Search results for: the risk index
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8988

Search results for: the risk index

7458 Semantic Indexing Improvement for Textual Documents: Contribution of Classification by Fuzzy Association Rules

Authors: Mohsen Maraoui

Abstract:

In the aim of natural language processing applications improvement, such as information retrieval, machine translation, lexical disambiguation, we focus on statistical approach to semantic indexing for multilingual text documents based on conceptual network formalism. We propose to use this formalism as an indexing language to represent the descriptive concepts and their weighting. These concepts represent the content of the document. Our contribution is based on two steps. In the first step, we propose the extraction of index terms using the multilingual lexical resource Euro WordNet (EWN). In the second step, we pass from the representation of index terms to the representation of index concepts through conceptual network formalism. This network is generated using the EWN resource and pass by a classification step based on association rules model (in attempt to discover the non-taxonomic relations or contextual relations between the concepts of a document). These relations are latent relations buried in the text and carried by the semantic context of the co-occurrence of concepts in the document. Our proposed indexing approach can be applied to text documents in various languages because it is based on a linguistic method adapted to the language through a multilingual thesaurus. Next, we apply the same statistical process regardless of the language in order to extract the significant concepts and their associated weights. We prove that the proposed indexing approach provides encouraging results.

Keywords: concept extraction, conceptual network formalism, fuzzy association rules, multilingual thesaurus, semantic indexing

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7457 Identification of Architectural Design Error Risk Factors in Construction Projects Using IDEF0 Technique

Authors: Sahar Tabarroki, Ahad Nazari

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The design process is one of the most key project processes in the construction industry. Although architects have the responsibility to produce complete, accurate, and coordinated documents, architectural design is accompanied by many errors. A design error occurs when the constraints and requirements of the design are not satisfied. Errors are potentially costly and time-consuming to correct if not caught early during the design phase, and they become expensive in either construction documents or in the construction phase. The aim of this research is to identify the risk factors of architectural design errors, so identification of risks is necessary. First, a literature review in the design process was conducted and then a questionnaire was designed to identify the risks and risk factors. The questions in the form of the questionnaire were based on the “similar service description of study and supervision of architectural works” published by “Vice Presidency of Strategic Planning & Supervision of I.R. Iran” as the base of architects’ tasks. Second, the top 10 risks of architectural activities were identified. To determine the positions of possible causes of risks with respect to architectural activities, these activities were located in a design process modeled by the IDEF0 technique. The research was carried out by choosing a case study, checking the design drawings, interviewing its architect and client, and providing a checklist in order to identify the concrete examples of architectural design errors. The results revealed that activities such as “defining the current and future requirements of the project”, “studies and space planning,” and “time and cost estimation of suggested solution” has a higher error risk than others. Moreover, the most important causes include “unclear goals of a client”, “time force by a client”, and “lack of knowledge of architects about the requirements of end-users”. For error detecting in the case study, lack of criteria, standards and design criteria, and lack of coordination among them, was a barrier, anyway, “lack of coordination between architectural design and electrical and mechanical facility”, “violation of the standard dimensions and sizes in space designing”, “design omissions” were identified as the most important design errors.

Keywords: architectural design, design error, risk management, risk factor

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7456 Analysis of the Aquifer Vulnerability of a Miopliocene Arid Area Using Drastic and SI Models

Authors: H. Majour, L. Djabri

Abstract:

Many methods in the groundwater vulnerability have been developed in the world (methods like PRAST, DRIST, APRON/ARAA, PRASTCHIM, GOD). In this study, our choice dealt with two recent complementary methods using category mapping of index with weighting criteria (Point County Systems Model MSCP) namely the standard DRASTIC method and SI (Susceptibility Index). At present, these two methods are the most used for the mapping of the intrinsic vulnerability of groundwater. Two classes of groundwater vulnerability in the Biskra sandy aquifer were identified by the DRASTIC method (average and high) and the SI method (very high and high). Integrated analysis has revealed that the high class is predominant for the DRASTIC method whereas for that of SI the preponderance is for the very high class. Furthermore, we notice that the method SI estimates better the vulnerability for the pollution in nitrates, with a rate of 85 % between the concentrations in nitrates of groundwater and the various established classes of vulnerability, against 75 % for the DRASTIC method. By including the land use parameter, the SI method produced more realistic results.

Keywords: DRASTIC, SI, GIS, Biskra sandy aquifer, Algeria

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7455 Strategies to Promote Safety and Reduce the Vulnerability of Urban Worn-out Textures to the Potential Risk of Earthquake

Authors: Bahareh Montakhabi

Abstract:

Earthquake is known as one of the deadliest natural disasters, with a high potential for damage to life and property. Some of Iran's cities were completely destroyed after major earthquakes, and the people of the region suffered a lot of mental, financial and psychological damage. Tehran is one of the cities located on the fault line. According to experts, the only city that could be severely damaged by a moderate earthquake in Earthquake Engineering Intensity Scale (EEIS) (70% destruction) is Tehran because Tehran is built precisely on the fault. Seismic risk assessment (SRA) of cities in the scale of urban areas and neighborhoods is the first phase of the earthquake crisis management process, which can provide the information required to make optimal use of available resources and facilities in order to reduce the destructive effects and consequences of an earthquake. This study has investigated strategies to promote safety and reduce the vulnerability of worn-out urban textures in the District 12 of Tehran to the potential risk of earthquake aimed at prioritizing the factors affecting the vulnerability of worn-out urban textures to earthquake crises and how to reduce them, using the analytical-exploratory method, analytical hierarchy process (AHP), Expert choice and SWOT technique. The results of SWAT and AHP analysis of the vulnerability of the worn-out textures of District 12 to internal threats (1.70) and external threats (2.40) indicate weak safety of the textures of District 12 regarding internal and external factors and a high possibility of damage.

