Search results for: artificial intelligence ethics
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3091

Search results for: artificial intelligence ethics

571 Formation of an Artificial Cultural and Language Environment When Teaching a Foreign Language in the Material of Original Films

Authors: Konysbek Aksaule

Abstract:

The purpose of this work is to explore new and effective ways of teaching English to students who are studying a foreign language since the timeliness of the problem disclosed in this article is due to the high level of English proficiency that potential specialists must have due to high competition in the context of global globalization. The article presents an analysis of the feasibility and effectiveness of using an authentic feature film in teaching English to students. The methodological basis of the study includes an assessment of the level of students' proficiency in a foreign language, the stage of evaluating the film, and the method of selecting the film for certain categories of students. The study also contains a list of practical tasks that can be applied in the process of viewing and perception of an original feature film in a foreign language, and which are aimed at developing language skills such as speaking and listening. The results of this study proved that teaching English to students through watching an original film is one of the most effective methods because it improves speech perception, speech reproduction ability, and also expands the vocabulary of students and makes their speech fluent. In addition, learning English through watching foreign films has a huge impact on the cultural views and knowledge of students about the country of the language being studied and the world in general. Thus, this study demonstrates the high potential of using authentic feature film in English lessons for pedagogical science and methods of teaching English in general.

Keywords: university, education, students, foreign language, feature film

Procedia PDF Downloads 136
570 Statistical Time-Series and Neural Architecture of Malaria Patients Records in Lagos, Nigeria

Authors: Akinbo Razak Yinka, Adesanya Kehinde Kazeem, Oladokun Oluwagbenga Peter

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Time series data are sequences of observations collected over a period of time. Such data can be used to predict health outcomes, such as disease progression, mortality, hospitalization, etc. The Statistical approach is based on mathematical models that capture the patterns and trends of the data, such as autocorrelation, seasonality, and noise, while Neural methods are based on artificial neural networks, which are computational models that mimic the structure and function of biological neurons. This paper compared both parametric and non-parametric time series models of patients treated for malaria in Maternal and Child Health Centres in Lagos State, Nigeria. The forecast methods considered linear regression, Integrated Moving Average, ARIMA and SARIMA Modeling for the parametric approach, while Multilayer Perceptron (MLP) and Long Short-Term Memory (LSTM) Network were used for the non-parametric model. The performance of each method is evaluated using the Mean Absolute Error (MAE), R-squared (R2) and Root Mean Square Error (RMSE) as criteria to determine the accuracy of each model. The study revealed that the best performance in terms of error was found in MLP, followed by the LSTM and ARIMA models. In addition, the Bootstrap Aggregating technique was used to make robust forecasts when there are uncertainties in the data.

Keywords: ARIMA, bootstrap aggregation, MLP, LSTM, SARIMA, time-series analysis

Procedia PDF Downloads 63
569 Calcium Biochemical Indicators in a Group of Schoolchildren with Low Socioeconomic Status from Barranquilla, Colombia

Authors: Carmiña L. Vargas-Zapata, María A. Conde-Sarmiento, Maria Consuelo Maestre-Vargas

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Calcium is an essential element for good growth and development of the organism, and its requirement is increased at school age. Low socio-economic populations of developing countries such as Colombia may have food deficiency of this mineral in schoolchildren that could be reflected in calcium biochemical indicators, bone alterations and anthropometric indicators. The objective of this investigation was to evaluate some calcium biochemical indicators in a group of schoolchildren of low socioeconomic level from Barranquilla city and to correlate with body mass index. 60 schoolchildren aged 7 to 15 years were selected from Jesus’s Heart Educational Institution in Barranquilla-Atlántico, apparently healthy, without suffering from infectious or gastrointestinal diseases, without habits of drinking alcohol or smoking another hallucinogenic substance and without taking supplementation with calcium in the last six months or another substance that compromises bone metabolism. The research was approved by the ethics committee at Universidad del Atlántico. The selected children were invited to donate a blood and urine sample in a fasting time of 12 hours, the serum was separated by centrifugation and frozen at ˗20 ℃ until analyzed and the same was done with the urine sample. On the day of the biological collections, the weight and height of the students were measured to determine the nutritional status by BMI using the WHO tables. Calcium concentrations in serum and urine (SCa, UCa), alkaline phosphatase activity total and of bone origin (SAPT, SBAP) and urinary creatinine (UCr) were determined by spectrophotometric methods using commercial kits. Osteocalcin and Cross-linked N-telopeptides of type I collagen (NTx-1) in serum were measured with an enzyme-linked inmunosorbent assay. For statistical analysis the Statgraphics software Centurium XVII was used. 63% (n = 38) and 37% (n = 22) of the participants were male and female, respectively. 78% (n = 47), 5% (n = 3) and 17% (n = 10) had a normal, malnutrition and high nutritional status, respectively. The averages of evaluated indicators levels were (mean ± SD): 9.50 ± 1.06 mg/dL for SCa; 181.3 ± 64.3 U/L for SAPT, 143.8 ± 73.9 U/L for SBAP; 9.0 ± 3.48 ng/mL for osteocalcin and 101.3 ± 12.8 ng/mL for NTx-1. UCa level was 12.8 ± 7.7 mg/dL that adjusted with creatinine ranged from 0.005 to 0.395 mg/mg. Considering serum calcium values, approximately 7% of school children were hypocalcemic, 16% hypercalcemic and 77% normocalcemic. The indicators evaluated did not correlate with the BMI. Low values ​​were observed in calcium urinary excretion and high in NTx-1, suggesting that mechanisms such as increase in renal retention of calcium and in bone remodeling may be contributing to calcium homeostasis.

