Commenced in January 2007
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Edition: International
Paper Count: 2861

Search results for: Charlson comorbidity index

2861 An Investigation of the Relevant Factors of Unplanned Readmission within 14 Days of Discharge in a Regional Teaching Hospital in South Taiwan

Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee


Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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2860 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan

Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee


Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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2859 Comparison of Comorbidity of Six Pathological Areas of MMPI and SCL-90-R Tests of Obsessive–Compulsive Patients

Authors: Fahimeh Rafiezadeh, Mehdi Khanbani


Aim:The goal of this research is to compare the comorbidity of mental disorders of obsessive–compulsive patients between multiplasic Minesota Personality Inventory (MMPI)and symptom checklist -90-R(SCL-90-R). Material and Method: In sorting, 50 individuals: 25 male and 25 female who were compulsive, were selected samples. The comparison was made in 6 pathological areas (somatoform, Depression, Anxiety, Paranoid, Phsychotism, and antisocial disorders). Frequencies were analyzed with chi-squre test. Results: results was concluded: In comparison between two sexes, there was a significant difference of frequency in depression disorder. Comparing the two tests, there was a significant difference of frequency between paranoid, depression and psychoticism disorders. Depression disorder had the highest comorbidity and antisocial disorder had the lowest comorbidity among male females and total. Conclusion: The depression has most comorbidity in OCD and is very important in the trapt of this patients.

Keywords: obsessive, compulsive disorder, comorbidity, MMPI test, SCL-90–R test

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2858 The Role of ALDH2 Genotypes in Bipolar II Disorder Comorbid with Anxiety Disorder

Authors: Yun-Hsuan Chang, Chih-Chun Huang, Ru-Band Lu


Dopamine, metabolized to 3,4-dihydroxyphenylacetic acid (DOPAC) by aldehyde dehydrogenase 2 (ALDH2), ALDH2*1/*1, and ALDH2*1/*2+ALDH*2/*2 equally carried in Han Chinese. The relationship between dopamine metabolic enzyme and cognitive performance in bipolar II disorder comorbid with anxiety disorder (AD) remains unclear. This study proposed to explore the association between ALDH2 polymorphisms, anxiety comorbidity in bipolar II disorder. One hundred and ninety-seven BPII with or without AD comorbidity were recruited and compared with 130 Health controls (HC). A polymerase chain reaction and restriction fragment length polymorphism analysis was used to determine genotypes for ALDH2, and neuropsychological battery was performed. Two factor analyses with AD comorbidity and ALDH2 showed a significant main effect of ALDH2 on attention and marginally significant interaction between AD and ALDH2 memory performance. The ALDH2 polymorphisms may play a different role in the neuropsychological performance on varied neuropsychological performance in BPII comorbid with and without AD.

Keywords: anxiety disorder, bipolar II disorder, comorbidity, genetic

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2857 The Role Previous Cytomegalovirus Infection in Subsequent Lymphoma Develompment

Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid


Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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2856 Topological Indices of Some Graph Operations

Authors: U. Mary


Let be a graph with a finite, nonempty set of objects called vertices together with a set of unordered pairs of distinct vertices of called edges. The vertex set is denoted by and the edge set by. Given two graphs and the wiener index of, wiener index for the splitting graph of a graph, the first Zagreb index of and its splitting graph, the 3-steiner wiener index of, the 3-steiner wiener index of a special graph are explored in this paper.

Keywords: complementary prism graph, first Zagreb index, neighborhood corona graph, steiner distance, splitting graph, steiner wiener index, wiener index

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2855 The Correlation between Clostridium Difficile Infection and Bronchial Lung Cancer Occurrence

Authors: Molnar Catalina, Lexi Frankel, Amalia Ardeljan, Enoch Kim, Marissa Dallara, Omar Rashid


