits are needed. The new US standard of 12μg/m3 would reduce premature mortality by 46% worldwide, 4% in the US and 20% in the EU. Implementing the AQG by the WHO of 10μg/m3 would reduce global premature mortality by 54%, 76% in China and 59% in India. In the EU and US, the mortality would be reduced by 36% and 14%, respectively. Hence, following the WHO guideline will prevent 1.7 million premature deaths per year. Sensitivity calculations indicate that even small changes at the lower PM2.5 standards can have major impacts on global mortality rates.

Keywords: air quality guidelines, outdoor air pollution, particulate matter, premature mortality

Procedia PDF Downloads 310

Authors: Rawan Masarwa, Merav Ben Natan, Yaron Berkovich

Abstract:

Background: Hip fracture repair surgery carries a certain mortality risk, yet evidence suggests that orthopedic surgeons often refrain from discussing this issue with patients prior to surgery. Aim: This study aims to examine whether orthopedic surgeons address the issue of one-year post-surgery mortality before hip fracture repair surgery and to explore the factors influencing this decision. Method: The study uses a cross-sectional design, administering validated digital questionnaires to 150 orthopedic surgeons. Results: A minority of orthopedic surgeons reported consistently informing patients about the risk of mortality in the year following hip fracture surgery. The primary reasons for not discussing this risk were a desire to avoid frightening patients, time constraints, and concerns about undermining patient hope. Surgeons reported a medium-high level of perceived self-efficacy, with higher self-efficacy linked to a reduced likelihood of discussing one-year mortality risk. In contrast, older age and holding a specialist status in orthopedic surgery were associated with a higher likelihood of discussing this risk with patients. Conclusions: The findings suggest a need for interventions to address communication barriers and ensure consistent provision of essential information to patients undergoing hip fracture surgery. Additionally, they emphasize the importance of considering individual factors such as self-efficacy, age, and expertise in developing strategies to enhance patient-provider communication in orthopedic care settings.

Keywords: orthopedic surgeons, hip fracture surgery, mortality risk communication, patient information

Procedia PDF Downloads 25

Authors: Antonio B.Tangayan Jr., Hershey P. Mondejar, Pet Roey Pascual, Zeam Voltaire E. Amper

Abstract:

A study on in vitro larvicidal acitivity of different levels of Madre de Cacao (Gliricidia sepium) concentrated crude ethanolic extract (CCEE) against horn fly larvae (Haematobia irritans) was conducted. The air-dried leaves of Gliricidia sepium were infused in a 1:3 ratio (w/v) using ethanol as solvent and concentrated in a rotary evaporator (60°C). A total of 120 larvae of Haematobia irritans were exposed in various concentration: 200, 400, 800 and 1000 ppm. Based on the result after 5 hours of exposure, CCE G. sepium extract at 200 ppm showed less effect with 30% mortality compared to 400 ppm, 800 ppm and 1000 ppm with 70%, 83%, and 100% mortality, respectively. Findings also revealed that CCE of G. sepium extract at 1000 ppm, 800 ppm, and commercial larvicide were comparable in causing mortality of H. irritans larvae from the first hour up to the fifth hours of exposure. However, on the fifth hour, 400 ppm was also found to be effective. This suggests that the higher the concentration of CCE G. sepium extract and the longer the time of exposure, the higher is the percentage mortality of the larvae. Thus, CCE G. sepium extract can be used as an alternative for commercial larvicide.

Keywords: horn fly, in vitro, larvicidal, Madre de Cacao

Procedia PDF Downloads 284

Authors: H. Idouhar-Saadi, A. Smaï, S. Zenia, F. Haddadj, M. Aissi, S. Doumandji

Abstract:

During the period of reproduction, the collection of eggs of the Barbary gambra partridge is made only once a week in the morning, considering the sensibility in the stress of this native species. The number of considered samples is 33 eggs. The duration of the incubation is of 18 days. Unhatched eggs and eggs eliminated previously at the time of the mirage are collected and forwarded to the laboratories of microbiology and parasitology. The average weight of the eggs of the Barbary Partridge vary much [20.08 ± 1.81 g. (2006) < Pm < 20.82 ± 2,11g. (2008)]. The percentage of unhatched eggs varies between 9.3% in 2005 and 15.55% in 2007. It appears that the rate of embryonic mortality is slightly higher compared to that of infertile eggs. Microbiological analysis of unhatched eggs showed the presence of pathogenic germs such as lute Chryseomonas luteola. Chryseomonas ola and Escherichia coli. As against the parasites research is negative.

Keywords: barbary partridge, unhatched eggs, embryo mortality, pathogenic germs

Procedia PDF Downloads 535

Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

Abstract:

The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

Procedia PDF Downloads 76

Authors: Mohammad A. Alolayan, John S. Evans, James K. Hammitt

Abstract:

The value of statistical life has been estimated for a middle eastern country with high economical subsidization system. In this study, in-person interviews were conducted on a stratified random sample to estimate the value of mortality risk. Double-bounded dichotomous choice questions followed by open-ended question were used in the interview to investigate the willingness to pay of the respondent for mortality risk reduction. High willingness to pay was found to be associated with high income and education. Also, females were found to have lower willingness to pay than males. The estimated value of statistical life is larger than the ones estimated for western countries where taxation system exists. This estimate provides a baseline for monetizing the health benefits for proposed policy or program to the decision makers in an eastern country. Also, the value of statistical life for a country in the region can be extrapolated from this this estimate by using the benefit transfer method.

Keywords: mortality, risk, VSL, willingness-to-pay

Procedia PDF Downloads 315

Authors: Yin-Yann Chen, Tzu-Ling Chen

Abstract:

This study presents the case of an actual Taiwanese semiconductor assembly and testing manufacturer. Three major bottleneck manufacturing processes, namely, die bond, wire bond, and molding, are analyzed to determine how to use finite resources to achieve the optimal capacity allocation. A medium-term capacity allocation planning model is developed by considering the optimal total profit to satisfy the promised volume demanded by customers and to obtain the best migration decision among production lines for machines and tools. Finally, sensitivity analysis based on the actual case is provided to explore the effect of various parameter levels.

Keywords: capacity planning, capacity allocation, machine migration, resource configuration

Procedia PDF Downloads 461

Authors: Sumit Kumar, Sunil Kumar, Chandan Deep Singh

Abstract:

This paper presents modeling and simulation of flexible robot in an underwater environment. The underwater environment completely contrasts with ground or space environment. The robot in an underwater situation is subjected to various dynamic forces like buoyancy forces, hydrostatic and hydrodynamic forces. The underwater robot is modeled as Rayleigh beam. The developed model further allows estimating the deflection of tip in two directions. The complete dynamics of the underwater robot is analyzed, which is the main focus of this investigation. The control of robot trajectory is not discussed in this paper. Simulation is performed using Symbol Shakti software.

Keywords: bond graph modeling, dynamics. modeling, rayleigh beam, underwater robot

Procedia PDF Downloads 587