Search results for: attack risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6562

Search results for: attack risk

4642 Using Analytics to Redefine Athlete Resilience

Authors: Phil P. Wagner

Abstract:

There is an overwhelming amount of athlete-centric information available for sport practitioners in this era of tech and big data, but protocols in athletic rehabilitation remain arbitrary. It is a common assumption that the rate at which tissue heals amongst individuals is the same; yielding protocols that are entirely time-based. Progressing athletes through rehab programs that lack individualization can potentially expose athletes to stimuli they are not prepared for or unnecessarily lengthen their recovery period. A 7-year aggregated and anonymous database was used to develop reliable and valid assessments to measure athletic resilience. Each assessment utilizes force plate technology with proprietary protocols and analysis to provide key thresholds for injury risk and recovery. Using a T score to analyze movement qualities, much like the Z score used for bone density from a Dexa scan, specific prescriptions are provided to mitigate the athlete’s inherent injury risk. In addition to obliging to surgical clearance, practitioners must put in place a clearance protocol guided by standardized assessments and achievement in strength thresholds. In order to truly hold individuals accountable (practitioners, athletic trainers, performance coaches, etc.), success in improving pre-defined key performance indicators must be frequently assessed and analyzed.

Keywords: analytics, athlete rehabilitation, athlete resilience, injury prediction, injury prevention

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4641 Geriatric Nutrition: An Important Marker for Oral Health Related Quality of Life of Complete Denture Patients

Authors: Rajlakshmi Banerjee, Sujoy Banerjee

Abstract:

The prevalence of malnutrition, as the most common cause of morbidity and mortality increases with old age, especially in developing countries like India, because of many factors out of which dentate status is one. It affects diet, nutritional status and general health due to reduced chewing ability and poor food choices. Aim and Objective: This study aimed to evaluate the effect of nutritional status, dietary intake on the Oral Health-related Quality of life (OHRQoL) of elderly edentulous complete denture wearing patients and to know whether they are at a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counselling during Prosthodontic rehabilitation of elderly edentulous patients. Materials and method: A cross-sectional study was conducted among 200 elderly denture wearing patients above 60 yrs of age from Nagpur, Maharashtra. The majority of study subjects (60%) were between the age group 60 and 75 years. Mini-Nutritional Assessment (MNA) Questionnaire was used to assess nutritional status and General Oral Health Assessment Index (GOHAI) questionnaire was used to determine the Oral health related Quality of life of these patients.Descriptive statistics was used to analyze data using SPSS version 21. Results: Among the assessed subjects, nearly 80% of them had total scores of GOHAI between 12 and 57 which require ‘needed dental care.’ As per MNA, 10.5% had adequate nutrition, 70 % were at risk of malnutrition, and remaining 19.5 % of subjects were malnourished. There was a significant correlation between GOHAI and MNA scores. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL.Conclusion: The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly and therefore severely affecting the quality of life. Dietary analysis and counselling should be strictly incorporated into geriatric treatment planning during Prosthetic rehabilitation.

Keywords: general oral health assessment index, General Oral Health Assessment Index (GOHAI), nutritional assessment, mini-nutritional assessment, Mini-Nutritional Assessment (MNA), quality of life

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4640 Managing the Magnetic Protection of Workers in Magnetic Resonance Imaging

Authors: Safoin Aktaou, Aya Al Masri, Kamel Guerchouche, Malorie Martin, Fouad Maaloul

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Introduction: In the ‘Magnetic Resonance Imaging (MRI)’ department, all workers involved in preparing the patient, setting it up, tunnel cleaning, etc. are likely to be exposed to ‘ElectroMagnetic fields (EMF)’ emitted by the MRI device. Exposure to EMF can cause adverse radio-biological effects to workers. The purpose of this study is to propose an organizational process to manage and control EMF risks. Materials and methods: The study was conducted at seven MRI departments using machines with 1.5 and 3 Tesla magnetic fields. We assessed the exposure of each one by measuring the two electromagnetic fields (static and dynamic) at different distances from the MRI machine both inside and around the examination room. Measurement values were compared with British and American references (those of the UK's ‘Medicines and Healthcare Regulatory Agency (MHRA)’ and the ‘American Radiology Society (ACR)’). Results: Following the results of EMF measurements and their comparison with the recommendations of learned societies, a zoning system that adapts to needs of different MRI services across the country has been proposed. In effect, three risk areas have been identified within the MRI services. This has led to the development of a good practice guide related to the magnetic protection of MRI workers. Conclusion: The guide established by our study is a standard that allows MRI workers to protect themselves against the risk of electromagnetic fields.