Keywords: calcium, calcium biochemical, indicators, school children, low socioeconomic status

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568 Enhancing the Pricing Expertise of an Online Distribution Channel

Authors: Luis N. Pereira, Marco P. Carrasco

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Dynamic pricing is a revenue management strategy in which hotel suppliers define, over time, flexible and different prices for their services for different potential customers, considering the profile of e-consumers and the demand and market supply. This means that the fundamentals of dynamic pricing are based on economic theory (price elasticity of demand) and market segmentation. This study aims to define a dynamic pricing strategy and a contextualized offer to the e-consumers profile in order to improve the number of reservations of an online distribution channel. Segmentation methods (hierarchical and non-hierarchical) were used to identify and validate an optimal number of market segments. A profile of the market segments was studied, considering the characteristics of the e-consumers and the probability of reservation a room. In addition, the price elasticity of demand was estimated for each segment using econometric models. Finally, predictive models were used to define rules for classifying new e-consumers into pre-defined segments. The empirical study illustrates how it is possible to improve the intelligence of an online distribution channel system through an optimal dynamic pricing strategy and a contextualized offer to the profile of each new e-consumer. A database of 11 million e-consumers of an online distribution channel was used in this study. The results suggest that an appropriate policy of market segmentation in using of online reservation systems is benefit for the service suppliers because it brings high probability of reservation and generates more profit than fixed pricing.

Keywords: dynamic pricing, e-consumers segmentation, online reservation systems, predictive analytics

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567 Extension Services' Needs of Small Farmers in Biliran Province, Philippines

Authors: Mario C. Nierras

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This study aimed to determine the extension services’ needs of small farmers in Biliran province, Philippines. It also sought to find out other issues/concerns of the small farmers. Extension services’ needs of small farmers were gathered through personal interviewing and observational analysis of randomly-selected small farmers in Biliran, Philippines. Biliran small farmers extension services’ needs include: raising fruits, raising legumes, raising vegetables, raising swine, raising cattle, and raising chicken (as priority broad skills). For the specific skills, diagnosing symptoms on fertilizer deficiencies, controlling plant pests and diseases, diagnosing signs on specific pest and disease damage, controlling animal pests and diseases, and doing artificial insemination were the priority skills. They considered an on-farm trial of new technology as most needed to be coupled with industry and quality-orientedness, as positive behaviors needed in farming success. The farmers still adhere to the so-called wait-and-see attitude, thus they are more convinced to follow a particular technology if they see a concrete result of the introduced changes. Technical needs prioritization of Biliran small farmers showed that they have a real need for crop and animal production skills to include the other issues/concerns. Extension service program planning for small farmers should be patterned after their technical needs giving due attention to some issues/concerns so that extension work could deliver the right skills for the right needs of the farmers.

Keywords: extension, extension service, extension service needs, extension service program, farmers, small farmers, marginal farmers

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566 Human Immunodeficiency Virus (HIV) Test Predictive Modeling and Identify Determinants of HIV Testing for People with Age above Fourteen Years in Ethiopia Using Data Mining Techniques: EDHS 2011

Authors: S. Abera, T. Gidey, W. Terefe

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Introduction: Testing for HIV is the key entry point to HIV prevention, treatment, and care and support services. Hence, predictive data mining techniques can greatly benefit to analyze and discover new patterns from huge datasets like that of EDHS 2011 data. Objectives: The objective of this study is to build a predictive modeling for HIV testing and identify determinants of HIV testing for adults with age above fourteen years using data mining techniques. Methods: Cross-Industry Standard Process for Data Mining (CRISP-DM) was used to predict the model for HIV testing and explore association rules between HIV testing and the selected attributes among adult Ethiopians. Decision tree, Naïve-Bayes, logistic regression and artificial neural networks of data mining techniques were used to build the predictive models. Results: The target dataset contained 30,625 study participants; of which 16, 515 (53.9%) were women. Nearly two-fifth; 17,719 (58%), have never been tested for HIV while the rest 12,906 (42%) had been tested. Ethiopians with higher wealth index, higher educational level, belonging 20 to 29 years old, having no stigmatizing attitude towards HIV positive person, urban residents, having HIV related knowledge, information about family planning on mass media and knowing a place where to get testing for HIV showed an increased patterns with respect to HIV testing. Conclusion and Recommendation: Public health interventions should consider the identified determinants to promote people to get testing for HIV.

Keywords: data mining, HIV, testing, ethiopia

Procedia PDF Downloads 477
565 Ethicality of Algorithmic Pricing and Consumers’ Resistance

Authors: Zainab Atia, Hongwei He, Panagiotis Sarantopoulos

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Over the past few years, firms have witnessed a massive increase in sophisticated algorithmic deployment, which has become quite pervasive in today’s modern society. With the wide availability of data for retailers, the ability to track consumers using algorithmic pricing has become an integral option in online platforms. As more companies are transforming their businesses and relying more on massive technological advancement, pricing algorithmic systems have brought attention and given rise to its wide adoption, with many accompanying benefits and challenges to be found within its usage. With the overall aim of increasing profits by organizations, algorithmic pricing is becoming a sound option by enabling suppliers to cut costs, allowing better services, improving efficiency and product availability, and enhancing overall consumer experiences. The adoption of algorithms in retail has been pioneered and widely used in literature across varied fields, including marketing, computer science, engineering, economics, and public policy. However, what is more, alarming today is the comprehensive understanding and focus of this technology and its associated ethical influence on consumers’ perceptions and behaviours. Indeed, due to algorithmic ethical concerns, consumers are found to be reluctant in some instances to share their personal data with retailers, which reduces their retention and leads to negative consumer outcomes in some instances. This, in its turn, raises the question of whether firms can still manifest the acceptance of such technologies by consumers while minimizing the ethical transgressions accompanied by their deployment. As recent modest research within the area of marketing and consumer behavior, the current research advances the literature on algorithmic pricing, pricing ethics, consumers’ perceptions, and price fairness literature. With its empirical focus, this paper aims to contribute to the literature by applying the distinction of the two common types of algorithmic pricing, dynamic and personalized, while measuring their relative effect on consumers’ behavioural outcomes. From a managerial perspective, this research offers significant implications that pertain to providing a better human-machine interactive environment (whether online or offline) to improve both businesses’ overall performance and consumers’ wellbeing. Therefore, by allowing more transparent pricing systems, businesses can harness their generated ethical strategies, which fosters consumers’ loyalty and extend their post-purchase behaviour. Thus, by defining the correct balance of pricing and right measures, whether using dynamic or personalized (or both), managers can hence approach consumers more ethically while taking their expectations and responses at a critical stance.