Keywords: risk management, vulnerability, worn-out textures, earthquake

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7454 Ecological Investigations for the Control of Aedes aegypti (Diptera: Culicidae) in the Selected Study Districts of Punjab, Pakistan

Authors: Muhammad Sohail Sajid, Muhammad Abdullah Malik, Muhammad Saqib, Faiz Ahmad Raza, Waseem Akram

Abstract:

Aedes (Ae.) aegypti, the vector of pathogens of one health significance, has gained currency over the last decade. The present study reports the prevalence of A. aegypti larvae in indoor and outdoor niches from the three districts of different agro-geo-climatic zones of Punjab, including Chakwal (north), Faisalabad (central), and Dera Ghazi Khan (south). Mosquito larvae were collected, preserved, and transferred for identification. The relevant data were collected on a predesigned questionnaire. Stegomyia indices, including House Index (HI), Breteau Index (BI), and Container Index (CI), were calculated. The association of different breeding containers with the prevalence of Ae. aegypti larvae were estimated through Chi-square analysis. The highest Stegomyia indices were calculated in Chakwal (HI = 46.61%, BI = 91.67%, and CI = 15.28%) as compared to Faisalabad (HI = 34.11%, BI = 68.75% and, CI = 13.04%) and DG Khan (HI = 28.39%, BI = 68.23% and, CI = 11.29%), respectively. Irrespective of the geographical area, earthen jars, water tanks, and tree holes were found to be significantly associated (p < 0.05) with the abundance of Ae. aegypti larvae. However, tires and plastic bottles in Faisalabad and DG Khan while flower tubs and plastic buckets in Faisalabad and Chakwal were found to be significantly associated (p < 0.05) with the larval abundance. The results are a maiden attempt to correlate the magnitude of Ae. aegypti larvae in various microclimatic niches of Punjab, Pakistan, which might help in policy-making for preventive management of the menace.

Keywords: Aedes aegypti, ecology, breeding habitats, Stegomyia indices, breeding containers

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7453 Performance Assessment of Islamic Banks in the Light of Maqasid Al-Shariah

Authors: Asma Ammar

Abstract:

Being different in theory and practice from their conventional counterparts, this research aims to assess the performance of Islamic banks beyond the financial performance by emphasizing their ethical and social identity based on the higher purposes of Islamic law, namely Maqasid al-Shariah. Using Imam al-Ghazali’s theory of Maqasid al-Shariah and Sekaran’s (2000) method, we develop a Maqasid-based index including the five objectives of Shariah (preservation of life, religion, intellect, posterity, and wealth). Our sample covers 9 Islamic banks considered among the largest Islamic banks in the world. For the five years of study (2017-2021), our results reveal that the highest score is performed by Bank Muamalat while the least score is given to Dubai Islamic Bank. The overall Maqasid performance of the sample is unimpressive, indicating that there is a lack of achievement in Maqasid al-Shariah performance of Islamic banks. Consequently, serious measures should be taken by Islamic banks to improve their Maqasid performance and thus contribute effectively to the socio-economic development of the countries in which they operate.

Keywords: Maqasid al-Shariah, Maqasid al-Shariah index, Islamic banks, performance assessment

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7452 The Aromaticity of P-Substituted O-(N-Dialkyl)Aminomethylphenols

