Search results for: adjusted cumulative incidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1996

Search results for: adjusted cumulative incidence

1846 Unveiling the Black Swan of the Inflation-Adjusted Real Excess Returns-Risk Nexus: Evidence From Pakistan Stock Exchange

Authors: Mohammad Azam

Abstract:

The purpose of this study is to investigate risk and real excess portfolio returns using inflation adjusted risk-free rates, a measuring technique that focuses on the momentum augmented Fama-French six-factor model and use monthly data from 1994 to 2022. With the exception of profitability, the data show that market, size, value, momentum, and investment factors are all strongly associated to excess portfolio stock returns using ordinary lease square regression technique. According to the Gibbons, Ross, and Shanken test, the momentum augmented Fama-French six-factor model outperforms the market. This technique discovery may be utilised by academics and professionals to acquire an in-depth knowledge of the Pakistan Stock Exchange across a broad stock pattern for investing decisions and portfolio construction.

Keywords: real excess portfolio returns, momentum augmented fama & french five-factor model, GRS-test, pakistan stock exchange

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1845 Enhancement of Mulberry Leaf Yield and Water Productivity in Eastern Dry Zone of Karnataka, India

Authors: Narayanappa Devakumar, Chengalappa Seenappa

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The field experiments were conducted during Rabi 2013 and summer 2014 at College of Sericulture, Chintamani, Chickaballapur district, Karnataka, India to find out the response of mulberry to different methods, levels of irrigation and mulching. The results showed that leaf yield and water productivity of mulberry were significantly influenced by different methods, levels of irrigation and mulching. Subsurface drip with lower level of irrigation at 0.8 CPE (Cumulative Pan Evaporation) recorded higher leaf yield and water productivity (42857 kg ha-1 yr-1and 364.41 kg hacm-1) than surface drip with higher level of irrigation at 1.0 CPE (38809 kg ha-1 yr-1 and 264.10 kg hacm-1) and micro spray jet (39931 kg ha-1 yr-1 and 271.83 kg hacm-1). Further, subsurface drip recorded minimum water used to produce one kg of leaf and to earn one rupee of profit (283 L and 113 L) compared to surface drip (390 L and 156 L) and micro spray jet (379 L and 152 L) irrigation methods. Mulberry leaf yield increased and water productivity decreased with increased levels of irrigation. However, these results indicated that irrigation of mulberry with subsurface drip increased leaf yield and water productivity by saving 20% of irrigation water than surface drip and micro spray jet irrigation methods in Eastern Dry Zone (EDZ) of Karnataka.

Keywords: cumulative pan evaporation, mulaberry, subsurface drip irrigation, water productivity

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1844 Incidence of Post-Stroke Depression in a Tertiary Hospital in Cebu City, Philippines

Authors: Ivory A. Rulona, Jarungchai Anton S. Vatanagul

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Background: Depression is common after stroke with quoted rates ranging from 18% to 61%. 8 Mood disturbance is common after stroke and may present as depression or anxiety. Psychological mood disturbance is associated with higher rates of mortality, long term disability, and hospital readmission. Objectives: To investigate the incidence of post-stroke depression in a tertiary hospital in Cebu City, Philippines and to determine its associated factors. The study is designed to be prospective, descriptive, cross-sectional survey. Participants: Adult patients seen and diagnosed to have stroke either infarct or hemorrhage within the period of January 1 to July 31, 2014. Results: A total of 100 patients with stroke were interviewed using the 17-item Hamilton Depression Rating Scale (HDRS) questionnaire. The average age of the respondents was 60.50 years old ±1.18, majority were males (55%), 83% were married, and 81% were employed. The most common co-morbidity was hypertension 78% followed by diabetes mellitus at 50%. Moreover, 39% of these patients had stroke in months, 26% in years, and 18% in weeks. The average functional capacity based on Modified Rankin Scale was 2.14+/-0.14. Among 100 patients, a total of 30 patients (30%) had depression: 2 (2%) very severe, 5 (5%) moderate and 23 (23%) had mild depression while 70 patients (70%) had no depression. Stroke located at the dominant hemisphere was not associated with severe depression (p=0.102). A similar trend was also noted among those with stroke at the right side (p=0.183), pons (p=0.634), bilateral (p=0.776), and midbrain (p=0.336). Conclusion: This study showed that majority of stroke patients were males with average age of 60.50 years. Hypertension was the most common co-morbidity. There was no association between stroke location and depression. The incidence of PSD was 30%.

Keywords: post-stroke depression, co-morbidity, disturbance, bilateral

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1843 Performance Effects of Demergers in India

Authors: Pavak Vyas, Hiral Vyas

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Spin-offs commonly known as demergers in India, represents dismantling of conglomerates which is a common phenomenon in financial markets across the world. Demergers are carried out with different motives. A demerger generally refers to a corporate restructuring where, a large company divests its stake in in its subsidiary and distributes the shares of the subsidiary - demerged entity to the existing shareholders without any consideration. Demergers in Indian companies are over a decade old phenomena, with many companies opting for the same. This study examines the demerger regulations in Indian capital markets and the announcement period price reaction of demergers during year 2010-2015. We study total 97 demerger announcements by companies listed in India and try to establish that demergers results into abnormal returns for the shareholders of the parent company. Using event study methodology we have analyzed the security price performance of the announcement day effect 10 days prior to announcement to 10 days post demerger announcement. We find significant out-performance of the security over the benchmark index post demerger announcements. The cumulative average abnormal returns range from 3.71% on the day of announcement of a private demerger to 2.08% following 10 days surrounding the announcement, and cumulative average abnormal returns range from 5.67% on the day of announcement of a public demerger to 4.15% following10 days surrounding the announcement.