Keywords: algorithmic pricing, dynamic pricing, personalized pricing, price ethicality

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564 Comparison of the Effects of Alprazolam and Zaleplon on Anxiety Levels in Patients Undergoing Abdominal Gynecological Surgery

Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

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Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

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563 Radio Frequency Identification Device Based Emergency Department Critical Care Billing: A Framework for Actionable Intelligence

Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

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Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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562 Wind Speed Forecasting Based on Historical Data Using Modern Prediction Methods in Selected Sites of Geba Catchment, Ethiopia

Authors: Halefom Kidane

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This study aims to assess the wind resource potential and characterize the urban area wind patterns in Hawassa City, Ethiopia. The estimation and characterization of wind resources are crucial for sustainable urban planning, renewable energy development, and climate change mitigation strategies. A secondary data collection method was used to carry out the study. The collected data at 2 meters was analyzed statistically and extrapolated to the standard heights of 10-meter and 30-meter heights using the power law equation. The standard deviation method was used to calculate the value of scale and shape factors. From the analysis presented, the maximum and minimum mean daily wind speed at 2 meters in 2016 was 1.33 m/s and 0.05 m/s in 2017, 1.67 m/s and 0.14 m/s in 2018, 1.61m and 0.07 m/s, respectively. The maximum monthly average wind speed of Hawassa City in 2016 at 2 meters was noticed in the month of December, which is around 0.78 m/s, while in 2017, the maximum wind speed was recorded in the month of January with a wind speed magnitude of 0.80 m/s and in 2018 June was maximum speed which is 0.76 m/s. On the other hand, October was the month with the minimum mean wind speed in all years, with a value of 0.47 m/s in 2016,0.47 in 2017 and 0.34 in 2018. The annual mean wind speed was 0.61 m/s in 2016,0.64, m/s in 2017 and 0.57 m/s in 2018 at a height of 2 meters. From extrapolation, the annual mean wind speeds for the years 2016,2017 and 2018 at 10 heights were 1.17 m/s,1.22 m/s, and 1.11 m/s, and at the height of 30 meters, were 3.34m/s,3.78 m/s, and 3.01 m/s respectively/Thus, the site consists mainly primarily classes-I of wind speed even at the extrapolated heights.

Keywords: artificial neural networks, forecasting, min-max normalization, wind speed

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561 A Neural Network Approach for an Automatic Detection and Localization of an Open Phase Circuit of a Five-Phase Induction Machine Used in a Drivetrain of an Electric Vehicle

Authors: Saad Chahba, Rabia Sehab, Ahmad Akrad, Cristina Morel

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Nowadays, the electric machines used in urban electric vehicles are, in most cases, three-phase electric machines with or without a magnet in the rotor. Permanent Magnet Synchronous Machine (PMSM) and Induction Machine (IM) are the main components of drive trains of electric and hybrid vehicles. These machines have very good performance in healthy operation mode, but they are not redundant to ensure safety in faulty operation mode. Faced with the continued growth in the demand for electric vehicles in the automotive market, improving the reliability of electric vehicles is necessary over the lifecycle of the electric vehicle. Multiphase electric machines respond well to this constraint because, on the one hand, they have better robustness in the event of a breakdown (opening of a phase, opening of an arm of the power stage, intern-turn short circuit) and, on the other hand, better power density. In this work, a diagnosis approach using a neural network for an open circuit fault or more of a five-phase induction machine is developed. Validation on the simulator of the vehicle drivetrain, at reduced power, is carried out, creating one and more open circuit stator phases showing the efficiency and the reliability of the new approach to detect and to locate on-line one or more open phases of a five-induction machine.

Keywords: electric vehicle drivetrain, multiphase drives, induction machine, control, open circuit (OC) fault diagnosis, artificial neural network

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560 Benefits of Collegial Teaming to Improve Knowledge-Worker Productivity

Authors: Prakash Singh, Piet Maphodisa Kgohlo

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Knowledge-worker productivity is one of the biggest leadership challenges facing all organizations in the twenty-first century. It cannot be denied that knowledge-worker productivity affects all organizations. The work and the workforce are both undergoing greater changes currently than at any time, since the beginning of the industrial revolution two centuries ago. Employees welcome collegial teaming (CT) as an innovative way to develop their work-integrated learning competencies. Human resource development policies must evoke the symbiotic relationship between CT and work-integrated learning, seeing that employees need to be endowed with the competence to move from one skill to another, as each one becomes obsolete, and to simultaneously develop their cognitive and emotional intelligence. The outcome of this relationship must culminate in the development of highly productive knowledge-workers. While this study focuses on teachers, the conceptual framework and the findings of this research can be beneficial for any organization, public or private sector, business or non-business. Therefore, in this quantitative study, the benefits of CT are considered in developing human resources to sustain knowledge-worker productivity. The ANOVA p-values reveal that the majority of teachers agree that CT can empower them to overcome the challenges of managing curriculum change. CT can equip them with continuous and sustained learning, growth and improvement, necessary for knowledge-worker productivity. This study, therefore, confirms that CT benefits all workers, immaterial of their age, gender or experience. Hence, this exploratory research provides a new perspective of CT in addressing knowledge-worker productivity when organizational change alters the vision of the organization.