Keywords: comparison with international references, measurement of electromagnetic fields, magnetic protection of workers, magnetic resonance imaging

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4639 Longevity of Soybean Seeds Submitted to Different Mechanized Harvesting Conditions

Authors: Rute Faria, Digo Moraes, Amanda Santos, Dione Morais, Maria Sartori

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Seed vigor is a fundamental component for the good performance of the entire soybean production process. Seeds with mechanical damage at harvest time will be more susceptible to fungal and insect attack during storage, which will invariably reduce their vigor to the field, compromising uniformity and final stand performance. Harvesters, even the most modern ones, when not properly regulated or operated, can cause irreversible damages to the seeds, compromising even their commercialization. Therefore, the control of an efficient harvest is necessary in order to guarantee a good quality final product. In this work, the damage caused by two different harvesters (one rented, and another one) was evaluated, traveling in two speeds (4 and 8 km / h). The design was completely randomized in 2 x 2 factorial, with four replications. To evaluate the physiological quality seed germination and vigor tests were carried out over a period of six months. A multivariate analysis of Principal Components (PCA) and clustering allowed us to verify that the leased machine had better performance in the incidence of immediate damages in the seeds, but after a storage period of 6 months the vigor of these seeds reduced more than own machine evidencing that such a machine would bring more damages to the seeds.

Keywords: Glycine max (L.), cluster analysis, PCA, vigor

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4638 Age, Body Composition, Body Mass Index and Chronic Venous Diseases in Postmenopausal Women

Authors: Grygorii Kostromin, Vladyslav Povoroznyuk

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Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: chronic venous disease, risk factors, age, obesity, postmenopausal women

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4637 When Helping Hurts: Addressing Violence in Healthcare Settings

Authors: Jason Maffia, Maria D’urso, Robert Crupi, Margaret Cartmell

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The emotional aspects of traumatic events such as workplace violence are often ignored, causing low productivity, disillusionment, and resentment within an organization. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. This review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. It is essential that health care organizations are prepared physically and emotionally for traumatic situations. This study explores the theoretical nature of addressing work-related violence in healthcare settings as well as traumatic stress reactivity and the context within which reactions occur and recovery takes place. Cognitive, social, and organizational influences on response are identified and used to tentatively offer explanations for identifying security risks, development, and implementation of de-escalation teams, CISM programs and training staff in violence prevention are among strategies hospitals are employing to keep workers and patients safe. General conclusion regarding the implications for intervention effectiveness and design are discussed.

Keywords: healthcare settings, stress reactions, traumatic events, workplace violence

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4636 Anti-Obesity Effect of Cordyceps militaris Fermented Black Rice

Authors: Chih-Hung Liang, Jung-Jung Chen, Shen-Shih Chiang

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Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health, which are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Cordyceps militaris (CM) is a well-known traditional medicine in Asian countries and a rich source of biologically active components. Black rice (Oryza sativa L.) is a special cultivar of rice that contains rich anthocyanins and regarded as a health-promoting food in China and other Eastern. The aim of this study was to investigate the anti-obesity effect of Cordyceps militaris fermented black rice (CB) on HFD-induced BALB/c mice model. The results indicated that administration of low and high dosage of CB powder significantly reduced the body weights (7.38% and 7.78%), body fat ratio (2.37% and 2.78%), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels compared to the HF group (p<0.05). Histopathological analysis showed that the score of fatty liver in HF group (5.0) was significantly higher than CB groups (2.1 and 3.6) (p<0.05). In conclusion, Cordyceps militaris fermented black rice can reduce the body weight via inhibition of the fat accumulation in liver and body and possess the anti-obesity potency.