Keywords: demergers, event study, spin offs, stock returns

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1842 Efficacy of Eutectic Mixture of Local Anaesthetics and Diclofenac Spray in Attenuating Intravenous Cannulation Pain- Paeallel Randomized Trial

Authors: Anju Rani, Geeta, Sudha Rani, Choudhary, Puhal

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Method- A total of 300 patients were studied, with 100 patients in each group. Patients aged 16-60 years, ASA grade I and II undergoing elective general surgical, urology and orthopedic procedures were included in the study. The patients were randomly allocated to any of the three groups by Using Sealed envelopes. 1. Group A: EMLA (eutectic mixture of 2.5% lidocaine with 2.5% prilocaine) - Patients receiving eutectic Lidocaine/ Prilocaine cream (2gm/10cm2) of Prilox cream), for 60- 70 min under occlusive dressing. 2. Group B - Patients receiving topical diclofenac 4 % spray gel for 60- 70 min, covering an absorption area of 50 cm2 3. Group C: control – Direct cannulation was done without any intervention. Results - Group B showed significantly least number of patients complaining pain on IV cannulation in comparison to group A and group C. The Mean VAS scores were found to be maximum in GROUP C: control-8.76 ± 4.14, then in GROUP A: EMLA- 2.54 ± 4.21.and least in GROUP B: Diclofenac 4% spray-1.13 ± 3.05. Erythema, induration and edema were significantly reported to be higher for the control group. Also group A patients reported adverse skin reactions more than patients in group B. Conclusion - It can be concluded that diclofenac spray 4 % and EMLA cream are effective in reducing the incidence and severity of venous cannulation pain as compared to the control group. However, a higher incidence of skin blanching, erythema, and oedema associated with EMLA cream and a lower incidence of these adverse effects favours the use of diclofenac spray 4%. They are promising agents for the treatment of venous cannulation pain.

Keywords: diclofenac spray, EMLA, intravenous, pain

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1841 Derivation of Runoff Susceptibility Map Using Slope-Adjusted SCS-CN in a Tropical River Basin

Authors: Abolghasem Akbari

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The Natural Resources Conservation Service Curve Number (NRCS-CN) method is widely used for predicting direct runoff from rainfall. It employs the hydrologic soil groups and land use information along with period soil moisture conditions to derive NRCS-CN. This method has been well documented and available in popular rainfall-runoff models such as HEC-HMS, SWAT, SWMM and much more. Despite all benefits and advantages of this well documented and easy-to-use method, it does not take into account the effect of terrain slope and drainage area. This study aimed to first investigate the effect of slope on CN and then slope-adjusted runoff potential map is generated for Kuantan River Basin, Malaysia. The Hanng method was used to adjust CN values provided in National Handbook of Engineering and The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) Global Digital Elevation Model (GDEM) version 2 is used to derive slope map with the spatial resolution of 30 m for Kuantan River Basin (KRB). The study significantly enhanced the application of GIS tools and recent advances in earth observation technology to analyze the hydrological process.

Keywords: Kuantan, ASTER-GDEM, SCS-CN, runoff

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1840 A Fourier Method for Risk Quantification and Allocation of Credit Portfolios

Authors: Xiaoyu Shen, Fang Fang, Chujun Qiu

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Herewith we present a Fourier method for credit risk quantification and allocation in the factor-copula model framework. The key insight is that, compared to directly computing the cumulative distribution function of the portfolio loss via Monte Carlo simulation, it is, in fact, more efficient to calculate the transformation of the distribution function in the Fourier domain instead and inverting back to the real domain can be done in just one step and semi-analytically, thanks to the popular COS method (with some adjustments). We also show that the Euler risk allocation problem can be solved in the same way since it can be transformed into the problem of evaluating a conditional cumulative distribution function. Once the conditional or unconditional cumulative distribution function is known, one can easily calculate various risk metrics. The proposed method not only fills the niche in literature, to the best of our knowledge, of accurate numerical methods for risk allocation but may also serve as a much faster alternative to the Monte Carlo simulation method for risk quantification in general. It can cope with various factor-copula model choices, which we demonstrate via examples of a two-factor Gaussian copula and a two-factor Gaussian-t hybrid copula. The fast error convergence is proved mathematically and then verified by numerical experiments, in which Value-at-Risk, Expected Shortfall, and conditional Expected Shortfall are taken as examples of commonly used risk metrics. The calculation speed and accuracy are tested to be significantly superior to the MC simulation for real-sized portfolios. The computational complexity is, by design, primarily driven by the number of factors instead of the number of obligors, as in the case of Monte Carlo simulation. The limitation of this method lies in the "curse of dimension" that is intrinsic to multi-dimensional numerical integration, which, however, can be relaxed with the help of dimension reduction techniques and/or parallel computing, as we will demonstrate in a separate paper. The potential application of this method has a wide range: from credit derivatives pricing to economic capital calculation of the banking book, default risk charge and incremental risk charge computation of the trading book, and even to other risk types than credit risk.