Keywords: collegial teaming, human resource development, knowledge-worker productivity, work-integrated learning

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559 Links between Inflammation and Insulin Resistance in Children with Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a clinical state associated with low-grade inflammation. It is also a major risk factor for insulin resistance (IR). In its advanced stages, metabolic syndrome (MetS), a much more complicated disease which may lead to life-threatening problems, may develop. Obesity-mediated IR seems to correlate with the inflammation. Human studies performed particularly on pediatric population are scarce. The aim of this study is to detect possible associations between inflammation and IR in terms of some related ratios. 549 children were grouped according to their age- and sex-based body mass index (BMI) percentile tables of WHO. MetS components were determined. Informed consent and approval from the Ethics Committee for Clinical Investigations were obtained. The principles of the Declaration of Helsinki were followed. The exclusion criteria were infection, inflammation, chronic diseases and those under drug treatment. Anthropometric measurements were obtained. Complete blood cell, fasting blood glucose, insulin, and C-reactive protein (CRP) analyses were performed. Homeostasis model assessment of insulin resistance (HOMA-IR), systemic immune inflammation (SII) index, tense index, alanine aminotransferase to aspartate aminotransferase ratio (ALT/AST), neutrophils to lymphocyte (NLR), platelet to lymphocyte, and lymphocyte to monocyte ratios were calculated. Data were evaluated by statistical analyses. The degree for statistical significance was 0.05. Statistically significant differences were found among the BMI values of the groups (p < 0.001). Strong correlations were detected between the BMI and waist circumference (WC) values in all groups. Tense index values were also correlated with both BMI and WC values in all groups except overweight (OW) children. SII index values of children with normal BMI were significantly different from the values obtained in OW, obese, morbid obese and MetS groups. Among all the other lymphocyte ratios, NLR exhibited a similar profile. Both HOMA-IR and ALT/AST values displayed an increasing profile from N towards MetS3 group. BMI and WC values were correlated with HOMA-IR and ALT/AST. Both in morbid obese and MetS groups, significant correlations between CRP versus SII index as well as HOMA-IR versus ALT/AST were found. ALT/AST and HOMA-IR values were correlated with NLR in morbid obese group and with SII index in MetS group, (p < 0.05), respectively. In conclusion, these findings showed that some parameters may exhibit informative differences between the early and late stages of obesity. Important associations among HOMA-IR, ALT/AST, NLR and SII index have come to light in the morbid obese and MetS groups. This study introduced the SII index and NLR as important inflammatory markers for the discrimination of normal and obese children. Interesting links were observed between inflammation and IR in morbid obese children and those with MetS, both being late stages of obesity.

Keywords: children, inflammation, insulin resistance, metabolic syndrome, obesity

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558 The Misuse of Social Media in Order to Exploit "Generation Y"; The Tactics of IS

Authors: Ali Riza Perçin, Eser Bingül

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Internet technologies have created opportunities with which people share their ideologies, thoughts and products. This virtual world, named social media has given the chance of gathering individual users and people from the world's remote locations and establishing an interaction between them. However, to an increasingly higher degree terrorist organizations today use the internet and most notably social-network media to create the effects they desire through a series of on-line activities. These activities, designed to support their activities, include information collection (intelligence), target selection, propaganda, fundraising and recruitment to name a few. Meanwhile, these have been used as the most important tool for recruitment especially from the different region of the world, especially disenfranchised youth, in the West in order to mobilize support and recruit “foreign fighters.” The recruits have obtained the statue, which is not accessible in their society and have preferred the style of life that is offered by the terrorist organizations instead of their current life. Like other terrorist groups, for a while now the terrorist organization Islamic State (IS) in Iraq and Syria has employed a social-media strategy in order to advance their strategic objectives. At the moment, however, IS seems to be more successful in their on-line activities than other similar organizations. IS uses social media strategically as part of its armed activities and for the sustainability of their military presence in Syria and Iraq. In this context, “Generation Y”, which could exist at the critical position and undertake active role, has been examined. Additionally, the explained characteristics of “Generation Y” have been put forward and the duties of families and society have been stated as well.

Keywords: social media, "generation Y", terrorist organization, islamic state IS

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557 A Proposal for an Excessivist Social Welfare Ordering

Authors: V. De Sandi

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In this paper, we characterize a class of rank-weighted social welfare orderings that we call ”Excessivist.” The Excessivist Social Welfare Ordering (eSWO) judges incomes above a fixed threshold θ as detrimental to society. To accomplish this, the identification of a richness or affluence line is necessary. We employ a fixed, exogenous line of excess. We define an eSWF in the form of a weighted sum of individual’s income. This requires introducing n+1 vectors of weights, one for all possible numbers of individuals below the threshold. To do this, the paper introduces a slight modification of the class of rank weighted class of social welfare function. Indeed, in our excessivist social welfare ordering, we allow the weights to be both positive (for individuals below the line) and negative (for individuals above). Then, we introduce ethical concerns through an axiomatic approach. The following axioms are required: continuity above and below the threshold (Ca, Cb), anonymity (A), absolute aversion to excessive richness (AER), pigou dalton positive weights preserving transfer (PDwpT), sign rank preserving full comparability (SwpFC) and strong pareto below the threshold (SPb). Ca, Cb requires that small changes in two income distributions above and below θ do not lead to changes in their ordering. AER suggests that if two distributions are identical in any respect but for one individual above the threshold, who is richer in the first, then the second should be preferred by society. This means that we do not care about the waste of resources above the threshold; the priority is the reduction of excessive income. According to PDwpT, a transfer from a better-off individual to a worse-off individual despite their relative position to the threshold, without reversing their ranks, leads to an improved distribution if the number of individuals below the threshold is the same after the transfer or the number of individuals below the threshold has increased. SPb holds only for individuals below the threshold. The weakening of strong pareto and our ethics need to be justified; we support them through the notion of comparative egalitarianism and income as a source of power. SwpFC is necessary to ensure that, following a positive affine transformation, an individual does not become excessively rich in only one distribution, thereby reversing the ordering of the distributions. Given the axioms above, we can characterize the class of the eSWO, getting the following result through a proof by contradiction and exhaustion: Theorem 1. A social welfare ordering satisfies the axioms of continuity above and below the threshold, anonymity, sign rank preserving full comparability, aversion to excessive richness, Pigou Dalton positive weight preserving transfer, and strong pareto below the threshold, if and only if it is an Excessivist-social welfare ordering. A discussion about the implementation of different threshold lines reviewing the primary contributions in this field follows. What the commonly implemented social welfare functions have been overlooking is the concern for extreme richness at the top. The characterization of Excessivist Social Welfare Ordering, given the axioms above, aims to fill this gap.