Authors: Khodzhaberdi Allaberdiev

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Aromaticity, one of the most important concepts in organic chemistry, has attracted considerable interest from both experimentalists and theoreticians. The geometry optimization of p-substituted o-(N-dialkyl)aminomethylphenols, o-DEAMPH XC₆ H₅CH ₂Y (X=p-OCH₃, CH₃, H, F, Cl, Br, COCH₃, COOCH₃, CHO, CN and NO₂, Y=o-N (C₂H₅)₂, o-DEAMPHs have been performed in the gas phase using the B3LYP/6-311+G(d,p) level. Aromaticities of the considered molecules were investigated using different indices included geometrical (HOMA and Bird), electronic (FLU, PDI and SA) magnetic (NICS(0), NICS(1) and NICS(1)zz indices. The linear dependencies were obtained between some aromaticity indices. The best correlation is observed between the Bird and PDI indices (R² =0.9240). However, not all types of indices or even different indices within the same type correlate well among each other. Surprisingly, for studied molecules in which geometrical and electronic cannot correctly give the aromaticity of ring, the magnetism based index successfully predicts the aromaticity of systems. 1H NMR spectra of compounds were obtained at B3LYP/6–311+G(d,p) level using the GIAO method. Excellent linear correlation (R²= 0.9996) between values the chemical shift of hydrogen atom obtained experimentally of 1H NMR and calculated using B3LYP/6–311+G(d,p) demonstrates a good assignment of the experimental values chemical shift to the calculated structures of o-DEAMPH. It is found that the best linear correlation with the Hammett substituent constants is observed for the NICS(1)zz index in comparison with the other indices: NICS(1)zz =-21.5552+1,1070 σp- (R²=0.9394). The presence intramolecular hydrogen bond in the studied molecules also revealed changes the aromatic character of substituted o-DEAMPHs. The HOMA index predicted for R=NO2 the reduction in the π-electron delocalization of 3.4% was about double that observed for p-nitrophenol. The influence intramolecular H-bonding on aromaticity of benzene ring in the ground state (S0) are described by equations between NICS(1)zz and H-bond energies: experimental, Eₑₓₚ, predicted IR spectroscopical, Eν and topological, EQTAIM with correlation coefficients R² =0.9666, R² =0.9028 and R² =0.8864, respectively. The NICS(1)zz index also correlates with usual descriptors of the hydrogen bond, while the other indices do not give any meaningful results. The influence of the intramolecular H-bonding formation on the aromaticity of some substituted o-DEAMPHs is criteria to consider the multidimensional character of aromaticity. The linear relationships as well as revealed between NICS(1)zz and both pyramidality nitrogen atom, ΣN(C₂H₅)₂ and dihedral angle, φ CAr – CAr -CCH₂ –N, to characterizing out-of-plane properties.These results demonstrated the nonplanar structure of o-DEAMPHs. Finally, when considering dependencies of NICS(1)zz, were excluded data for R=H, because the NICS(1) and NICS(1)zz values are the most negative for unsubstituted DEAMPH, indicating its highest aromaticity; that was not the case for NICS(0) index.

Keywords: aminomethylphenols, DFT, aromaticity, correlations

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7451 The Research about Environmental Assessment Index of Brownfield Redevelopment in Taiwan - A Case Study on Formosa Chemicals and Fibre Corporation, Changhua Branch

Authors: Yang, Min-chih, Shih-Jen Feng, Bo-Tsang Li

Abstract:

The concept of “Brownfield” has been developed for nearly 35 years since it was put forward in 《Comprehensive Environmental Response, Compensation, and Liability Act, CERCLA》of USA in 1980 for solving the problem of soil contamination of those old industrial lands, and later, many countries have put forward relevant policies and researches continuously. But the related concept in Taiwan, a country has developed its industry for 60 years, is still in its infancy. This leads to the slow development of Brownfield related research and policy in Taiwan. When it comes to build the foundation of Brownfield development, we have to depend on the related experience and research of other countries. They are four aspects about Brownfield: 1. Contaminated Land; 2. Derelict Land; 3. Vacant Land; 4. Previously Development Land. This study will focus on and deeply investigate the Vacant land and contaminated land.

Keywords: brownfield, industrial land, redevelopment, assessment index

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7450 Process Flows and Risk Analysis for the Global E-SMC

Authors: Taeho Park, Ming Zhou, Sangryul Shim

Abstract:

With the emergence of the global economy, today’s business environment is getting more competitive than ever in the past. And many supply chain (SC) strategies and operations have significantly been altered over the past decade to overcome more complexities and risks imposed onto the global business. First, offshoring and outsourcing are more adopted as operational strategies. Manufacturing continues to move to better locations for enhancing competitiveness. Second, international operations are a challenge to a company’s SC system. Third, the products traded in the SC system are not just physical goods, but also digital goods (e.g., software, e-books, music, video materials). There are three main flows involved in fulfilling the activities in the SC system: physical flow, information flow, and financial flow. An advance of the Internet and electronic communication technologies has enabled companies to perform the flows of SC activities in electronic formats, resulting in the advent of an electronic supply chain management (e-SCM) system. A SC system for digital goods is somewhat different from the supply chain system for physical goods. However, it involves many similar or identical SC activities and flows. For example, like the production of physical goods, many third parties are also involved in producing digital goods for the production of components and even final products. This research aims at identifying process flows of both physical and digital goods in a SC system, and then investigating all risk elements involved in the physical, information, and financial flows during the fulfilment of SC activities. There are many risks inherent in the e-SCM system. Some risks may have severe impact on a company’s business, and some occur frequently but are not detrimental enough to jeopardize a company. Thus, companies should assess the impact and frequency of those risks, and then prioritize them in terms of their severity, frequency, budget, and time in order to be carefully maintained. We found risks involved in the global trading of physical and digital goods in four different categories: environmental risk, strategic risk, technological risk, and operational risk. And then the significance of those risks was investigated through a survey. The survey asked companies about the frequency and severity of the identified risks. They were also asked whether they had faced those risks in the past. Since the characteristics and supply chain flows of digital goods are varying industry by industry and country by country, it is more meaningful and useful to analyze risks by industry and country. To this end, more data in each industry sector and country should be collected, which could be accomplished in the future research.

Keywords: digital goods, e-SCM, risk analysis, supply chain flows

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7449 Poisoning in Morocco: Evolution and Risk Factors

Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh

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The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.

Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight

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7448 Effect of Non-Newtonian Behavior of Oil Phase on Oil-Water Stratified Flow in a Horizontal Channel

Authors: Satish Kumar Dewangan, Santosh Kumar Senapati

Abstract:

The present work focuses on the investigation of the effect of non-Newtonian behavior on the oil-water stratified flow in a horizontal channel using ANSYS Fluent. Coupled level set and volume of fluid (CLSVOF) has been used to capture the evolving interface assuming unsteady, coaxial flow with constant fluid properties. The diametric variation of oil volume fraction, mixture velocity, total pressure and pressure gradient has been studied. Non-Newtonian behavior of oil has been represented by the power law model in order to investigate the effect of flow behavior index. Stratified flow pattern tends to assume dispersed flow pattern with the change in the behavior of oil to non-Newtonian. The pressure gradient is found to be very much sensitive to the flow behavior index. The findings could be useful in designing the transportation pipe line in petroleum industries.

Keywords: oil-water stratified flow, horizontal channel, CLSVOF, non–Newtonian behaviour.

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7447 Exposure Assessment for Worker Exposed to Heavy Metals during Road Marking Operations

Authors: Yin-Hsuan Wu, Perng-Jy Tsai, Ying-Fang Wang, Shun-Hui Chung

Abstract:

The present study was conducted to characterize exposure concentrations, concentrations deposited on the different respiratory regions, and resultant health risks associated with heavy metal exposures for road marking workers. Road marking workers of three similar exposure groups (SEGs) were selected, including the paint pouring worker, marking worker, and preparing worker. Personal exposure samples were collected using an inhalable dust sampler (IOM), and the involved particle size distribution samples were estimated using an eight-stage Marple personal cascade impactor during five working days. In total, 25 IOM samples and 20 Marple samples were collected. All collected samples were analyzed for their heavy metal contents using the ICP/MS. The resultant heavy metal particle size distributions were also used to estimate the fractions of particle deposited on the head airways (Chead), tracheobronchial (Cthorac) and alveolar regions (Cresp) of the exposed workers. In addition, Pb and Cr were selected to estimate the incremental cancer risk, and Zn, Ti, and Mo were selected to estimate the corresponding non-cancer risk in the present study. Results show that three heavy metals, including Pb, Cr, and Ti, were found with the highest concentrations for the SEG of the paint pouring worker (=0.585±2.98, 0.307±1.71, 0.902±2.99 μg/m³, respectively). For the fraction of heavy metal particle deposited on the respiratory tract, both alveolar and head regions were found with the highest values (=23-43% and 39-61%, respectively). For both SEGs of the paint pouring and marking, 51% of Cr, 59-61% of Zn, and 48-51% of Ti were found to be deposited on the alveolar region, and 41-43% of Pb was deposited on the head region. Finally, the incremental cancer risk for the SEGs of the paint pouring, marking, and preparing were found as 1.08×10⁻⁵, 2.78×10⁻⁶, and 2.20×10⁻⁶, respectively. In addition, the estimated non-cancer risk for the above three SEGs was found to be consistently less than unity. In conclusion, though the estimated non-cancer risk was less than unity, all resultant incremental cancer risk was greater than 10⁻⁶ indicating the abatement of workers’ exposure is necessary. It is suggested that strategies, including placing on the molten kettle, substitution the currently used paints for less heavy metal containing paints, and wearing fume protecting personal protective equipment can be considered in the future from reducing the worker’s exposure aspect.

Keywords: health risk assessment, heavy metal, respiratory track deposition, road marking

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7446 Association of Zinc with New Generation Cardiovascular Risk Markers in Childhood Obesity

Authors: Mustafa M. Donma, Orkide Donma

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Zinc is a vital element required for growth and development. This fact makes zinc important, particularly for children. It maintains normal cellular structure and functions. This essential element appears to have protective effects against coronary artery disease and cardiomyopathy. Higher serum zinc levels are associated with lower risk of cardiovascular diseases (CVDs). There is a significant association between low serum zinc levels and heart failure. Zinc may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis, and prognosis of CVDs. The aim of this study is to determine zinc as well as new generation cardiac markers profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children, and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. Forty-five MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99, and above 99 for N-BMI, OB, and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses, including zinc, were performed. High sensitive-cTnT and cMyBP-C concentrations were measured by kits based on enzyme-linked immunosorbent assay principle. Appropriate statistical tests within the scope of SPSS were used for the evaluation of the study data. p<0.05 was accepted as statistically significant. Four groups were matched for age and gender. Decreased zinc concentrations were measured in Groups 2, 3, and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between zinc and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between zinc and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of this physiologically essential trace element accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both zinc and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity

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7445 Dimensionless Binding Values in the Evaluation of Paracetamol Tablet Formulation

Authors: Abayomi T. Ogunjimi, Gbenga Alebiowu

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Mechanical properties of paracetamol tablets containing Neem (Azadirachta indica) gum were compared with standard Acacia gum BP as binder. Two dimensionless binding quantities BEN and BEC were used in assessing the influence of binder type on two mechanical properties, Tensile Strength (TS) and Brittle Fracture Index (BFI). The two quantities were also used to assess the influence of relative density and binder concentration on TS and BFI as well as compare Binding Efficiencies (BE). The result shows that TS is dependent on relative density, binder type and binder concentration while BFI is dependent on the binder type and binder concentration; and that although, the inclusion of NMG in a paracetamol tablet formulation may not enhance the TS of the tablets produced, however it will decrease the tendency of the tablets to cap or laminate. This work concludes that BEN may be useful in quantitative assessment while BEC may be appropriate for qualitative assessment.