Keywords: credit portfolio, risk allocation, factor copula model, the COS method, Fourier method

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1839 Body Mass Index, Components of Metabolic Syndrome and Hyperuricemia among Women in Postmenopausal Period

Authors: Vladyslav Povoroznyuk, Galina Dubetska, Roksolana Povoroznyuk

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In recent years, the problem of hyperuricemia is getting a particular importance due to its increased incidence in the world population. The aim of this study was to determine uriс acid level in blood serum, incidence of hyperuricemia among women in postmenopausal period and their association with body mass index and some components of metabolic syndrome (triglyceride, cholesterol, systolic and diastolic pressure). We examined 412 women in postmenopausal period. They were divided in to the following groups: I group (BMI = 18,5-24,9), II group (BMI = 25,0-29,9), III group (BMI = 30,0-34,9), IV group (BMI > 35). We determined uric acid level among women during postmenopausal period depending on their body mass index. The higher level of uric acid was found in patients with the maximal body mass index (BMI > 35). In the I group it was 277,52 ± 8,40; in the II group – 286,81 ± 7,79; in the III group – 291,81 ± 7,56; in the IV group – 327,17 ± 12,17. Incidence of hyperuricemia among women in the I group was 10,2%, in the II group – 15,9%; in the III group – 21,2%, in the IV group – 34,2%. We found an interdependence between an uric acid level and BMI in the examined women (r = 0,21, p < 0,05). We determined that the highest level of triglyceride (F = 18,62, p < 0,05), cholesterol (F = 3,64, p < 0,05), atherogenic coefficient (F = 22,64, p < 0,05), systolic (F = 10,5, p < 0,05) and diastolic pressure (F = 4,30, p < 0,05) was among women with hyperuricemia. It was an interdependence between an uric acid level and triglyceride (r = 0,26, p < 0,05), atherogenic coefficient (r = 0,24, p < 0,05) among women in postmenopausal period.

Keywords: hyperuricemia, uric acid, body mass index, women

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1838 Aboriginal Head and Neck Cancer Patients Have Different Patterns of Metastatic Involvement, and Have More Advanced Disease at Diagnosis

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.

Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease

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1837 The Disruptive Effect of COVID-19 on the Informativeness of Dividend Increases: Some Evidence from Johannesburg Stock Exchange-Listed Companies

Authors: Faustina Masocha

Abstract:

This study sought to determine if the Covid-19 pandemic played a disruptive role in the signalling effect of dividend increases for the Top 40 companies listed on the Johannesburg Stock Exchange. With the use of Event Study Methodologies, it was found that dividend increases that were announced in the 2018 and 2019 financial years resulted in Cumulative Abnormal Returns (CARs) that were significantly different from zero, as confirmed by a p-value of 0,0300. This resulted in the conclusion that, under normal circumstances, dividend increases follow the precepts outlined in signalling theories which indicate that the announcement of dividend increases sent positive signals about the expected financial performance of a company. To prove the notion that Covid-19 plays a disruptive role on the signalling hypothesis, it was found from both parametric and non-parametric tests of significance that CARs related to dividend increases that were announced during the 2020 and 2021 financial years, when the Covid-19 pandemic was at its peak, were not significantly different from zero. Therefore, although the dividend increases still resulted in some CARs, such CARs were not statistically different from zero to confirm the signalling hypothesis. A p-value of 0.9830 from parametric t-tests and a p-value of 0.8971 from the Wilcoxon signed-rank test were used as a gauge that led to the conclusion that Covid-19 plays a disruptive effect on the signalling process of dividend increases.

Keywords: cumulative abnormal returns, dividend increases, event study methodology, signalling

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1836 Neighborhood Linking Social Capital as a Predictor of Drug Abuse: A Swedish National Cohort Study

Authors: X. Li, J. Sundquist, C. Sjöstedt, M. Winkleby, K. S. Kendler, K. Sundquist

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Aims: This study examines the association between the incidence of drug abuse (DA) and linking (communal) social capital, a theoretical concept describing the amount of trust between individuals and societal institutions. Methods: We present results from an 8-year population-based cohort study that followed all residents in Sweden, aged 15-44, from 2003 through 2010, for a total of 1,700,896 men and 1,642,798 women. Social capital was conceptualized as the proportion of people in a geographically defined neighborhood who voted in local government elections. Multilevel logistic regression was used to estimate odds ratios (ORs) and between-neighborhood variance. Results: We found robust associations between linking social capital (scored as a three level variable) and DA in men and women. For men, the OR for DA in the crude model was 2.11 [95% confidence interval (CI) 2.02-2.21] for those living in areas with the lowest vs. highest level of social capital. After accounting for neighborhood-level deprivation, the OR fell to 1.59 (1.51-1-68), indicating that neighborhood deprivation lies in the pathway between linking social capital and DA. The ORs remained significant after accounting for age, sex, family income, marital status, country of birth, education level, and region of residence, and after further accounting for comorbidities and family history of comorbidities and family history of DA. For women, the OR decreased from 2.15 (2.03-2.27) in the crude model to 1.31 (1.22-1.40) in the final model, adjusted for multiple neighborhood-level and individual-level variables. Conclusions: Our study suggests that low linking social capital may have important independent effects on DA.