Keywords: comparative egalitarianism, excess income, inequality aversion, social welfare ordering

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556 An Application of Path Planning Algorithms for Autonomous Inspection of Buried Pipes with Swarm Robots

Authors: Richard Molyneux, Christopher Parrott, Kirill Horoshenkov

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This paper aims to demonstrate how various algorithms can be implemented within swarms of autonomous robots to provide continuous inspection within underground pipeline networks. Current methods of fault detection within pipes are costly, time consuming and inefficient. As such, solutions tend toward a more reactive approach, repairing faults, as opposed to proactively seeking leaks and blockages. The paper presents an efficient inspection method, showing that autonomous swarm robotics is a viable way of monitoring underground infrastructure. Tailored adaptations of various Vehicle Routing Problems (VRP) and path-planning algorithms provide a customised inspection procedure for complicated networks of underground pipes. The performance of multiple algorithms is compared to determine their effectiveness and feasibility. Notable inspirations come from ant colonies and stigmergy, graph theory, the k-Chinese Postman Problem ( -CPP) and traffic theory. Unlike most swarm behaviours which rely on fast communication between agents, underground pipe networks are a highly challenging communication environment with extremely limited communication ranges. This is due to the extreme variability in the pipe conditions and relatively high attenuation of acoustic and radio waves with which robots would usually communicate. This paper illustrates how to optimise the inspection process and how to increase the frequency with which the robots pass each other, without compromising the routes they are able to take to cover the whole network.

Keywords: autonomous inspection, buried pipes, stigmergy, swarm intelligence, vehicle routing problem

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555 Comparison of the Cyclic Fatigue Resistance of Endoart Gold, Endoart Blue, Protaper Universal, and Protaper Gold Files at Body Temperature

Authors: Ayhan Eymirli, Sila N. Usta

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The aim of this study is the comparison of the cyclic fatigue resistance of EndoArt Gold (EAG, Inci Dental, Istanbul, Turkey), EndoArt Blue (EAB, Inci Dental, Istanbul, Turkey), ProTaper Universal (PTU, Dentsply Tulsa Dental Specialties), and ProTaper Gold (PTG, Dentsply Tulsa Dental Specialties) files at body temperature. Twelve instruments of each EAG, EAB, PTU, PTG file system were included in this study. All selected files were rotated in the artificial canals, which have a 60° angle and a 5-mm radius of curvature until fracture occurred. The time to fracture (Ttf) was measured in seconds by a chronometer in the control panel that presents in the cyclic fatigue testing device when a fracture was detected visually and/or audibly. The lengths of the fractured fragments (FL) were also measured with a digital microcaliper. The data of Ttf and FL were analyzed using Kruskal-Wallis, one-way ANOVA and post hoc Bonferroni tests at the 5% significance level. There was a statistically significant difference among the file systems (p < 0.05). EAB had the statistically highest fatigue resistance, and PTU had the statistically lowest fatigue resistance (p < 0.05). PTG system had a statistically higher FL means than EAB and PTU file systems (p < 0.05). EAB had the greatest cyclic fatigue resistance amongst the other file systems. It can be stated that heat treatments may be a factor that increases fatigue resistance.

Keywords: cyclic fatigue resistance, Endo art blue, Endo art gold, pro taper gold, pro taper universal

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554 A Study on Vitalization Factors of Itaewon Commercial Street-Focused on Itaewon-Ro

Authors: Park, Yoon Hong, Wang, Jung Kab, Choi Seong-Won, Kim, Hong Kyu

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Itaewon-Ro is a special place where the Seoul Metropolitan city designated as the fist are of tourism, specially with the commercial supremacy that foreigners may like. It is the place that grew with regional specialty. Study on the vitalization factors of commercialist were analyzed on consumer shop choice factor, Physical environment based on commercial supremacy vitalization, Functional side of the road and regional specialty. However, since Itaewon seemed to take great place in the cultural factor, Because of its regional specialty, Research was processed. This study is the analysis on the vitalization of Itaewon commercialist that looked for important factors with AHP analysis on consumers use as commercialist. Based on the field study and preceded study, top three factors were distinguished with physical factor, cultural factor, landscape factor, and thirteen detail contents were found. This study focused on the choice of the consumer and with a consumer-based questionnaire, we analyzed the importance of vitalization factors. Results of the research are shown in the following paragraphs. In the Itaewon commercial market, mostly women in the 20~30s were the main consumers for meeting and hopping. Vitalization category that the consumer thinks it most importantly was 'attraction', 'various businesses', and 'convenience of transportation'. 'Attraction that cannot be seen in other places', Which was chosen as the most important factor was judged that Itaewon holds cultural identity that is shown in the process of development, Instead of showing artificial and physical composition.

Keywords: commercialist, vitalization factor, regional specialty, cultural factor, AHP analysis

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553 Development and Characterization of Novel Topical Formulation Containing Niacinamide