Introduction: Clostridium difficile (C. diff) is a toxin-producing bacteria that can cause diarrhea and colitis. U.S. Center for Disease Control and Prevention revealed that C. difficile infection (CDI) has increased from 31 cases per 100,000 persons per year in 1996 to 61 per 100,000 in 2003. Approximately 500,000 cases per year occur in the United States. After exposure, the bacteria colonize the colon, where it adheres to the intestinal epithelium where it produces two toxins: TcdA and TcdB. TcdA affects the intestinal epithelium, causing fluid secretion, inflammation, and tissue necrosis, while TcdB acts as a cytotoxin purpose of this study was to evaluate the association between C diff infection and bronchial lung cancer development. Methods: Using ICD- 9 and ICD-10 codes, the data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to assess the patients infected with C diff as opposed to the non-infected patients. The Holy Cross Health, Fort Lauderdale, granted access to the database for the purpose of academic research. Patients were matched for age and Charlson Comorbidity Index (CCI). Standard statistical methods were used. Results: Bronchial lung cancer occurrence in the population not infected with C diff infection was 4741, as opposed to the population infected with C. diff, where 2039 cases of lung cancer were observed. The difference was statistically significant (p-value < 2.2x10^e-16), which reveals that C diff might be protective against bronchial lung cancer. The data was then matched by treatment to create to minimize the effect of treatment bias. Bronchial cancer incidence was 422 and 861 in infected vs. non-infected (p-value of < 2.2x10^e-16), which once more indicates that C diff infection could be beneficial in diminishing bronchial cancer development. Conclusion: This retrospective study conveys a statistical correlation between C diff infection and decreased incidence of lung bronchial cancer. Further studies are needed to comprehend the protective mechanisms of C. Diff infection on lung cancer.

Keywords: C. diff, lung cancer, protective, microbiology

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2854 The Healthcare Costs of BMI-Defined Obesity among Adults Who Have Undergone a Medical Procedure in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach


Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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2853 Hospital Malnutrition and its Impact on 30-day Mortality in Hospitalized General Medicine Patients in a Tertiary Hospital in South India

Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.


Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.

Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)

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2852 A Comparative Study of Multi-SOM Algorithms for Determining the Optimal Number of Clusters

Authors: Imèn Khanchouch, Malika Charrad, Mohamed Limam


The interpretation of the quality of clusters and the determination of the optimal number of clusters is still a crucial problem in clustering. We focus in this paper on multi-SOM clustering method which overcomes the problem of extracting the number of clusters from the SOM map through the use of a clustering validity index. We then tested multi-SOM using real and artificial data sets with different evaluation criteria not used previously such as Davies Bouldin index, Dunn index and silhouette index. The developed multi-SOM algorithm is compared to k-means and Birch methods. Results show that it is more efficient than classical clustering methods.

Keywords: clustering, SOM, multi-SOM, DB index, Dunn index, silhouette index

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2851 Acupoint Injection of High Concentration of Glucose Attenuates Mice Chronic Pain and Depression Comorbidity

Authors: Chanya Inprasit, Yi-Wen Lin


Inflammation causes changes of peripheral and central nervous system properties, affecting both neuronal and non-neuronal cells, resulting in inflammatory pain. Acupoint injection (AI) was developed in the 1950s and has been widely used for relieving pain. It is an acupoint-stimulating technique that utilizes anatomically based meridians derived from Chinese medicine theory. AI has been accepted as an effective treatment and is thought to display superior results when compared to traditional acupuncture methods. However, the mechanism of AI needs to be ratified by more scientific evidence in order to support the theory and its therapeutic development. In this study, we explored the effect of AI on the comorbidity of chronic pain and depression. Mice hindpaw was injected by complete Freund’s adjuvant (CFA) to induce the condition of chronic pain. Measurements of mechanical and thermal hyperalgesia and depression-like behavior were analyzed. The results indicated a positive tendency to AI treatment. The comorbidity of chronic pain and depression was investigated with relation to transient receptor potential V1 (TRPV1) mechanism through the use of TRPV1 gene deletion. The expression of nociceptors such as voltage-gated sodium channels (Navs) or TRPV1, was significantly down-regulated by AI. The expression of inflammation-activated molecules: astrocytic marker glial fibrillary acidic protein (GFAP), the microglial marker Iba-1, S100B, and related kinases, were reversed by AI in both the peripheral and central nervous system. Taken together, these data provided a detailed molecular mechanism of AI-induced analgesia and anti-inflammatory properties. This finding may be utilized for clinical practice to treat chronic pain and depression comorbidity.

Keywords: inflammatory pain, acupoint injection, TRPV1, GFAP, S100B

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2850 Effect of Addition and Reduction of Sharia Index Constituents

Authors: Rosyidah, Permata Wulandari


We investigate the price effect of addition and deletions from the Indonesia Sharia Stock Index (ISSI) and Jakarta Islamic Index (JII). Using event study methodology, we measure abnormal returns for firms over the period June 2019 - to December 2021. Through the sample of 107 additions and 95 deletions, we find evidence to support the theory of Muslim country investment behavior. We find that additions to the Islamic index led to a significant positive stock market reaction and deletions to the Islamic index led to a negative stock market reaction on Jakarta Islamic Index (JII) and there is no significant reaction of addition and deletion on Indonesia Sharia Stock Index (ISSI).