Keywords: drug abuse, social linking capital, environment, family

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1835 Pathway Linking Early Use of Electronic Device and Psychosocial Wellbeing in Early Childhood

Authors: Rosa S. Wong, Keith T.S. Tung, Winnie W. Y. Tso, King-Wa Fu, Nirmala Rao, Patrick Ip

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Electronic devices have become an essential part of our lives. Various reports have highlighted the alarming usage of electronic devices at early ages and its long-term developmental consequences. More sedentary screen time was associated with increased adiposity, worse cognitive and motor development, and psychosocial health. Apart from the problems caused by children’s own screen time, parents today are often paying less attention to their children due to hand-held device. Some anecdotes suggest that distracted parenting has negative impact on parent-child relationship. This study examined whether distracted parenting detrimentally affected parent-child activities which may, in turn, impair children’s psychosocial health. In 2018/19, we recruited a cohort of preschoolers from 32 local kindergartens in Tin Shui Wai and Sham Shui Po for a 5-year programme aiming to build stronger foundations for children from disadvantaged backgrounds through an integrated support model involving medical, education and social service sectors. A comprehensive set of questionnaires were used to survey parents on their frequency of being distracted while parenting and their frequency of learning and recreational activities with children. Furthermore, they were asked to report children’s screen time amount and their psychosocial problems. Mediation analyses were performed to test the direct and indirect effects of electronic device-distracted parenting on children’s psychosocial problems. This study recruited 873 children (448 females and 425 males, average age: 3.42±0.35). Longer screen time was associated with more psychosocial difficulties (Adjusted B=0.37, 95%CI: 0.12 to 0.62, p=0.004). Children’s screen time positively correlated with electronic device-distracted parenting (r=0.369, p < 01). We also found that electronic device-distracted parenting was associated with more hyperactive/inattentive problems (Adjusted B=0.66, p < 0.01), fewer prosocial behavior (Adjusted B=-0.74, p < 0.01), and more emotional symptoms (Adjusted B=0.61, p < 0.001) in children. Further analyses showed that electronic device-distracted parenting exerted influences both directly and indirectly through parent-child interactions but to different extent depending upon the outcome under investigation (38.8% for hyperactivity/inattention, 31.3% for prosocial behavior, and 15.6% for emotional symptoms). We found that parents’ use of devices and children’s own screen time both have negative effects on children’s psychosocial health. It is important for parents to set “device-free times” each day so as to ensure enough relaxed downtime for connecting with children and responding to their needs.

Keywords: early childhood, electronic device, psychosocial wellbeing, parenting

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1834 Patterns of Occurrence of Bovine Haemoparasitic Diseases and Its Co-Incidence with Viral Epidemics of Foot and Mouth Disease and Lumpy Skin Disease

Authors: Amir Hamed Abd-Elrahman, Mohamed Bessat

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450 fattening cattle and buffaloes aged from 6 to 30 months old were examined clinically to determine patterns of occurrence of hemoparasitic diseases and the efficacy of different anti theilerial drugs. 420 animals examined clinically to determine relation between different outbreak of FMD and LSD in Egypt 2012- 2013 and haemoprotozoal diseases. The clinical pictures of haemoprotozoal diseases are variable, from sever to mild, depending on the endemic situation which governed by frequent previous exposure and tick infestation. B. bigemina is the most common haemoprotozoal diseases in the area of study and the infection rate in a descending manner for B. bigemina, A. marginale and T. annulata were 20%, 9.7% and 6.6% respectively. The species susceptibility of B. bigemina and T. annulata showed a higher incidence in cattle than buffaloes while in A. marginale showed a little difference in cattle and buffaloes susceptibility by 10% and 9.2% respectively. The breed susceptibility of B. bigemina and T. annulata showed a higher incidence in crossbred cattle than native baladi cattle while A. marginale showed a higher incidence in native baladi cattle than crossbred cattle. The maximal infection rates were recorded during summer months. The infection rates of B. bigemina and A. marginale were higher among young animals over 6 months and declined above 2 year old while in T. annulata the infection rates were lower among young animals and increased above 2 year old. The case fatality of T. annulata was higher than A. marginale and B. bigemina. Efficacy of different anti theilerial drugs were studied, cure rate of chlouroquine group and Butalex group were 60% disappearance of schizont in lymph node smear after 9 days and 5 days respectively while cure rate of Oxytetracycline Dihydrate (Alamycine) group 20% with disappearance of schizont in lymph node smear after 14 days. FMD and LSD infection enhancement the occurrence of bovine haemoprotozoal diseases.

Keywords: Babesia bigemina, Anaplasma marginale, Theileria annulata, FMD, LSD, ephemeral fever

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1833 Qualitative and Quantitative Research Methodology Theoretical Framework and Descriptive Theory: PhD Construction Management

Authors: Samuel Quashie

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PhDs in Construction Management often designs their methods based on those established in social sciences using theoretical models, to collect, gather and analysis data to answer research questions. Work aim is to apply qualitative and quantitative as a data analysis method, and as part of the theoretical framework - descriptive theory. To improve the ability to replicate the contribution to knowledge the research. Using practical triangulation approach, which covers, interviews and observations, literature review and (archival) document studies, project-based case studies, questionnaires surveys and review of integrated systems used in, construction and construction related industries. The clarification of organisational context and management delivery that influences organizational performance and quality of product and measures are achieved. Results illustrate improved reliability in this research approach when interpreting real world phenomena; cumulative results of research can be applied with confidence under similar environments. Assisted validity of the PhD research outcomes and strengthens the confidence to apply cumulative results of research under similar conditions in the Built Environment research systems, which have been criticised for the lack of reliability in approaches when interpreting real world phenomena.