Keywords: Cordyceps militaris, black rice, obesity, HFD-induced mice

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4635 Children Protection in the Digital Space

Authors: Beverly Komen

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Online crimes have been on the rise in the recent days, especially with the hit of the covid-19 pandemic. The coronavirus pandemic has led to an unprecedented rise in screen time, this means more families are relying on technology and digital solutions to keep children learning, spending more time on the virtual platforms can leave children vulnerable to online abuse and exploitation. With ease access of affordable phones, internet, and increased online activities, all children are at risk of being abused online hence making the digital space unsafe for children. With these increased use of technology and its accessibility, children are at risk of facing challenges such as access to inappropriate content, online grooming, identity theft, cyber bullying, among other risks. The big question is; as we enjoy the benefits brought in by technology, how do we ensure that our children are save in this digital space? With the analysis of the current trends, there is a gap in knowledge on people’s understanding on child online protection and safety measures when using the digital space. A survey conducted among 50 parents in Nairobi in Kenya indicated that there is a gap in knowledge on online protection of children and over 50 % of the participants shared that for sure they have no idea on how to protect children online. This paper seeks to address the concept of child protection in the digital space and come up with viable solutions in protecting children from online vices.

Keywords: child protection, digital space, online risks, online grooming, cyber bulying, online child sexual exploitation, and abuse

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4634 D-Epi App: Mobile Application to Control Sodium Valproat Administration in Children with Idiopatic Epilepsy in Indonesia

Authors: Nyimas Annissa Mutiara Andini

Abstract:

There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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4633 Risk Management Approach for a Secure and Performant Integration of Automated Drug Dispensing Systems in Hospitals

Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, Hospitals, Human-centered automated system, Risk management

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4632 Studying the Effects of Conditional Conservatism and Lack of Information Asymmetry on the Cost of Capital of the Accepted Companies in Tehran Stock Exchange

Authors: Fayaz Moosavi, Saeid Moradyfard

Abstract:

One of the methods in avoiding management fraud and increasing the quality of financial information, is the notification of qualitative features of financial information, including conservatism characteristic. Although taking a conservatism approach, while boosting the quality of financial information, is able to reduce the informational risk and the cost of capital stock of commercial department, by presenting an improper image about the situation of the commercial department, raises the risk of failure in returning the main and capital interest, and consequently the cost of capital of the commercial department. In order to know if conservatism finally leads to the increase or decrease of the cost of capital or does not have any influence on it, information regarding accepted companies in Tehran stock exchange is utilized by application of pooling method from 2007 to 2012 and it included 124 companies. The results of the study revealed that there is an opposite and meaningful relationship between conditional conservatism and the cost of capital of the company. In other words, if bad and unsuitable news and signs are reflected sooner than good news in accounting profit, the cost of capital of the company increases. In addition, there is a positive and meaningful relationship between the cost of capital and lack of information asymmetry.

Keywords: conditional conservatism, lack of information asymmetry, the cost of capital, stock exchange

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4631 Incidence and Risk Factors of Traumatic Lumbar Puncture in Newborns in a Tertiary Care Hospital

Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

Abstract:

Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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4630 Prevalence of Seropositivity for Cytomegalovirus in Patients with Hereditary Bleeding Diseases in West Azerbaijan of Iran

Authors: Zakieh Rostamzadeh, Zahra Shirmohammadi

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Human cytomegalovirus is a species of the cytomegalovirus family of viruses, which in turn is a member of the viral family known as herpesviridae or herpesviruses. Although they may be found throughout the body, HCMV infections are frequently associated with the salivary glands. HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised such as HIV-infected persons, organ transplant recipients, or newborn infants. After infection, HCMV has an ability to remain latent within the body over long periods. Cytomegalovirus (CMV) causes infection in immunocompromised, hemophilia patients and those who received blood transfusion frequently. This study aimed at determining the prevalence of cytomegalovirus (CMV) antibodies in hemophilia patients. Materials and Methods: A retrospective observational study was carried out in Urmia, North West of Iran. The study population comprised a sample of 50 hemophilic patients born after 1985 and have received blood factors in West Azerbaijan. The exclusion criteria include: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling. All samples were evaluated with the method of ELISA, with a certain kind of kit and by a certain laboratory. Results: Fifty hemophiliacs from 250 patients registered with Urmia Hemophilia Society were enrolled in the study including 43 (86%) male, and 7 (14%) female. The mean age of patients was 10.3 years, range 3 to 25 years. None of patients had risk factors mentioned above. Among our studied population, 34(68%) had hemophilia A, 1 (2%) hemophilia B, 8 (16%) VWF, 3(6%) factor VII deficiency, 1 (2%) factor V deficiency, 1 (2%) factor X deficiency, 1 (2%). Sera of 50 Hemodialysis patients were investigated for CMV-specific immunoglobulin G (IgG) and IgM. % 91.89 patients were anti-CMV IgG positive and %40.54 was seropositive for anti-CMV IgM. 37.8% patient had serological evidence of reactivation and 2.7% of patients had the primary infection. Discussion: There was no relationship between the antibody titer and: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling.