Authors: Sevdenur Onger, Ali Asram Sagiroglu

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Hyperpigmentation is a cosmetically unappealing skin problem caused by an overabundance of melanin in the skin. Its pathophysiology is caused by melanocytes being exposed to paracrine melanogenic stimuli, which can upregulate melanogenesis-related enzymes (such as tyrosinase) and cause melanosome formation. Tyrosinase is linked to the development of melanosomes biochemically, and it is the main target of hyperpigmentation treatment. therefore, decreasing tyrosinase activity to reduce melanosomes has become the main target of hyperpigmentation treatment. Niacinamide (NA) is a natural chemical found in a variety of plants that is used as a skin-whitening ingredient in cosmetic formulations. NA decreases melanogenesis in the skin by inhibiting melanosome transfer from melanocytes to covering keratinocytes. Furthermore, NA protects the skin from reactive oxygen species and acts as a main barrier with the skin, reducing moisture loss by increasing ceramide and fatty acid synthesis. However, it is very difficult for hydrophilic compounds such as NA to penetrate deep into the skin. Furthermore, because of the nicotinic acid in NA, it is an irritant. As a result, we've concentrated on strategies to increase NA skin permeability while avoiding its irritating impacts. Since nanotechnology can affect drug penetration behavior by controlling the release and increasing the period of permanence on the skin, it can be a useful technique in the development of whitening formulations. Liposomes have become increasingly popular in the cosmetics industry in recent years due to benefits such as their lack of toxicity, high penetration ability in living skin layers, ability to increase skin moisture by forming a thin layer on the skin surface, and suitability for large-scale production. Therefore, liposomes containing NA were developed for this study. Different formulations were prepared by varying the amount of phospholipid and cholesterol and examined in terms of particle sizes, polydispersity index (PDI) and pH values. The pH values of the produced formulations were determined to be suitable with the pH value of the skin. Particle sizes were determined to be smaller than 250 nm and the particles were found to be of homogeneous size in the formulation (pdi<0.30). Despite the important advantages of liposomal systems, they have low viscosity and stability for topical use. For these reasons, in this study, liposomal cream formulations have been prepared for easy topical application of liposomal systems. As a result, liposomal cream formulations containing NA have been successfully prepared and characterized. Following the in-vitro release and ex-vivo diffusion studies to be conducted in the continuation of the study, it is planned to test the formulation that gives the most appropriate result on the volunteers after obtaining the approval of the ethics committee.

Keywords: delivery systems, hyperpigmentation, liposome, niacinamide

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552 Examining the Impact of Intelligence Quotients on Balance and Coordination in Adolescents with Intellectual Disability

Authors: Bilge B. Calik, Ummuhan B. Aslan, Suat Erel, Sehmus Aslan

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Objective: Intellectual disability (ID) is characterized by limitations in both intellectual functioning and adaptive behavior, which covers many everyday social and practical skills. The aim of this study was to evaluate the balance and coordination performance determined between mild and moderate ID adolescents who regularly play sport. Methods: The study comprised a total of 179 participants, of which 135 were male adolescents with mild and moderate-level ID who regularly play sports (16.52 ± 2.17 years) and 44 age-matched male adolescents with typical development without ID who do not do any sports (16.52 ± 0.99 years). The participants with ID were students of Special Education Schools for the mentally disabled and had been diagnosed with ID at a Ministry of Health Hospital. The adolescents with mild and moderate ID had been playing football in their school teams at least 2 days a week, for at least one year. Balance and coordination of adolescents were assessed by Bilateral coordination and balance subtests of Short Form Bruininks-Oseretsky Test of Motor Proficiency (BOT-2 SF). Results: As a result of the evaluations comparing coordination and balance scores significant differences were determined between all three groups in favor of the peers without ID (p<0.05). Conclusions: It was observed that balance and coordination levels of adolescents with mild ID were better than those of adolescents with moderate-level ID but lower than those of peers without ID. These results indicate a relationship between IQ level and motor performance. Further comparative studies are needed on individuals with ID who play and do not play sports in order to examine the impact of participation in sports on the motor skills of individuals with ID.

Keywords: balance, coordination, intellectual disability, motor skills, sport

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551 The Motion of Ultrasonically Propelled Nanomotors Operating in Biomimetic Environments

Authors: Suzanne Ahmed

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Nanomotors, also commonly referred to as nanorobotics or nanomachines, have garnered considerable research attention due to their numerous potential applications in biomedicine, including drug delivery and microsurgery. Nanomotors typically consist of inorganic or polymeric particles that are powered to undergo motion. These artificial, man-made nanoscale motors operate in the low Reynolds number regime and typically have no moving parts. Several methods have been developed to actuate the motion of nanomotors including magnetic fields, electrical fields, electromagnetic waves, and chemical fuel. Since their introduction in 2012, ultrasonically powered nanomotors have been explored in biocompatible fluids and even within living cells. Due to the common use of ultrasound within the biomedical community for both imaging and therapeutics, the introduction of ultrasonically propelled nanomotors holds significant potential for biomedical applications. In this work, metallic nanomotors are electrochemically plated within porous anodic alumina templates to have a diameter of 300 nm and a length that is 2-4 µm. Nanomotors are placed within an acoustic chamber capable of producing bulk acoustic waves in the ultrasonic range. The motion of nanomotors within biomimetic confines is explored. The control over nanomotor motion is exerted by virtue of the properties of the acoustic signal within these biomimetic confines to control speed, modes of motion and directionality of motion. To expand the range of control over nanorod motion within biomimetic confines, external forces from biocompatible magnetic fields, are exerted onto the acoustically propelled nanomotors.

Keywords: nanomotors, nanomachines, nanorobots, ultrasound

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550 Modeling Fertility and Production of Hazelnut Cultivars through the Artificial Neural Network under Climate Change of Karaj

Authors: Marziyeh Khavari

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In recent decades, climate change, global warming, and the growing population worldwide face some challenges, such as increasing food consumption and shortage of resources. Assessing how climate change could disturb crops, especially hazelnut production, seems crucial for sustainable agriculture production. For hazelnut cultivation in the mid-warm condition, such as in Iran, here we present an investigation of climate parameters and how much they are effective on fertility and nut production of hazelnut trees. Therefore, the climate change of the northern zones in Iran has investigated (1960-2017) and was reached an uptrend in temperature. Furthermore, the descriptive analysis performed on six cultivars during seven years shows how this small-scale survey could demonstrate the effects of climate change on hazelnut production and stability. Results showed that some climate parameters are more significant on nut production, such as solar radiation, soil temperature, relative humidity, and precipitation. Moreover, some cultivars have produced more stable production, for instance, Negret and Segorbe, while the Mervill de Boliver recorded the most variation during the study. Another aspect that needs to be met is training and predicting an actual model to simulate nut production through a neural network and linear regression simulation. The study developed and estimated the ANN model's generalization capability with different criteria such as RMSE, SSE, and accuracy factors for dependent and independent variables (environmental and yield traits). The models were trained and tested while the accuracy of the model is proper to predict hazelnut production under fluctuations in weather parameters.