Keywords: binding efficiency, brittle fracture index, dimensionless binding, tensile strength

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7444 Risk Factors for Postoperative Fever in Patients Undergoing Lumbar Fusion

Authors: Bang Haeyong

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Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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7443 Personality-Focused Intervention for Adolescents: Impact on Bullying and Distress

Authors: Erin V. Kelly, Nicola C. Newton, Lexine A. Stapinski, Maree Teesson

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Introduction: There is a lack of targeted prevention programs for reducing bullying and distress among adolescents involved in bullying. The current study aimed to examine the impact of a personality-targeted intervention (Preventure) on bullying (victimization and perpetration) and distress among adolescent victims/bullies with high-risk personality types. Method: A cluster randomized trial (RCT) was conducted in 26 secondary schools (2190 students) in NSW and Victoria, Australia, as part of the Climate Schools and Preventure trial. The schools were randomly allocated to Preventure (13 schools received Preventure, 13 did not). Students were followed up at 4 time points (6, 12, 24 and 36 months post-baseline). Preventure involves two group sessions, based on cognitive behavioral therapy, and tailored to four personality types shown to increase risk of substance misuse and other emotional and behavioural problems, including impulsivity, sensation-seeking, anxiety sensitivity and hopelessness. Students were allocated to the personality-targeted groups based on their scores on the Substance Use Risk Profile Scale. Bullying was measured using an amended version of the Revised Olweus Bully/Victim Scale. Psychological distress was measured using the Kessler Psychological Distress Scale. Results: Among high-risk students classified as victims at baseline, those in Preventure schools reported significantly less victimization and distress over time than those in control schools. Among high-risk students classified as bullies at baseline, those in Preventure schools reported significantly less distress over time than those in control schools (no difference for perpetration). Conclusion: Preventure is a promising intervention for reducing bullying victimization and psychological distress among adolescents involved in bullying.

Keywords: adolescents, bullying, personality, prevention

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7442 Management of Diabetics on Hemodialysis

Authors: Souheila Zemmouchi

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Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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7441 Explanatory Variables for Crash Injury Risk Analysis

Authors: Guilhermina Torrao

Abstract:

An extensive number of studies have been conducted to determine the factors which influence crash injury risk (CIR); however, uncertainties inherent to selected variables have been neglected. A review of existing literature is required to not only obtain an overview of the variables and measures but also ascertain the implications when comparing studies without a systematic view of variable taxonomy. Therefore, the aim of this literature review is to examine and report on peer-reviewed studies in the field of crash analysis and to understand the implications of broad variations in variable selection in CIR analysis. The objective of this study is to demonstrate the variance in variable selection and classification when modeling injury risk involving occupants of light vehicles by presenting an analytical review of the literature. Based on data collected from 64 journal publications reported over the past 21 years, the analytical review discusses the variables selected by each study across an organized list of predictors for CIR analysis and provides a better understanding of the contribution of accident and vehicle factors to injuries acquired by occupants of light vehicles. A cross-comparison analysis demonstrates that almost half the studies (48%) did not consider vehicle design specifications (e.g., vehicle weight), whereas, for those that did, the vehicle age/model year was the most selected explanatory variable used by 41% of the literature studies. For those studies that included speed risk factor in their analyses, the majority (64%) used the legal speed limit data as a ‘proxy’ of vehicle speed at the moment of a crash, imposing limitations for CIR analysis and modeling. Despite the proven efficiency of airbags in minimizing injury impact following a crash, only 22% of studies included airbag deployment data. A major contribution of this study is to highlight the uncertainty linked to explanatory variable selection and identify opportunities for improvements when performing future studies in the field of road injuries.

Keywords: crash, exploratory, injury, risk, variables, vehicle

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7440 Forecasting Impacts on Vulnerable Shorelines: Vulnerability Assessment Along the Coastal Zone of Messologi Area - Western Greece

Authors: Evangelos Tsakalos, Maria Kazantzaki, Eleni Filippaki, Yannis Bassiakos

Abstract:

The coastal areas of the Mediterranean have been extensively affected by the transgressive event that followed the Last Glacial Maximum, with many studies conducted regarding the stratigraphic configuration of coastal sediments around the Mediterranean. The coastal zone of the Messologi area, western Greece, consists of low relief beaches containing low cliffs and eroded dunes, a fact which, in combination with the rising sea level and tectonic subsidence of the area, has led to substantial coastal. Coastal vulnerability assessment is a useful means of identifying areas of coastline that are vulnerable to impacts of climate change and coastal processes, highlighting potential problem areas. Commonly, coastal vulnerability assessment takes the form of an ‘index’ that quantifies the relative vulnerability along a coastline. Here we make use of the coastal vulnerability index (CVI) methodology by Thieler and Hammar-Klose, by considering geological features, coastal slope, relative sea-level change, shoreline erosion/accretion rates, and mean significant wave height as well as mean tide range to assess the present-day vulnerability of the coastal zone of Messologi area. In light of this, an impact assessment is performed under three different sea level rise scenarios, and adaptation measures to control climate change events are proposed. This study contributes toward coastal zone management practices in low-lying areas that have little data information, assisting decision-makers in adopting best adaptations options to overcome sea level rise impact on vulnerable areas similar to the coastal zone of Messologi.