Keywords: bioinformatics, biomedicine, cytomegalovirus, immunocompromise

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4629 The Effectiveness of Probiotics in the Treatment of Minimal Hepatic Encephalopathy Among Patients with Cirrhosis: An Expanded Meta-Analysis

Authors: Erwin Geroleo, Higinio Mappala

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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.

Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy

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4628 Aerodynamic Analysis of Dimple Effect on Aircraft Wing

Authors: E. Livya, G. Anitha, P. Valli

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The main objective of aircraft aerodynamics is to enhance the aerodynamic characteristics and maneuverability of the aircraft. This enhancement includes the reduction in drag and stall phenomenon. The airfoil which contains dimples will have comparatively less drag than the plain airfoil. Introducing dimples on the aircraft wing will create turbulence by creating vortices which delays the boundary layer separation resulting in decrease of pressure drag and also increase in the angle of stall. In addition, wake reduction leads to reduction in acoustic emission. The overall objective of this paper is to improve the aircraft maneuverability by delaying the flow separation point at stall and thereby reducing the drag by applying the dimple effect over the aircraft wing. This project includes both computational and experimental analysis of dimple effect on aircraft wing, using NACA 0018 airfoil. Dimple shapes of Semi-sphere, hexagon, cylinder, square are selected for the analysis; airfoil is tested under the inlet velocity of 30m/s at different angle of attack (5˚, 10˚, 15˚, 20˚, and 25˚). This analysis favours the dimple effect by increasing L/D ratio and thereby providing the maximum aerodynamic efficiency, which provides the enhanced performance for the aircraft.

Keywords: airfoil, dimple effect, turbulence, boundary layer separation

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4627 Postpartum Depression Screening and Referrals for Lower-Income Women in North Carolina, USA

Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

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4626 Towards an Adversary-Aware ML-Based Detector of Spam on Twitter Hashtags

Authors: Niddal Imam, Vassilios G. Vassilakis

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After analysing messages posted by health-related spam campaigns in Twitter Arabic hashtags, we found that these campaigns use unique hijacked accounts (we call them adversarial hijacked accounts) as adversarial examples to fool deployed ML-based spam detectors. Existing ML-based models build a behaviour profile for each user to detect hijacked accounts. This approach is not applicable for detecting spam in Twitter hashtags since they are computationally expensive. Hence, we propose an adversary-aware ML-based detector, which includes a newly designed feature (avg posts) to improve the detection of spam tweets posted by the adversarial hijacked accounts at a tweet-level in trending hashtags. The proposed detector was designed considering three key points: robustness, adaptability, and interpretability. The new feature leverages the account’s temporal patterns (i.e., account age and number of posts). It is faster to compute compared to features discussed in the literature and improves the accuracy of detecting the identified hijacked accounts by 73%.

Keywords: Twitter spam detection, adversarial examples, evasion attack, adversarial concept drift, account hijacking, trending hashtag

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4625 Reaction of Nine Candidate Wheat Lines/Mutants against Leaf Rust: Lodging and Aphid Population under Field Condition

Authors: Muhammad Mohsan, Mehboob Ur-Rahman, Sana Zulfiqar, Shumila Ashfaq

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Brown Rust (Puccinia triticina), also known as leaf rust, pose a serious threat to wheat cultivation in the world. Nine candidate wheat lines/mutants were subjected to rust inoculation, lodging and aphid population in vivo conditions. Four lines/mutants (E-284, E-505, 2008-6 MR and 2008-14MR) were found resistant to leaf rust attack. Two lines (PGMB 15-29 and 2011-1 MR) displayed moderately resistant reactions against the disease. Three lines/mutants were depicted as susceptible to leaf rust. The lowest population of aphids, i.e., 16.67, was observed on 2008-14MR. Three lines/mutants (NN1-47, NN1-89 and PGMB 15-29) were found under zero level of lodging. The presence and absence of different leaf rust-resistant genes like Lr13, Lr34, Lr46 and Lr67 were assessed with the help of molecular markers. All the wheat lines/mutants were found loaded with leaf rust-resistant genes such as Lr13 and Lr 34, while Lr46 and Lr67 were found in 66% of wheat lines/mutants. The resistant source can be exploited in the breeding program to develop rust, aphid and lodging with race-nonspecific resistant wheat variety.