Keywords: case studies, descriptive theory, theoretical framework, qualitative and quantitative research

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1832 Effect of the Endotracheal Care Nursing Guideline Utilization on the Incidence of Endotracheal Tube Displacement, Oxygen Deficiency after Extubation, Re-intubation, and Nurses Satisfaction

Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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1831 Effective Wind-Induced Natural Ventilation in a Residential Apartment Typology

Authors: Tanvi P. Medshinge, Prasad Vaidya, Monisha E. Royan

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In India, cooling loads in residential sector is a major contributor to its total energy consumption. Due to the increasing cooling need, the market penetration of air-conditioners is further expected to rise. Natural Ventilation (NV), however, possesses great potential to save significant energy consumption especially for residential buildings in moderate climates. As multifamily residential apartment buildings are designed by repetitive use of prototype designs, deriving individual NV based design prototype solutions for a combination of different wind incidence angles and orientations would provide significant opportunity to address the rise in cooling loads by residential sector. This paper presents the results of NV performance of a selected prototype apartment design with a cluster of four units in Pune, India, and an attempt to improve the NV performance through design modifications. The water table apparatus, a physical modelling tool, is used to study the flow patterns and simulate wind-induced NV performance. Quantification of NV performance is done by post processing images captured from video recordings in terms of percentage of area with good and poor access to ventilation. NV performance of the existing design for eight wind incidence angles showed that of the cluster of four units, the windward units showed good access to ventilation for all rooms, and the leeward units had lower access to ventilation with the bedrooms in the leeward units having the least access. The results showed improved performance in all the units for all wind incidence angles to more than 80% good access to ventilation. Some units showed an additional improvement to more than 90% good access to ventilation. This process of design and performance evaluation improved some individual units from 0% to 100% for good access to ventilation. The results demonstrate the ease of use and the power of the water table apparatus for performance-based design to simulate wind induced NV.  

Keywords: fluid dynamics, prototype design, natural ventilation, simulations, water table apparatus, wind incidence angles

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1830 90-Day Strength Training Intervention Decreases Incidence of Sarcopenia: A Pre- and Posttest Pilot Study of Older Adults in a Skilled Nursing Facility

Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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1829 Analysis of the Scattered Fields by Dielectric Sphere Inside Different Dielectric Mediums: The Case of the Source and Observation Point Is Reciprocal

Authors: Emi̇ne Avşar Aydin, Nezahat Günenç Tuncel, A. Hami̇t Serbest

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The electromagnetic scattering from a canonical structure is an important issue in electromagnetic theory. In this study, the electromagnetic scattering from a dielectric sphere with oblique incidence is investigated. The incident field is considered as a plane wave with H polarized. The scattered and transmitted field expressions with unknown coefficients are written. The unknown coefficients are obtained by using exact boundary conditions. Then, the sphere is considered as having frequency dependent dielectric permittivity. The frequency dependence is shown by Cole-Cole model. The far scattered field expressions are found respect to different incidence angles in the 1-8 GHz frequency range. The observation point is the angular distance of pi from an incident wave. While an incident wave comes with a certain angle, observation point turns from 0 to 360 degrees. According to this, scattered field amplitude is maximum at the location of the incident wave, scattered field amplitude is minimum at the across incident wave. Also, the scattered fields are plotted versus frequency to show frequency-dependence explicitly. Graphics are shown for some incident angles compared with the Harrington's solution. Thus, the results are obtained faster and more reliable with reciprocal rotation. It is expected that when there is another sphere with different properties in the outer sphere, the presence and location of the sphere will be detected faster. In addition, this study leads to use for biomedical applications in the future.

Keywords: scattering, dielectric sphere, oblique incidence, reciprocal rotation

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1828 Serum 25-Hydroxyvitamin D Levels in Korean Breast Cancer Patients

Authors: Sung Yong Kim, Byung Joo Song

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Background: Circulating 25-hydroxyvitamin D (25(OH)D) levels has been considered to be inversely related to breast cancer development, recurrence risk, and mortality. Mean vitamin D levels in Korean population is lower than western countries due to higher incidence of lactose intolerance and lower exposure to sunlight. The purpose of this study was to assess incidence of 25(OH)D deficiency at diagnosis and after adjuvant chemotherapy and to investigate the correlation serum 25(OH)D levels with clinicopathologic features. Methods: From December 2011 to October 2012, 280 breast cancer patients seen at a single tertiary cancer center were enrolled. Serum 25(OH)D was measured at the time of surgery and after completion of adjuvant chemotherapy. Statistical analyses used chi-square test, Fisher's exact test, t-test, and ANOVA. Results: Mean serum 25(OH)D was 18.5 ng/ml. The 25(OH)D levels were deficient (<20 ng/ml) in 190 patients (67.9%), insufficient (20-29 ng/ml) in 51 patients(18.2%), and sufficient (30-150 ng/ml) in 39 patients(13.9%). A notable decrease in 25(OH)D concentration was observed(p<0.001) after chemotherapy but was not related to chemotherapy regimens. It was found significant lower 25(OH)D levels at winter season(from October to March, p=0.030). Subjects with invasive carcinoma (IDC or ILC) had significantly lower circulating levels of 25(OH)D than those with ductal carcinoma in situ(DCIS) (p=0.010). Patients with larger tumor size tends to have lower serum 25(OH)D but there were no statistical significance. Conclusions: Most of the breast cancer patients showed deficient or insufficient serum 25(OH)D concentration. Incidence of vitamin D deficiency was higher in invasive carcinoma than DCIS. Serum 25(OH)D levels were decreased after chemotherapy. Consideration should be given to the supplement of vitamin D to those patients.