Keywords: coastal vulnerability index, coastal erosion, sea level rise, GIS

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7439 Uptake of Hepatitis B Vaccine among Hepatitis C Positive Patients and Their Vaccine Response in Myanmar

Authors: Zaw Z Aung

Abstract:

Background: High-risk groups for hepatitis B infection (HBV) are people who injected drugs (PWID), men who have sex with men (MSM), people living with HIV (PLHIV) and persons with hepatitis C (HCV), etc. HBV/HCV coinfected patients are at increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. To the best of author’s knowledge, there is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response. Methodology: From February 2018 to May 2018, consented participants at or above 18 years who came to the clinic in Mandalay were tested with the anti-HCV rapid test. Those who tested HCV positive (n=168) were further tested with hepatitis B profile and asked about their previous hepatitis B vaccination history and risk factors. Results: Out of 168 HCV positive participants, three were excluded for active HBV infections. The remaining 165 were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), General Population (GP) monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9). Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 63 participants completed third doses of vaccination (PWID=36, GP=13, HIV/HCV=14). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): HIV/HCV (86%, n=12), PWID (44%, n=16), and GP (46%, n=6) Conclusion: Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, HIV/AIDS and hepatitis C treatment centers is desirable. About half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Keywords: Hepatitis B vaccine, Hepatitis C, HIV, Myanmar

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7438 Static Application Security Testing Approach for Non-Standard Smart Contracts

Authors: Antonio Horta, Renato Marinho, Raimir Holanda

Abstract:

Considered as an evolution of the Blockchain, the Ethereum platform, besides allowing transactions of its cryptocurrency named Ether, it allows the programming of decentralised applications (DApps) and smart contracts. However, this functionality into blockchains has raised other types of threats, and the exploitation of smart contracts vulnerabilities has taken companies to experience big losses. This research intends to figure out the number of contracts that are under risk of being drained. Through a deep investigation, more than two hundred thousand smart contracts currently available in the Ethereum platform were scanned and estimated how much money is at risk. The experiment was based in a query run on Google Big Query in July 2022 and returned 50,707,133 contracts published on the Ethereum platform. After applying the filtering criteria, the experimentgot 430,584 smart contracts to download and analyse. The filtering criteria consisted of filtering out: ERC20 and ERC721 contracts, contracts without transactions, and contracts without balance. From this amount of 430,584 smart contracts selected, only 268,103 had source codes published on Etherscan, however, we discovered, using a hashing process, that there were contracts duplication. Removing the duplicated contracts, the process ended up with 20,417 source codes, which were analysed using the open source SAST tool smartbugswith oyente and securify algorithms. In the end, there was nearly $100,000 at risk of being drained from the potentially vulnerable smart contracts. It is important to note that the tools used in this study may generate false positives, which may interfere with the number of vulnerable contracts. To address this point, our next step in this research is to develop an application to test the contract in a parallel environment to verify the vulnerability. Finally, this study aims to alert users and companies about the risk on not properly creating and analysing their smart contracts before publishing them into the platform. As any other application, smart contracts are at risk of having vulnerabilities which, in this case, may result in direct financial losses.

Keywords: blockchain, reentrancy, static application security testing, smart contracts

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7437 The Relationship of Weight Regain with Biochemical and Psychological Factors in Non Postmenopausal Women

Authors: Farzad Shidfar, Najmeh Rostami, Ziaodin Mazhari, Fatemeh Hosseini Baharanchi

Abstract:

Background and Aim: The rate of failure to maintain a reduced weight has been increased. By definition, people who regain about one-third to two-thirds of their lost weight after one year from the end of the dietary treatment and return all the lost weight after 5 years it is called weight regain. This study was performed to find the causes of weight regain and its relationship with biochemical and psychological factors. Materials and Methods: This cross-sectional study was performed by reviewing the files of people who followed the dietary treatment in 1397-1398.seventy-three persons was in the weight regain group, and seventy-three people were in the weight maintenance group. Psychological factors such as depression, anxiety, quality of life, physical activity, and dietary frequency were assessed through a questionnaire, and biochemical factors such as serum insulin and fasting blood sugar were measured. The mean basal energy in the weight regain group was significantly higher than the weight maintenance group (p = 0.004). There was no significant difference between the two groups in terms of food intake and inflammatory index of food. There was no significant difference between the two groups in terms of food intake and inflammatory index of food. Mean serum insulin concentration (p = 0.023), mean fasting blood sugar (p = 0.04) and insulin resistance (p = 0.013) in the weight regain group were higher than the weight maintenance group. The weight maintenance group showed higher insulin sensitivity than the weight regain group (p = 0.005). There was no significant difference between the two groups in terms of psychological indicators. Conclusion: The only body mass index after one year from the end of the treatment period, insulin sensitivity, serum insulin concentration, fasting blood sugar, insulin resistance, selenium intake, and basal energy expenditure Specific and significant with weight regain. However, the significance of insulin resistance, basal energy expenditure, and body mass index after one year from the end of the treatment period was higher than other variables in the weight regain group.