Keywords: climate change, neural network, hazelnut, global warming

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549 Quasiperiodic Magnetic Chains as Spin Filters

Authors: Arunava Chakrabarti

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A one-dimensional chain of magnetic atoms, representative of a quantum gas in an artificial quasi-periodic potential and modeled by the well-known Aubry-Andre function and its variants are studied in respect of its capability of working as a spin filter for arbitrary spins. The basic formulation is explained in terms of a perfectly periodic chain first, where it is shown that a definite correlation between the spin S of the incoming particles and the magnetic moment h of the substrate atoms can open up a gap in the energy spectrum. This is crucial for a spin filtering action. The simple one-dimensional chain is shown to be equivalent to a 2S+1 strand ladder network. This equivalence is exploited to work out the condition for the opening of gaps. The formulation is then applied for a one-dimensional chain with quasi-periodic variation in the site potentials, the magnetic moments and their orientations following an Aubry-Andre modulation and its variants. In addition, we show that a certain correlation between the system parameters can generate absolutely continuous bands in such systems populated by Bloch like extended wave functions only, signaling the possibility of a metal-insulator transition. This is a case of correlated disorder (a deterministic one), and the results provide a non-trivial variation to the famous Anderson localization problem. We have worked within a tight binding formalism and have presented explicit results for the spin half, spin one, three halves and spin five half particles incident on the magnetic chain to explain our scheme and the central results.

Keywords: Aubry-Andre model, correlated disorder, localization, spin filter

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548 Endeavor in Management Process by Executive Dashboards: The Case of the Financial Directorship in Brazilian Navy

Authors: R. S. Quintal, J. L. Tesch Santos, M. D. Davis, E. C. de Santana, M. de F. Bandeira dos Santos

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The objective is to identify the contributions from the introduction of the computerized system deal within the Accounting Department of Brazilian Navy Financial Directorship and its possible effects on the budgetary and financial harvest of Brazilian Navy. The relevance lies in the fact that the management process is responsible for the continuous improvement of organizational performance through higher levels of quality in their activities. Improvements in organizational processes have direct effects on crops cost, quality, reliability, flexibility and speed. The method of study of this research is the case study. The choice of case study attended, among other demands, a need for greater flexibility to study processes related to a computerized system. The sources of evidence were used literature, documentary and direct observation. Direct observation was made by monitoring the implementation of the computerized system in the Division of Management Analysis. The main findings of the study point to the fact that the computerized system may contribute significantly to the standardization of information. There was improvement of internal processes in the division of management analysis, made possible the consolidation of a standard management and performance analysis that contribute to global homogeneity in the treatment of information essential to the process of decision making. This study has limitations related to the fact the search result be subject exclusively to the case studied, and it is impossible to generalize to other organs of government.

Keywords: process management, management control, business intelligence, Brazilian Navy

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547 Estimation of the Length and Location of Ground Surface Deformation Caused by the Reverse Faulting

Authors: Nader Khalafian, Mohsen Ghaderi

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Field observations have revealed many examples of structures which were damaged due to ground surface deformation caused by the faulting phenomena. In this paper some efforts were made in order to estimate the length and location of the ground surface where large displacements were created due to the reverse faulting. This research has conducted in two steps; (1) in the first step, a 2D explicit finite element model were developed using ABAQUS software. A subroutine for Mohr-Coulomb failure criterion with strain softening model was developed by the authors in order to properly model the stress strain behavior of the soil in the fault rapture zone. The results of the numerical analysis were verified with the results of available centrifuge experiments. Reasonable coincidence was found between the numerical and experimental data. (2) In the second step, the effects of the fault dip angle (δ), depth of soil layer (H), dilation and friction angle of sand (ψ and φ) and the amount of fault offset (d) on the soil surface displacement and fault rupture path were investigated. An artificial neural network-based model (ANN), as a powerful prediction tool, was developed to generate a general model for predicting faulting characteristics. A properly sized database was created to train and test network. It was found that the length and location of the zone of displaced ground surface can be accurately estimated using the proposed model.

Keywords: reverse faulting, surface deformation, numerical, neural network

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546 Tomato-Weed Classification by RetinaNet One-Step Neural Network

Authors: Dionisio Andujar, Juan lópez-Correa, Hugo Moreno, Angela Ri

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The increased number of weeds in tomato crops highly lower yields. Weed identification with the aim of machine learning is important to carry out site-specific control. The last advances in computer vision are a powerful tool to face the problem. The analysis of RGB (Red, Green, Blue) images through Artificial Neural Networks had been rapidly developed in the past few years, providing new methods for weed classification. The development of the algorithms for crop and weed species classification looks for a real-time classification system using Object Detection algorithms based on Convolutional Neural Networks. The site study was located in commercial corn fields. The classification system has been tested. The procedure can detect and classify weed seedlings in tomato fields. The input to the Neural Network was a set of 10,000 RGB images with a natural infestation of Cyperus rotundus l., Echinochloa crus galli L., Setaria italica L., Portulaca oeracea L., and Solanum nigrum L. The validation process was done with a random selection of RGB images containing the aforementioned species. The mean average precision (mAP) was established as the metric for object detection. The results showed agreements higher than 95 %. The system will provide the input for an online spraying system. Thus, this work plays an important role in Site Specific Weed Management by reducing herbicide use in a single step.