Keywords: breast neoplasms, vitamin D, Korean population, breast cancer

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1827 Evaluation of the Risk Factors on the Incidence of Adjacent Segment Degeneration After Anterior Neck Discectomy and Fusion

Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

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1826 Debating the Role of Patriarchy in the Incidence of Gender-Based Violence in Jordan: Systematic Review of the Literature

Authors: Nour Daoud

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Patriarchy continues to thrive in Jordan where male-controlled values are still entrenched in a society that is suffering from upsetting percentages of Gender-based Violence (GBV). This paper is a systematic review of the literature with an attempt to evaluate and interpret all available research evidence relevant to determining the extent to which patriarchy contributes to the occurrence, re-occurrence, and continuation of GBV in Jordan. Twenty-one (21) full-text articles were selected for the in-depth review due to meeting the established criteria for inclusion. 81 percent of articles included primary data while 19 percent included secondary data. Analysis of data was based on a specific extraction form that was developed using the ‘Excel’ to respond to the main goal of the paper. Interpretation of data was in light of the theorization of different feminism schools on the relationship between patriarchy and gender-based violence. Findings show that 33 percent of the selected articles affirm that the patriarchal standpoint best explains the role of patriarchy in the incidence of gender-based violence in Jordan under its three main themes (Honor-based Violence, Intimate Partner Violence and Street Harassment). Apart from the limited number of articles that were found debating this argument and the low percentage of articles that acknowledged the role of patriarchy in the incidence of gender-based violence in Jordan, this paper breaks the ice to implement future empirical studies on this subject. Also, it is an invitation for all Jordanian women to unite their efforts in order to eradicate all forms of victimization against them.

Keywords: honor-based violence, intimate partner violence, middle-east, street harassment

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1825 Modeling Karachi Dengue Outbreak and Exploration of Climate Structure

Authors: Syed Afrozuddin Ahmed, Junaid Saghir Siddiqi, Sabah Quaiser

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Various studies have reported that global warming causes unstable climate and many serious impact to physical environment and public health. The increasing incidence of dengue incidence is now a priority health issue and become a health burden of Pakistan. In this study it has been investigated that spatial pattern of environment causes the emergence or increasing rate of dengue fever incidence that effects the population and its health. The climatic or environmental structure data and the Dengue Fever (DF) data was processed by coding, editing, tabulating, recoding, restructuring in terms of re-tabulating was carried out, and finally applying different statistical methods, techniques, and procedures for the evaluation. Five climatic variables which we have studied are precipitation (P), Maximum temperature (Mx), Minimum temperature (Mn), Humidity (H) and Wind speed (W) collected from 1980-2012. The dengue cases in Karachi from 2010 to 2012 are reported on weekly basis. Principal component analysis is applied to explore the climatic variables and/or the climatic (structure) which may influence in the increase or decrease in the number of dengue fever cases in Karachi. PC1 for all the period is General atmospheric condition. PC2 for dengue period is contrast between precipitation and wind speed. PC3 is the weighted difference between maximum temperature and wind speed. PC4 for dengue period contrast between maximum and wind speed. Negative binomial and Poisson regression model are used to correlate the dengue fever incidence to climatic variable and principal component score. Relative humidity is estimated to positively influence on the chances of dengue occurrence by 1.71% times. Maximum temperature positively influence on the chances dengue occurrence by 19.48% times. Minimum temperature affects positively on the chances of dengue occurrence by 11.51% times. Wind speed is effecting negatively on the weekly occurrence of dengue fever by 7.41% times.

Keywords: principal component analysis, dengue fever, negative binomial regression model, poisson regression model

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1824 The Second Smallest Eigenvalue of Complete Tripartite Hypergraph

Authors: Alfi Y. Zakiyyah, Hanni Garminia, M. Salman, A. N. Irawati

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In the terminology of the hypergraph, there is a relation with the terminology graph. In the theory of graph, the edges connected two vertices. In otherwise, in hypergraph, the edges can connect more than two vertices. There is representation matrix of a graph such as adjacency matrix, Laplacian matrix, and incidence matrix. The adjacency matrix is symmetry matrix so that all eigenvalues is real. This matrix is a nonnegative matrix. The all diagonal entry from adjacency matrix is zero so that the trace is zero. Another representation matrix of the graph is the Laplacian matrix. Laplacian matrix is symmetry matrix and semidefinite positive so that all eigenvalues are real and non-negative. According to the spectral study in the graph, some that result is generalized to hypergraph. A hypergraph can be represented by a matrix such as adjacency, incidence, and Laplacian matrix. Throughout for this term, we use Laplacian matrix to represent a complete tripartite hypergraph. The aim from this research is to determine second smallest eigenvalues from this matrix and find a relation this eigenvalue with the connectivity of that hypergraph.