Keywords: wheat, leaf rust, lodging, aphid

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4624 System Survivability in Networks

Authors: Asma Ben Yaghlane, Mohamed Naceur Azaiez

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We consider the problem of attacks on networks. We define the concept of system survivability in networks in the presence of intelligent threats. Our setting of the problem assumes a flow to be sent from one source node to a destination node. The attacker attempts to disable the network by preventing the flow to reach its destination while the defender attempts to identify the best path-set to use to maximize the chance of arrival of the flow to the destination node. Our concept is shown to be different from the classical concept of network reliability. We distinguish two types of network survivability related to the defender and to the attacker of the network, respectively. We prove that the defender-based-network survivability plays the role of a lower bound while the attacker-based-network survivability plays the role of an upper bound of network reliability. We also prove that both concepts almost never agree nor coincide with network reliability. Moreover, we use the shortest-path problem to determine the defender-based-network survivability and the min-cut problem to determine the attacker-based-network survivability. We extend the problem to a variety of models including the minimum-spanning-tree problem and the multiple source-/destination-network problems.

Keywords: defense/attack strategies, information, networks, reliability, survivability

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4623 Study on Metabolic and Mineral Balance, Oxidative Stress and Cardiovascular Risk Factors in Type 2 Diabetic Patients on Different Therapy

Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca

Abstract:

Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.

Keywords: cardiovascular risk, homocysteine, malondialdehyde, metformin, minerals, type 2 diabetes, vitamin B12

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4622 Use of a Laparoscopic Approach in Urgent Adhesive Small Bowel Obstructions

Authors: Nuhi Arslani, Aleks Brumec

Abstract:

Adhesive small bowel obstruction (ASBO) accounts for 20% of emergency surgical procedures and intraabdominal adhesions account for 65% of such cases. In a 10-year post-operative period of abdominal surgery patients, around 35% of them will be readmitted because of ASBO. The first step in approaching ASBOs is using the Bologna guidelines, which include a thorough initial evaluation to diagnose or rule out an ASBO and then proceed with either further imaging studies or emergency surgery, which can be either open or laparoscopic. The contraindications for a laparoscopic approach include hemodynamic instability of the patient and infections in the peritoneum or port sites. Studies have shown that a laparoscopic approach to adhesiolysis is linked with a significantly smaller risk of readmissions and reoperations as well as with faster recovery time and fewer postoperative infections, but has a higher risk of bowel injuries, so a careful selection of patients is required. Although studies favor a laparoscopic approach, many countries still prefer a laparotomy, often because a laparoscopic approach requires surgeons to be highly skilled in the procedure. In the US and UK, between 50 and 60% of surgeons would approach an ASBO with laparoscopy, while in Italy, this number is around 15% and it is most likely similar in Slovenia. We believe that in the right cases and in the right patients, a laparoscopic approach can be equally feasible for treating ASBOs and is associated with fewer intraoperative and postoperative complications.

Keywords: adhesive small bowel obstruction, laparoscopy, adhesions, adhesiolysis

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4621 A Saudi Woman with Tokophobia: A Case Report

Authors: Wid Kattan, Rahaf Albarraq

Abstract:

Background: Tokophobia is a pathological fear of pregnancy that can lead to the avoidance of childbirth. It is classified as primary or secondary. This report describes a patient with tokophobia, as well as her presentation, risk factors, comorbidities, and treatment. Case Presentation: A 43-year-old Saudi woman experienced tokophobia upon becoming pregnant for the fifth time. She was assessed in two clinical interviews by a consultant psychiatrist specializing in women’s mental health. In addition, she completed several questionnaires for assessment of different aspects of her mental health: overall depression, perinatal depression, generalized anxiety, maternal functioning, and fear of childbirth (FOC). Several risk factors and comorbidities that may have contributed to the development of tokophobia in this patient were discussed, including traumatic experiences in previous deliveries, the unplanned nature of the pregnancy, perinatal depression, and pronounced symptoms of anxiety. A collaborative decision to perform a C-section was made, in line with obstetric guidelines and good mental health practice. Full symptomatic recovery was achieved immediately after delivery. Conclusions: We hope to increase clinical awareness of the assessment and management of tokophobia, which is a relatively new concept and, as yet, understudied.