Keywords: abnormal return, abnormal volume, event study, index changes, sharia index

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2849 Reduction of Transient Receptor Potential Vanilloid 1 for Chronic Pain and Depression Co-Morbidity through Electroacupuncture and Gene Deletion in Mice Brain

Authors: Bernice Lottering, Yi-Wen Lin


Chronic pain and depression have an estimated 80% rate of comorbidity with unsatisfactory treatment interventions signifying the importance of developing effective therapeutic interventions for a serious chronic condition affecting a large majority of the global population. Chronic pain is defined as persistent pain presenting for over 3 months. This disease state increases the risk of developing depression in comparison to healthy individuals. In the current study, complete Freund’s adjuvant (CFA) was used to induce cell-mediated chronic inflammatory pain in a murine model. Significant mechanical and thermal hyperalgesia was induced, alongside observable depression-like behaviors. These conditions were attenuated through the use of electroacupuncture (EA). Similarly, these effects were also investigated with respect to the transient receptor potential vanilloid 1 (TRPV1), by analyzing the effects of TRPV1 gene deletion on the comorbidity of chronic pain and depression. The expression of the TRPV1 inflammatory response, and related downstream molecules, including protein kinases (PKs), mitogen-activated protein kinase (MAPKs), and transcriptional factors, were significantly reduced in the thalamus, prefrontal cortex (PFC), hippocampus, and periaqueductal gray (PAG) of CFA-treated mice. In addition, phosphorylated N-methyl-D-aspartate (NMDA) receptor 1 was also found to be reduced in the aforementioned areas, suggesting potential application and validity in a clinical setting. Our study determined the prospective therapeutic effects of EA in the treatment of chronic inflammatory pain and depression comorbidity and provides a novel and detailed mechanism underlying EA-mediated analgesia. These findings may be relevant in the utilization of clinical intervention approaches related to chronic pain and depression comorbidity.

Keywords: chronic pain, depression, NMDA, prefrontal cortex, TRPV1

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2848 The Association among Obesity, Lipid Profiles and Depression Severity in Patients with Depressive Disorder

Authors: In Hee Shim, Dong Sik Bae


Introduction: Obesity and unfavorable lipid profile may be linked to depressive disorders. This study compared the levels of obesity, lipid profiles and depression severity of patients with depressive disorders. Methods: This study included 156 patients diagnosed with a depressive disorder who were hospitalized between March 2012 and February 2016. The patients were categorized into mild to moderate and severe depressive groups, based on Hamilton Depression Rating Scale scores (Mild to moderate depression 8-23 vs. severe depression ≥ 24). The charts of the patients were reviewed to evaluate body mass index and lipid profiles, including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TG), confounding factors, such as other general medical disorders (hypertension, diabetes mellitus, and dyslipidemia), except smoking status (insufficient data). Demographic and clinical characteristics, such as age, sex, comorbidities, family history of mood disorders, psychotic features, and prescription patterns were also assessed. Results: Compared to the mild to the moderate depressive group, patients with severe depression had significantly lower rate of male and comorbidity. The patients with severe depression had a significantly lower TG than patients in the mild to moderate depressive group. After adjustment for the sex and comorbidity, there were no significant differences between the two groups in terms of the obesity and lipid profiles, including TG. Conclusion: These results did not show a significant difference in the association between obesity, lipid profiles and the depression severity. The role of obesity and lipid profiles in the pathophysiology of depression remains to be clarified.

Keywords: depression, HAM-D, lipid profiles, obesity

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2847 Comparison of the H-Index of Researchers of Google Scholar and Scopus

Authors: Adian Fatchur Rochim, Abdul Muis, Riri Fitri Sari


H-index has been widely used as a performance indicator of researchers around the world especially in Indonesia. The Government uses Scopus and Google scholar as indexing references in providing recognition and appreciation. However, those two indexing services yield to different H-index values. For that purpose, this paper evaluates the difference of the H-index from those services. Researchers indexed by Webometrics, are used as reference’s data in this paper. Currently, Webometrics only uses H-index from Google Scholar. This paper observed and compared corresponding researchers’ data from Scopus to get their H-index score. Subsequently, some researchers with huge differences in score are observed in more detail on their paper’s publisher. This paper shows that the H-index of researchers in Google Scholar is approximately 2.45 times of their Scopus H-Index. Most difference exists due to the existence of uncertified publishers, which is considered in Google Scholar but not in Scopus.