Keywords: connectivity, graph, hypergraph, Laplacian matrix

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1823 Psychological Sense of School Membership and Coping Ability as Predictors of Multidimensional Life Satisfaction among School Children

Authors: Mary Banke Iyabo Omoniyi

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Children in the developing countries have complex social, economic, political and environmental contexts that create a wide range of challenges for school children to surmount as they journey through school from childhood to adolescent. Many of these children have little or no personal resources and social support to confront these challenges. This study employed a descriptive research design of survey type to investigate the psychological sense of school membership and coping skills as they relate to the multidimensional life satisfaction of the school children. The sample consists of 835 school children with the age range of 7-11 years who were randomly selected from twenty schools in Ondo state, Nigeria. The instrument for data collection was a questionnaire consisting of 4 sections A, B, C and D. Section A contained items on the children’s bio-data (Age, School, father’s and mother’s educational qualifications), section B is the Multidimensional Children Life Satisfaction Questionnaire (MCLSQ) with a 20 item Likert type scale. The response format range from Never= 1 to Almost always =4. The (MCLSQ) was designed to provide profile of children satisfaction with important domains of (school, family and friends). Section C is the Psychological Sense of School Membership Questionnaire (PSSMQ) with 18 items having response format ranging from Not at true=1 to completely true=5. While section D is the Self-Report Coping Questionnaire (SRCQ) which has 16 items with response ranging from Never =1 to Always=5. The instrument has a test-retest reliability coefficient of r = 0.87 while the sectional reliabilities for MCLSQ, PSSMQ and SRCQ are 0.86, 0.92 and 0.89 respectively. The results indicated that self-report coping skill was significantly correlated with multidimensional life satisfaction (r=592;p<0.05). However, the correlation between multidimensional life satisfaction and psychological sense of school membership was not significant (r=0.038;p>0.05). The regression analysis indicated that the contribution of mother’s education and father’s education to psychological sense of school member of the children were 0.923, Adjusted R2 is 0.440 and 0.730 and Adjusted R2 is 0.446. The results also indicate that contribution of gender to psychological sense of school for male and female has R= 0.782, Adjusted R2 = 0.478 and R = 0.998, Adjusted R2 i= 0.932 respectively. In conclusion, mother’s education qualification was found to contribute more to children psychological sense of membership and multidimensional life satisfaction than father’s. The girl child was also found to have more sense of belonging to the school setting than boy child. The counselling implications and recommendations among others were geared towards positive emotional gender sensitivity with regards to the male folk. Education stakeholders are also encouraged to make the school environment more conducive and gender friendly.

Keywords: multidimensional life satisfaction, psychological sense of school, coping skills, counselling implications

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1822 UV Functionalised Short Implants as an Alternative to Avoid Crestal Sinus Lift Procedure: Controlled Case Series

Authors: Naira Ghambaryan, Gagik Hakobyan

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Purpose:The study was to evaluate the survival rate of short implants (5-6 mm) functionalized with UV radiation placed in the posterior segments of the atrophied maxilla. Materials and Methods:The study included 47 patients with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. A total of 64 short UV-functionalized implants and 62 standard implants over 10 mm in length were placed in patients. The clinical indices included the following parameters: ISQБ MBL, OHIP-G scale. Results: For short implants, the median ISQ at placement was 62.2 for primary stability, and the median ISQ at 5 months was 69.6 ISQ. For standart implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. Аfter 6 months mean MBL short implants 0.87 mm, after 1 year, 1.13 mm, after 5 year was 1.48 mm. Аfter 6 months, mean MBL standard implants 0.84 mm, after 1 year, 1.24 mm, after 5 year was 1.58 mm. Mean OHIP-G scores -patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative 5-year short implants rates was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Conclusions: Short implants with ultraviolet functionalization for prosthetic rehabilitation of the posterior resorbed maxilla region is a reliable, reasonable alternative to sinus lift, demonstrating fewer complications, satisfactory survival of a 5-year follow-up period, and reducing the number of additional surgical interventions and postoperative complications.

Keywords: short implant, ultraviolet functionalization, atrophic posterior maxilla, prosthodontic rehabilitation

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1821 Incidence, Risk Factors and Impact of Major Adverse Events Following Paediatric Cardiac Surgery

Authors: Sandipika Gupta

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Objective: Due to admirably low 30-day mortality rates for paediatric cardiac surgery, it is now pertinent to turn towards more intermediate-length outcomes such as morbidities closely associated with these surgeries. One such morbidity, major adverse events (MAE) comprises a group of adverse outcomes associated with paediatric cardiac surgery (e.g. cardiac arrest, major haemorrhage). Methods: This is a retrospective study that analysed the incidence and impact of MAE which was the primary outcome in the UK population. The data was collected in 5 centres between October 2015 and June 2017, amassing 3090 surgical episodes. The incidence and risk factors for MAE, were assessed through descriptive statistical analyses and multivariate logistic regression. The secondary outcomes of life status at 6 months and the length of hospital stay were also evaluated to understand the impact of MAE on patients. Results: Out of 3090 episodes, 134 (4.3%) had a postoperative MAE. The majority of the episodes were in: neonates (47%, P<0.001), high-risk cardiac diagnosis groups (20.1%, P<0.001), episodes with longer 5mes on the bypass (72.4%, P<0.001) and urgent surgeries (57.9%, P<0.001). Episodes reporting MAE also reported longer lengths of stay in hospital (29 days vs 9 days, P<0.001). Furthermore, patients experiencing MAE were at a higher risk of mortality at the 6-month life status check (mortality rates: 29.2% vs 2%, P<0.001).Conclusions: Key risk factors were identified. An important negative impact of MAE was found for patients. The identified risk factors could be used to profile and flag at-risk patients. Monitoring of MAE rates and closer investigation into the care pathway before and after individual MAEs in children’s heart units may lead to a reduction in these terrible events.