Keywords: tokophobia, fear of childbirth, mental health, anxiety, case report, depression, fear of delivery, psychiatry, cesarean section, perinatal depression

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4620 Molecular Electrostatic Potential in Z-3N(2-Ethoxyphenyl), 2-N'(2-Ethoxyphenyl) Imino Thiazolidin-4-one Molecule by Ab Initio and DFT Methods

Authors: Manel Boulakoud, Abdelkader Chouaih, Fodil Hamzaoui

Abstract:

In the present work we are interested in the determination of the Molecular electrostatic potential (MEP) in Z-3N(2-Ethoxyphenyl), 2-N’(2-Ethoxyphenyl) imino thiazolidin-4-one molecule by ab initio and Density Functional Theory (DFT) in the ground state. The MEP is related to the electronic density and is a very useful descriptor in understanding sites for electrophilic attack and nucleophilic reactions as well as hydrogen bonding interactions. First, geometry optimization was carried out using Hartree–Fock (HF) and DFT methods with 6-311G(d,p) basis set. In order to get more information on the molecule, its stability has been analyzed by natural bond orbital (NBO) analysis. Mulliken population analyses have been calculated. Finally, the molecular electrostatic potential (MEP) and HOMO-LUMO energy levels have been performed. The calculated HOMO and LUMO energies show also the charge transfer within the molecule. The energy gap obtained is about 4 eV which explain the stability of the studied compound. The obtained molecular electrostatic potential from the two methods confirms the nature of the electron charge transfer at the molecular shell and locate the electropositive part and the electronegative part in molecular scale of the title compound.

Keywords: DFT, ab initio, HOMO-LUMO, organic compounds

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4619 Risk Factors for Determining Anti-HBcore to Hepatitis B Virus Among Blood Donors

Authors: Tatyana Savchuk, Yelena Grinvald, Mohamed Ali, Ramune Sepetiene, Dinara Sadvakassova, Saniya Saussakova, Kuralay Zhangazieva, Dulat Imashpayev

Abstract:

Introduction. The problem of viral hepatitis B (HBV) takes a vital place in the global health system. The existing risk of HBV transmission through blood transfusions is associated with transfusion of blood taken from infected individuals during the “serological window” period or from patients with latent HBV infection, the marker of which is anti-HBcore. In the absence of information about other markers of hepatitis B, the presence of anti-HBcore suggests that a person may be actively infected or has suffered hepatitis B in the past and has immunity. Aim. To study the risk factors influencing the positive anti-HBcore indicators among the donor population. Materials and Methods. The study was conducted in 2021 in the Scientific and Production Center of Transfusiology of the Ministry of Healthcare in Kazakhstan. The samples taken from blood donors were tested for anti-HBcore, by CLIA on the Architect i2000SR (ABBOTT). A special questionnaire was developed for the blood donors’ socio-demographic characteristics. Statistical analysis was conducted by the R software (version 4.1.1, USA, 2021). Results.5709 people aged 18 to 66 years were included in the study, the proportion of men and women was 68.17% and 31.83%, respectively. The average age of the participants was 35.7 years. A weighted multivariable mixed effects logistic regression analysis showed that age (p<0.001), ethnicity (p<0.05), and marital status (p<0.05) were statistically associated with anti-HBcore positivity. In particular, analysis adjusting for gender, nationality, education, marital status, family history of hepatitis, blood transfusion, injections, and surgical interventions, with a one-year increase in age (adjOR=1.06, 95%CI:1.05-1.07), showed an 6% growth in odds of having anti-HBcore positive results. Those who were russian ethnicity (adjOR=0.65, 95%CI:0.46-0.93) and representatives of other nationality groups (adjOR=0.56, 95%CI:0.37-0.85) had lower odds of having anti-HBcore when compared to Kazakhs when controlling for other covariant variables. Among singles, the odds of having a positive anti-HBcore were lower by 29% (adjOR = 0.71, 95%CI:0.57-0.89) compared to married participants when adjusting for other variables. Conclusions.Kazakhstan is one of the countries with medium endemicity of HBV prevalence (2%-7%). Results of the study demonstrated the possibility to form a profile of risk factors (age, nationality, marital status). Taking into account the data, it is recommended to increase attention to donor questionnaires by adding leading questions and to improve preventive measures to prevent HBV. Funding. This research was supported by a grant from Abbott Laboratories.