Keywords: deep learning, object detection, cnn, tomato, weeds

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545 Population Structure Analysis of Pakistani Indigenous Cattle Population by Using High Density SNP Array

Authors: Hamid Mustafa, Huson J. Heather, Kim Eiusoo, McClure Matt, Khalid Javed, Talat Nasser Pasha, Afzal Ali1, Adeela Ajmal, Tad Sonstegard

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Genetic differences associated with speciation, breed formation or local adaptation can help to preserve and effective utilization of animals in selection programs. Analyses of population structure and breed diversity have provided insight into the origin and evolution of cattle. In this study, we used a high-density panel of SNP markers to examine population structure and diversity among ten Pakistani indigenous cattle breeds. In total, 25 individuals from three cattle populations, including Achi (n=08), Bhagnari (n=04) and Cholistani (n=13) were genotyped for 777, 962 single nucleotide polymorphism (SNP) markers. Population structure was examined using the linkage model in the program STRUCTURE. After characterizing SNP polymorphism in the different populations, we performed a detailed analysis of genetic structure at both the individual and population levels. The whole-genome SNP panel identified several levels of population substructure in the set of examined cattle breeds. We further searched for spatial patterns of genetic diversity among these breeds under the recently developed spatial principal component analysis framework. Overall, such high throughput genotyping data confirmed a clear partitioning of the cattle genetic diversity into distinct breeds. The resulting complex historical origins associated with both natural and artificial selection have led to the differentiation of numerous different cattle breeds displaying a broad phenotypic variety over a short period of time.

Keywords: Pakistan, cattle, genetic diversity, population structure

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544 Effect of Progressive Muscle Relaxation on the Postpartum Depression and General Comfort Levels

Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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543 Synthesis, Structural and Vibrational Studies of a New Lacunar Apatite: LIPB2CA2(PO4)3

Authors: A. Chari, A. El Bouari, B. Orayech, A. Faik, J. M. Igartua

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The phosphate is a natural resource of great importance in Morocco. In order to exploit this wealth, synthesis and studies of new a material based phosphate, were carried out. The apatite structure present o lot of characteristics, One of the main characteristics is to allow large and various substitutions for both cations and anions. Beside their biological importance in hard tissue (bone and teeth), apatites have been extensively studied for their potential use as fluorescent lamp phosphors or laser host materials.The apatite have interesting possible application fields such as in medicine as materials of bone filling, coating of dental implants, agro chemicals as artificial fertilizers. The LiPb2Ca2(PO4)3 was synthesized by the solid-state method, its crystal structure was investigated by Rietveld analysis using XRPD data. This material crystallizes with a structure of lacunar apatite anion deficit. The LiPb2Ca2(PO4)3 is hexagonal apatite at room temperature, adopting the space group P63/m (ITA No. 176), Rietveld refinements showed that the site 4f is shared by three cations Ca, Pb and Li. While the 6h is occupied by the Pb and Li cations. The structure can be described as built up from the PO4 tetrahedra and the sixfold coordination cavities, which delimit hexagonal tunnels along the c-axis direction. These tunnels are linked by the cations occupying the 4 f sites. Raman and Infrared spectroscopy analyses were carried out. The observed frequencies were assigned and discussed on the basis of unit-cell group analysis and by comparison to other apatite-type materials.

Keywords: apatite, Lacunar, crystal structure, Rietveldmethod, LiPb2Ca2(PO4)3, Phase transition

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542 Comorbidity, Disease Activity, and Functional Capacity Among Kosovo Ankylosing Spondylitis Patients Receiving Etanercept Treatment

Authors: Fitim Sadiku, Mjellma Rexhepi, Kreshnik Grezda, Jonijana Sadiku Tigani, Merita Qorolli, Blerta Rexhepi-Kelmendi, Zelie Sadiku, Laura Cakolli

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Background: According to the European Alliance of Associations for Rheumatology (EULAR), biologics should be considered alongside traditional treatments in Ankylosing Spondylitis (AS) patients with persistently high disease activity that directly affects functional capacity. Unfortunately, Kosovo’s health system only offers continuous treatment with etanercept (ETN), and most of the patients with AS are referred to be treated with this biological substance. Objectives: This study aims to explore the relationship between comorbidity, disease activity, and functional capacity in AS patients undergoing ETN treatment in Kosovo. Methods: In this cross-sectional study, we included patients diagnosed with AS who were being treated with ETN 50mg per week for at least 6 months at the Rheumatology Clinic of the University Clinical Center of Kosovo. Patients under 18, pregnant women, and patients with spinal fractures were excluded. This study was approved by the Ethics Committee of the Faculty of Medicine, University of Prishtina and a consent form was signed by patients for participating in the study. We collected data (September-December 2023) about socio-demographics and disease history. Moreover, the presence of comorbidities was measured by the Comorbidity Charlson Index; the disease activity was measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS), and the functional capacity was measured by the Bath Ankylosing Spondylitis Functional Index (BASFI). Results: A total of 31 out of the 39 patients with AS receiving etanercept were included aged 18 to above 65 years (M= 40 years, SD= 14.39), and 87% were male. Diagnose delay was, on average, 7 years from the first symptoms (min-max= 0-24), while the disease duration on average was 7.5 years (min-max= 1- 50). Treatment duration with etanercept was from 0.5 to 6 years. The results indicate a significant positive correlation between comorbidity and BASFI (r= .615, p= .01) and disease activity. Additionally, a significant positive correlation exists between disease activity and BASFI (r= .507, p= .004). Regression analysis highlights the significance of both comorbidity and disease activity as predictors of patients’ functional capacity F (1, 29) = 10.047, p= .05 and F(1, 29) = 17.678, p= .01. No notable gender differences were observed. The study found no significant variations in comorbidity, disease activity, and functional capacity concerning the duration of ETN treatment. Conclusion: We found that in Kosovo, it takes at least 7 years for individuals to be diagnosed with AS from the first-time symptoms are experienced. This study showed that there is a positive correlation between comorbidity and functional capacity, disease activity and functional capacity in patients with AS undergoing etanercept treatment. Furthermore, results showed that comorbidity and disease activity are predictors of the functional status of the patients with AS receiving ETN. Gender and treatment duration with etanercept did not show any significant variations in these patients.

Keywords: ankylosing spondilitis, etanercept, physical wellbeing, comorbidities

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