Keywords: body weight maintenance, weight regain, insulin resistance, insulin sensitivity

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7436 Health Exposure Assessment of Sulfur Loading Operation

Authors: Ayman M. Arfaj, Jose Lauro M. Llamas, Saleh Y Qahtani

Abstract:

Sulfur Loading Operation (SLO) is an operation that poses risk of exposure to toxic gases such as Hydrogen Sulfid and Sulfur Dioxide during molten sulfur loading operation. In this operation molten sulfur is loaded into a truck tanker in a liquid state and the temperature of the tanker must maintain liquid sulfur within a 43-degree range — between 266 degrees and 309 degrees Fahrenheit in order for safe loading and unloading to occur. Accordingly, in this study, the e potential risk of occupational exposure to the airborne toxic gases was assessed at three sulfur loading facilities. The concentrations of toxic airborne substances such as Hydrogen Sulfide (H2S) and Sulfur Dioxide (SO2), were monitored during operations at the different locations within the sulfur loading operation facilities. In addition to extensive real-time monitoring, over one hundred and fifty samples were collected and analysed at internationally accredited laboratories. The concentrations of H2S, and SO2 were all found to be well below their respective occupational exposure limits. Very low levels of H2S account for the odours observed intermittingly during mixing and application operations but do not pose a considerable health risk and hence these levels are considered a nuisance. These results were comparable to those reported internationally. Aside from observing the usual general safe work practices such as wearing safety glasses, there are no specific occupational health related concerns at the examined sulfur loading facilities.

Keywords: exposure assessment, sulfur loading operation, health risk study, molten sulfur, toxic airborne substances, air contaminants monitoring

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7435 Climate Change Winners and Losers: Contrasting Responses of Two Aphaniops Species in Oman

Authors: Aziza S. Al Adhoobi, Amna Al Ruheili, Saud M. Al Jufaili

Abstract:

This study investigates the potential effects of climate change on the habitat suitability of two Aphaniops species (Teleostei: Aphaniidae) found in the Oman Mountains and the Southwestern Arabian Coast. Aphaniops kruppi, an endemic species, is found in various water bodies such as wadis, springs, aflaj, spring-fed streams, and some coastal backwaters. Aphaniops stoliczkanus, on the other hand, inhabits brackish and freshwater habitats, particularly in the lower parts of wadies and aflaj, and exhibits euryhaline characteristics. Using Maximum Entropy Modeling (MaxEnt) in conjunction with ArcGIS (10.8.2) and CHELSA bioclimatic variables, topographic indices, and other pertinent environmental factors, the study modeled the potential impacts of climate change based on three Representative Concentration Pathways (RCPs 2.6, 7.0, 8.5) for the periods 2011-2040, 2041-2070, and 2071-2100. The model demonstrated exceptional predictive accuracy, achieving AUC values of 0.992 for A. kruppi and 0.983 for A. stoliczkanus. For A. kruppi, the most influential variables were the mean monthly climate moisture index (Cmi_m), the mean diurnal range (Bio2), and the sediment transport index (STI), accounting for 39.9%, 18.3%, and 8.4%, respectively. As for A. stoliczkanus, the key variables were the sediment transport index (STI), stream power index (SPI), and precipitation of the coldest quarter (Bio19), contributing 31%, 20.2%, and 13.3%, respectively. A. kruppi showed an increase in habitat suitability, especially in low and medium suitability areas. By 2071-2100, high suitability areas increased slightly by 0.05% under RCP 2.6, but declined by -0.02% and -0.04% under RCP 7.0 and 8.5, respectively. A. stoliczkanus exhibited a broader range of responses. Under RCP 2.6, all suitability categories increased by 2071-2100, with high suitability areas increasing by 0.01%. However, low and medium suitability areas showed mixed trends under RCP 7.0 and 8.5, with declines of -0.17% and -0.16%, respectively. The study highlights that climatic and topographical factors significantly influence the habitat suitability of Aphaniops species in Oman. Therefore, species-specific conservation strategies are crucial to address the impacts of climate change.

Keywords: Aphaniops kruppi, Aphaniops stoliczkanus, Climate change, Habitat suitability, MaxEnt

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7434 The Effect of Sustainable Land Management Technologies on Food Security of Farming Households in Kwara State, Nigeria

Authors: Shehu A. Salau, Robiu O. Aliu, Nofiu B. Nofiu

Abstract:

Nigeria is among countries of the world confronted with food insecurity problem. The agricultural production systems that produces food for the teaming population is not endurable. Attention is thus being given to alternative approaches of intensification such as the use of Sustainable Land Management (SLM) technologies. Thus, this study assessed the effect of SLM technologies on food security of farming households in Kwara State, Nigeria. A-three stage sampling technique was used to select a sample of 200 farming households for this study. Descriptive statistics, Shriar index, Likert scale, food security index and logistic regression were employed for the analysis. The result indicated that majority (41%) of the household heads were between the ages of 51 and 70 years with an average of 60.5 years. Food security index revealed that 35% and 65% of the households were food secure and food insecure respectively. The logistic regression showed that SLM technologies, estimated income, household size, gender and age of the household heads were the critical determinants of food security among farming households. The most effective coping strategies adopted by households geared towards lessening the effects of food insecurity are reduced quality of food consumed, employed off-farm jobs to raise household income and diversion of money budgeted for other uses to purchase foods. Governments should encourage the adoption and use of SLM technologies at all levels. Policies and strategies that reduce household size should be enthusiastically pursued to reduce food insecurity.