Keywords: anti-HBcore, blood donor, donation, hepatitis B virus, occult hepatitis

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4618 The Influence of Attachment Style on Sexual Health Beliefs and Risk of Hypoactive Sexual Desire Disorder (HSDD) In Chinese Women

Authors: Luo Lan, Huang Jingjing, Li Huafang

Abstract:

Hypoactive sexual desire disorder (HSDD) was common in China, and Chinese women's sexual health-seeking behaviors were found to be mainly impeded by their psychological barriers. However, underlying mechanisms for such unhealthy sexual health attitudes and symptoms of HSDD were unknown. Many studies suggested the correlation between women's psychological barriers, HSDD and attachment style but had limitations, so this study further explored their relationship. Chinese women of childbearing age were recruited from May 2020 to December 2022 in Shanghai, China. The Revised Adult Attachment Scale (RAAS), the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO), a sexual health attitude questionnaire, and a psychiatric interview were administered. The analytic sample contained 279 women, of which 107 women were HSDD patients. Women with a fearful attachment style were found to be more likely to be unwilling to communicate sexual health (aOR 2.55, 95%CI 1.05-6.28) and feel ashamed of sexual health-related disorders (aOR 2.66, 95%CI 1.14-6.13). They are also linked with a higher risk of HSDD (aOR 3.25, 95%CI 1.35-8.12). Therefore, fearful attachment style should be given enough attention in the whole process of the diagnosis and treatment of HSDD and should be one of the focuses that guide sexual education.

Keywords: attachment style, hypoactive sexual desire disorder, attitude to health, sexual desire, sexual distress

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4617 Distribution of Maximum Loss of Fractional Brownian Motion with Drift

Authors: Ceren Vardar Acar, Mine Caglar

Abstract:

In finance, the price of a volatile asset can be modeled using fractional Brownian motion (fBm) with Hurst parameter H>1/2. The Black-Scholes model for the values of returns of an asset using fBm is given as, 〖Y_t=Y_0 e^((r+μ)t+σB)〗_t^H, 0≤t≤T where Y_0 is the initial value, r is constant interest rate, μ is constant drift and σ is constant diffusion coefficient of fBm, which is denoted by B_t^H where t≥0. Black-Scholes model can be constructed with some Markov processes such as Brownian motion. The advantage of modeling with fBm to Markov processes is its capability of exposing the dependence between returns. The real life data for a volatile asset display long-range dependence property. For this reason, using fBm is a more realistic model compared to Markov processes. Investors would be interested in any kind of information on the risk in order to manage it or hedge it. The maximum possible loss is one way to measure highest possible risk. Therefore, it is an important variable for investors. In our study, we give some theoretical bounds on the distribution of maximum possible loss of fBm. We provide both asymptotical and strong estimates for the tail probability of maximum loss of standard fBm and fBm with drift and diffusion coefficients. In the investment point of view, these results explain, how large values of possible loss behave and its bounds.

Keywords: maximum drawdown, maximum loss, fractional brownian motion, large deviation, Gaussian process

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4616 Small Molecule Inhibitors of PD1-PDL1 Interaction

Authors: K. Żak, S. Przetocka, R. Kitel, K. Guzik, B. Musielak, S. Malicki, G. Dubin, T. A. Holak

Abstract:

Studies on tumor genesis revealed a number of factors that may potentially serve as molecular targets for immunotherapies. One of such promising targets are PD1 and PDL1 proteins. PD1 (Programmed cell death protein 1) is expressed by activated T cells and plays a critical role in modulation of the host's immune response. One of the PD1 ligands -PDL1- is expressed by macrophages, monocytes and cancer cells which exploit it to avoid immune attack. The notion of the mechanisms used by cancer cells to block the immune system response was utilized in the development of therapies blocking PD1-PDL1 interaction. Up to date, human PD1-PDL1 complex has not been crystallized and structure of the mouse-human complex does not provide a complete view of the molecular basis of PD1-PDL1 interactions. The purpose of this study is to obtain crystal structure of the human PD1-PDL1 complex which shall allow rational design of small molecule inhibitors of the interaction. In addition, the study presents results of binding small-molecules to PD1 and fragment docking towards PD1 protein which will facilitate the design and development of small–molecule inhibitors of PD1-PDL1 interaction.