Keywords:

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1820 Incidence and Causes of Elective Surgery Cancellations in Songklanagarind Hospital, Thailand

Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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1819 Improving the Frequency Response of a Circular Dual-Mode Resonator with a Reconfigurable Bandwidth

Authors: Muhammad Haitham Albahnassi, Adnan Malki, Shokri Almekdad

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In this paper, a method for reconfiguring bandwidth in a circular dual-mode resonator is presented. The method concerns the optimized geometry of a structure that may be used to host the tuning elements, which are typically RF (Radio Frequency) switches. The tuning elements themselves, and their performance during tuning, are not the focus of this paper. The designed resonator is able to reconfigure its fractional bandwidth by adjusting the inter-coupling level between the degenerate modes, while at the same time improving its response by adjusting the external-coupling level and keeping the center frequency fixed. The inter-coupling level has been adjusted by changing the dimensions of the perturbation element, while the external-coupling level has been adjusted by changing one of the feeder dimensions. The design was arrived at via optimization. Agreeing simulation and measurement results of the designed and implemented filters showed good improvements in return loss values and the stability of the center frequency.

Keywords: dual-mode resonators, perturbation theory, reconfigurable filters, software defined radio, cognitine radio

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1818 Investigation of Influence of Maize Stover Components and Urea Treatment on Dry Matter Digestibility and Fermentation Kinetics Using in vitro Gas Techniques

Authors: Anon Paserakung, Chaloemphon Muangyen, Suban Foiklang, Yanin Opatpatanakit

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Improving nutritive values and digestibility of maize stover is an alternative way to increase their utilization in ruminant and reduce air pollution from open burning of maize stover in the northern Thailand. The present study, 2x3 factorial arrangements in completely randomized design was conducted to investigate the effect of maize stover components (whole and upper stover; cut above 5th node). Urea treatment at levels 0, 3, and 6% DM on dry matter digestibility and fermentation kinetics of maize stover using in vitro gas production. After 21 days of urea treatment, results illustrated that there was no interaction between maize stover components and urea treatment on 48h in vitro dry matter digestibility (IVDMD). IVDMD was unaffected by maize stover components (P > 0.05), average IVDMD was 55%. However, using whole maize stover gave higher cumulative gas and gas kinetic parameters than those of upper stover (P<0.05). Treating maize stover by ensiling with urea resulted in a significant linear increase in IVDMD (P<0.05). IVDMD increased from 42.6% to 53.9% when increased urea concentration from 0 to 3% and maximum IVDMD (65.1%) was observed when maize stover was ensiled with 6% urea. Maize stover treated with urea at levels of 0, 3, and 6% linearly increased cumulative gas production at 96h (31.1 vs 50.5 and 59.1 ml, respectively) and all gas kinetic parameters excepted the gas production from the immediately soluble fraction (P<0.50). The results indicate that maize stover treated with 6% urea enhance in vitro dry matter digestibility and fermentation kinetics. This study provides a practical approach to increasing utilization of maize stover in feeding ruminant animals.

Keywords: maize stover, urea treatment, ruminant feed, gas production

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1817 Inferring Influenza Epidemics in the Presence of Stratified Immunity

Authors: Hsiang-Yu Yuan, Marc Baguelin, Kin O. Kwok, Nimalan Arinaminpathy, Edwin Leeuwen, Steven Riley

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Traditional syndromic surveillance for influenza has substantial public health value in characterizing epidemics. Because the relationship between syndromic incidence and the true infection events can vary from one population to another and from one year to another, recent studies rely on combining serological test results with syndromic data from traditional surveillance into epidemic models to make inference on epidemiological processes of influenza. However, despite the widespread availability of serological data, epidemic models have thus far not explicitly represented antibody titre levels and their correspondence with immunity. Most studies use dichotomized data with a threshold (Typically, a titre of 1:40 was used) to define individuals as likely recently infected and likely immune and further estimate the cumulative incidence. Underestimation of Influenza attack rate could be resulted from the dichotomized data. In order to improve the use of serosurveillance data, here, a refinement of the concept of the stratified immunity within an epidemic model for influenza transmission was proposed, such that all individual antibody titre levels were enumerated explicitly and mapped onto a variable scale of susceptibility in different age groups. Haemagglutination inhibition titres from 523 individuals and 465 individuals during pre- and post-pandemic phase of the 2009 pandemic in Hong Kong were collected. The model was fitted to serological data in age-structured population using Bayesian framework and was able to reproduce key features of the epidemics. The effects of age-specific antibody boosting and protection were explored in greater detail. RB was defined to be the effective reproductive number in the presence of stratified immunity and its temporal dynamics was compared to the traditional epidemic model using use dichotomized seropositivity data. Deviance Information Criterion (DIC) was used to measure the fitness of the model to serological data with different mechanisms of the serological response. The results demonstrated that the differential antibody response with age was present (ΔDIC = -7.0). The age-specific mixing patterns with children specific transmissibility, rather than pre-existing immunity, was most likely to explain the high serological attack rates in children and low serological attack rates in elderly (ΔDIC = -38.5). Our results suggested that the disease dynamics and herd immunity of a population could be described more accurately for influenza when the distribution of immunity was explicitly represented, rather than relying only on the dichotomous states 'susceptible' and 'immune' defined by the threshold titre (1:40) (ΔDIC = -11.5). During the outbreak, RB declined slowly from 1.22[1.16-1.28] in the first four months after 1st May. RB dropped rapidly below to 1 during September and October, which was consistent to the observed epidemic peak time in the late September. One of the most important challenges for infectious disease control is to monitor disease transmissibility in real time with statistics such as the effective reproduction number. Once early estimates of antibody boosting and protection are obtained, disease dynamics can be reconstructed, which are valuable for infectious disease prevention and control.

Keywords: effective reproductive number, epidemic model, influenza epidemic dynamics, stratified immunity

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