Keywords: agricultural practices, coping strategies, farming households, food security, SLM technologies, logistic regression

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7433 Effect of Swirling Mixer on the Exhaust Flow in a Diesel SCR Aftertreatment System

Authors: Doo Ki Lee, Kumaresh Selvakumar, Man Young Kim, In Jae Song

Abstract:

The widespread utilization of mixer in selective catalytic reduction (SCR) system marks a remarkable advantage in diesel engines. In the automotive selective catalytic reduction (SCR) system, the de-NOX efficiency can be improved by highly uniform flow with effective turbulent mixing. In this paper, the exhaust pipe is complemented with the swirling mixers of three different vane angles installed at the upstream of the SCR reactor. The attributes of the mixer are established by the variation in flow behavior followed by the drawback owing to the absence of mixer. In particular, the information pertaining to the selection of proper static mixer is provided based on the correlation between the uniformity index (UI) and the pressure drop. The uniform distribution of the flow at the entrance of the SCR reactor aids to determine the configuration which gives high mixing performance and comprehend the function of the mixer.

Keywords: pressure drop, selective catalytic reduction, static mixer, turbulent mixing, uniformity index

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7432 Genome-Wide Analysis of BES1/BZR1 Gene Family in Five Plant Species

Authors: Jafar Ahmadi, Zhohreh Asiaban, Sedigheh Fabriki Ourang

Abstract:

Brassinosteroids (BRs) regulate cell elongation, vascular differentiation, senescence and stress responses. BRs signal through the BES1/BZR1 family of transcription factors, which regulate hundreds of target genes involved in this pathway. In this research a comprehensive genome-wide analysis was carried out in BES1/BZR1 gene family in Arabidopsis thaliana, Cucumis sativus, Vitis vinifera, Glycin max, and Brachypodium distachyon. Specifications of the desired sequences, dot plot and hydropathy plot were analyzed in the protein and genome sequences of five plant species. The maximum amino acid length was attributed to protein sequence Brdic3g with 374aa and the minimum amino acid length was attributed to protein sequence Gm7g with 163aa. The maximum Instability index was attributed to protein sequence AT1G19350 equal with 79.99 and the minimum Instability index was attributed to protein sequence Gm5g equal with 33.22. Aliphatic index of these protein sequences ranged from 47.82 to 78.79 in Arabidopsis thaliana, 49.91 to 57.50 in Vitis vinifera, 55.09 to 82.43 in Glycin max, 54.09 to 54.28 in Brachypodium distachyon 55.36 to 56.83 in Cucumis sativus. Overall, data obtained from our investigation contributes a better understanding of the complexity of the BES1/BZR1 gene family and provides the first step towards directing future experimental designs to perform systematic analysis of the functions of the BES1/BZR1 gene family.

Keywords: BES1/BZR1, brassinosteroids, phylogenetic analysis, transcription factor

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7431 Molding Properties of Cobalt-Chrome-Based Feedstocks Used in Low-Pressure Powder Injection Molding

Authors: Ehsan Gholami, Vincent Demers

Abstract:

Low-pressure powder injection molding is an emerging technology for cost-effectively producing complex shape metallic parts with the proper dimensional tolerances, either in high or in low production volumes. In this study, the molding properties of cobalt-chrome-based feedstocks were evaluated for use in a low-pressure powder injection molding process. The rheological properties of feedstock formulations were obtained by mixing metallic powder with a proprietary wax-based binder system. Rheological parameters such as reference viscosity, shear rate sensitivity index, and activation energy for viscous flow, were extracted from the viscosity profiles and introduced into the Weir model to calculate the moldability index. Feedstocks were experimentally injected into a spiral mold cavity to validate the injection performance calculated with the model.

Keywords: binder, feedstock, moldability, powder injection molding, viscosity

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7430 Model-Independent Price Bounds for the Swiss Re Mortality Bond 2003

Authors: Raj Kumari Bahl, Sotirios Sabanis

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In this paper, we are concerned with the valuation of the first Catastrophic Mortality Bond that was launched in the market namely the Swiss Re Mortality Bond 2003. This bond encapsulates the behavior of a well-defined mortality index to generate payoffs for the bondholders. Pricing this bond is a challenging task. We adapt the payoff of the terminal principal of the bond in terms of the payoff of an Asian put option and present an approach to derive model-independent bounds exploiting comonotonic theory. We invoke Jensen’s inequality for the computation of lower bounds and employ Lagrange optimization technique to achieve the upper bound. The success of these bounds is based on the availability of compatible European mortality options in the market. We carry out Monte Carlo simulations to estimate the bond price and illustrate the strength of these bounds across a variety of models. The fact that our bounds are model-independent is a crucial breakthrough in the pricing of catastrophic mortality bonds.

Keywords: mortality bond, Swiss Re Bond, mortality index, comonotonicity

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7429 Half Dose Tissue Plasminogen Activator for Intermediate-Risk Pulmonary Embolism

Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

Procedia PDF Downloads 75