Keywords: PD1, PDL1, cancer, small molecule, drug discovery

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4615 Financing from Customers for SMEs and Managing Financial Risks: The Role of Customer Relationships

Authors: Yongsheng Guo, Mengyu Lu

Abstract:

This study investigates how Chinese SMEs manage financial risks in financing from customers from the perspectives of ethics and national culture. A grounded theory approach is adopted to identify the causal conditions, actions/interactions, and consequences. 32 interviews were conducted, and systematic coding methods were used to identify themes and categories. This study found that Chinese ethical principles, including integrity, friendship, and reciprocity, and cultural traits, including collectivism, acquaintance society, and long-term orientation, provide conditions for financing from customers. The SMEs establish trust-based relationships with customers through personal communications and social networks and reduce financial risk through diversification, frequent operations, and enterprise reputations. Both customers and SMEs can get benefits like financial resources and customer experiences. This study creates a theoretical framework that connects the causal conditions, processes, and outcomes, providing a deeper understanding of financing from customers. A resource and process capability theory of SMEs and a customer capital and customer value model are proposed to connect accounting and finance concepts. Suggestions are proposed for the authorities as more guidance and regulations are needed for this informal finance.

Keywords: CRM, culture, ethics, SME, risk management

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4614 Prediction of Trailing-Edge Noise under Adverse-Pressure Gradient Effect

Authors: Li Chen

Abstract:

For an aerofoil or hydrofoil in high Reynolds number flows, broadband noise is generated efficiently as the result of the turbulence convecting over the trailing edge. This noise can be related to the surface pressure fluctuations, which can be predicted by either CFD or empirical models. However, in reality, the aerofoil or hydrofoil often operates at an angle of attack. Under this situation, the flow is subjected to an Adverse-Pressure-Gradient (APG), and as a result, a flow separation may occur. This study is to assess trailing-edge noise models for such flows. In the present work, the trailing-edge noise from a 2D airfoil at 6 degree of angle of attach is investigated. Under this condition, the flow is experiencing a strong APG, and the flow separation occurs. The flow over the airfoil with a chord of 300 mm, equivalent to a Reynold Number 4x10⁵, is simulated using RANS with the SST k-ɛ turbulent model. The predicted surface pressure fluctuations are compared with the published experimental data and empirical models, and show a good agreement with the experimental data. The effect of the APG on the trailing edge noise is discussed, and the associated trailing edge noise is calculated.

Keywords: aero-acoustics, adverse-pressure gradient, computational fluid dynamics, trailing-edge noise

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4613 South Asia’s Political Landscape: Precipitating Terrorism

Authors: Saroj Kumar Rath

Abstract:

India's Muslims represent 15 percent of the nation's population, the world's third largest group in any nation after Indonesia and Pakistan. Extremist groups like the Islamic State, Al Qaeda, the Taliban and the Haqqani network increasingly view India as a target. Several trends explain the rise: Terrorism threats in South Asia are linked and mobile - if one source is batted down, jihadists relocate to find another Islamic cause. As NATO withdraws from Afghanistan, some jihadists will eye India. Pakistan regards India as a top enemy and some officials even encourage terrorists to target areas like Kashmir or Mumbai. Meanwhile, a stream of Wahhabi preachers have visited India, offering hard-line messages; extremist groups like Al Qaeda and the Islamic State compete for influence, and militants even pay jihadists. Muslims as a minority population in India could offer fertile ground for the extremist recruiters. This paper argues that there is an urgent need for the Indian government to profile militants and examine social media sites to attack Wahhabi indoctrination while supporting education and entrepreneurship for all of India's citizens.

Keywords: Al Qaeda, terrorism, Islamic state, India, haqqani network, Pakistan, Taliban

Procedia PDF Downloads 617