Keywords: Google Scholar, H-index, Scopus, performance indicator

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2846 Energy Efficiency Index Applied to Reactive Systems

Authors: P. Góes, J. Manzi


This paper focuses on the development of an energy efficiency index that will be applied to reactive systems, which is based in the First and Second Law of Thermodynamics, by giving particular consideration to the concept of maximum entropy. Among the requirements of such energy efficiency index, the practical feasibility must be essential. To illustrate the performance of the proposed index, such an index was used as decisive factor of evaluation for the optimization process of an industrial reactor. The results allow the conclusion to be drawn that the energy efficiency index applied to the reactive system is consistent because it extracts the information expected of an efficient indicator, and that it is useful as an analytical tool besides being feasible from a practical standpoint. Furthermore, it has proved to be much simpler to use than tools based on traditional methodologies.

Keywords: energy, efficiency, entropy, reactive

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2845 An Efficiency Measurement of E-Government Performance for United Nation Ranking Index

Authors: Yassine Jadi, Lin Jie


In order to serve the society in an electronic manner, many developing countries have launched tremendous e-government projects. The strategies of development and implementation e-government system have reached different levels, and to ensure consistency of development, the governments need to evaluate e-government performance. The United nation has design e-government development ranking index (EGDI) that rely on three indexes, Online service index (OSI), Telecommunication Infrastructure index (TII), and human capital index( HCI) which are not reflecting the interaction between a government and their citizens. Based on data envelopment analyses (DEA) technique, we are using E-participating index (EPI) as an output of government effort to evaluate the performance of e-government system. Therefore, the ranking index can be achieved in efficiency manner.

Keywords: e-government, DEA, efficiency measurement, EGDI

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2844 Eccentric Connectivity Index, First and Second Zagreb Indices of Corona Graph

Authors: A. Kulandai Therese


The eccentric connectivity index based on degree and eccentricity of the vertices of a graph is a widely used graph invariant in mathematics.In this paper, we present the explicit eccentric connectivity index, first and second Zagreb indices for a Corona graph and sub division-related corona graphs.

Keywords: corona graph, degree, eccentricity, eccentric connectivity index, first zagreb index, second zagreb index, subdivision graphs

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2843 Incidence of Breast Cancer and Enterococcus Infection: A Retrospective Analysis

Authors: Matthew Cardeiro, Amalia D. Ardeljan, Lexi Frankel, Dianela Prado Escobar, Catalina Molnar, Omar M. Rashid


Introduction: Enterococci comprise the natural flora of nearly all animals and are ubiquitous in food manufacturing and probiotics. However, its role in the microbiome remains controversial. The gut microbiome has shown to play an important role in immunology and cancer. Further, recent data has suggested a relationship between gut microbiota and breast cancer. These studies have shown that the gut microbiome of patients with breast cancer differs from that of healthy patients. Research regarding enterococcus infection and its sequala is limited, and further research is needed in order to understand the relationship between infection and cancer. Enterococcus may prevent the development of breast cancer (BC) through complex immunologic and microbiotic adaptations following an enterococcus infection. This study investigated the effect of enterococcus infection and the incidence of BC. Methods: A retrospective study (January 2010- December 2019) was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using a Humans Health Insurance Database. International Classification of Disease (ICD) 9th and 10th codes, Current Procedural Terminology (CPT), and National Drug Codes were used to identify BC diagnosis and enterococcus infection. Patients were matched for age, sex, Charlson Comorbidity Index (CCI), antibiotic treatment, and region of residence. Chi-squared, logistic regression, and odds ratio were implemented to assess the significance and estimate relative risk. Results: 671 out of 28,518 (2.35%) patients with a prior enterococcus infection and 1,459 out of 28,518 (5.12%) patients without enterococcus infection subsequently developed BC, and the difference was statistically significant (p<2.2x10⁻¹⁶). Logistic regression also indicated enterococcus infection was associated with a decreased incidence of BC (RR=0.60, 95% CI [0.57, 0.63]). Treatment for enterococcus infection was analyzed and controlled for in both enterococcus infected and noninfected populations. 398 out of 11,523 (3.34%) patients with a prior enterococcus infection and treated with antibiotics were compared to 624 out of 11,523 (5.41%) patients with no history of enterococcus infection (control) and received antibiotic treatment. Both populations subsequently developed BC. Results remained statistically significant (p<2.2x10-16) with a relative risk of 0.57 (95% CI [0.54, 0.60]). Conclusion & Discussion: This study shows a statistically significant correlation between enterococcus infection and a decrease incidence of breast cancer. Further exploration is needed to identify and understand not only the role of enterococcus in the microbiome but also the protective mechanism(s) and impact enterococcus infection may have on breast cancer development. Ultimately, further research is needed in order to understand the complex and intricate relationship between the microbiome, immunology, bacterial infections, and carcinogenesis.

Keywords: breast cancer, enterococcus, immunology, infection, microbiome

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2842 Brainwave Classification for Brain Balancing Index (BBI) via 3D EEG Model Using k-NN Technique

Authors: N. Fuad, M. N. Taib, R. Jailani, M. E. Marwan


In this paper, the comparison between k-Nearest Neighbor (kNN) algorithms for classifying the 3D EEG model in brain balancing is presented. The EEG signal recording was conducted on 51 healthy subjects. Development of 3D EEG models involves pre-processing of raw EEG signals and construction of spectrogram images. Then, maximum PSD values were extracted as features from the model. There are three indexes for the balanced brain; index 3, index 4 and index 5. There are significant different of the EEG signals due to the brain balancing index (BBI). Alpha-α (8–13 Hz) and beta-β (13–30 Hz) were used as input signals for the classification model. The k-NN classification result is 88.46% accuracy. These results proved that k-NN can be used in order to predict the brain balancing application.

Keywords: power spectral density, 3D EEG model, brain balancing, kNN

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2841 Quality of Age Reporting from Tanzania 2012 Census Results: An Assessment Using Whipple’s Index, Myer’s Blended Index, and Age-Sex Accuracy Index

Authors: A. Sathiya Susuman, Hamisi F. Hamisi


Background: Many socio-economic and demographic data are age-sex attributed. However, a variety of irregularities and misstatement are noted with respect to age-related data and less to sex data because of its biological differences between the genders. Noting the misstatement/misreporting of age data regardless of its significance importance in demographics and epidemiological studies, this study aims at assessing the quality of 2012 Tanzania Population and Housing Census Results. Methods: Data for the analysis are downloaded from Tanzania National Bureau of Statistics. Age heaping and digit preference were measured using summary indices viz., Whipple’s index, Myers’ blended index, and Age-Sex Accuracy index. Results: The recorded Whipple’s index for both sexes was 154.43; male has the lowest index of about 152.65 while female has the highest index of about 156.07. For Myers’ blended index, the preferences were at digits ‘0’ and ‘5’ while avoidance were at digits ‘1’ and ‘3’ for both sexes. Finally, Age-sex index stood at 59.8 where sex ratio score was 5.82 and age ratio scores were 20.89 and 21.4 for males and female respectively. Conclusion: The evaluation of the 2012 PHC data using the demographic techniques has qualified the data inaccurate as the results of systematic heaping and digit preferences/avoidances. Thus, innovative methods in data collection along with measuring and minimizing errors using statistical techniques should be used to ensure accuracy of age data.

Keywords: age heaping, digit preference/avoidance, summary indices, Whipple’s index, Myer’s index, age-sex accuracy index

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2840 The Research of Weights Identify of Harbin Ecological Security Evaluation Index Based on AHP

Authors: Rong Guo, Mengshi Huang, Yujing Bai


With the rapid development of urbanization, the urban population increases and urban sprawl appeared. And these issues led to a sharp deterioration of the ecological environment. So, the urban ecological security evaluation was imminent. The weights identify of index was a key step of the research of ecological security evaluation. The AHP was widely used in the extensive research of weights identify of ecological security index. The characteristics of authority and quantitative can fully reflect the views of relevant experts. On the basis of building the ecological security evaluation index of Harbin, the paper combed and used the basic principle of the AHP, and calculated the weights of Harbin ecological security evaluation index through the process of the expert opinions “summary-feedback-summary”. And lay a foundation of future study of Harbin ecological security index, and guide the quantitative evaluation of Harbin ecological security.

Keywords: AHP, ecological security, evaluation Index, weights identify, harbin

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2839 On Estimating the Headcount Index by Using the Logistic Regression Estimator

Authors: Encarnación Álvarez, Rosa M. García-Fernández, Juan F. Muñoz, Francisco J. Blanco-Encomienda


The problem of estimating a proportion has important applications in the field of economics, and in general, in many areas such as social sciences. A common application in economics is the estimation of the headcount index. In this paper, we define the general headcount index as a proportion. Furthermore, we introduce a new quantitative method for estimating the headcount index. In particular, we suggest to use the logistic regression estimator for the problem of estimating the headcount index. Assuming a real data set, results derived from Monte Carlo simulation studies indicate that the logistic regression estimator can be more accurate than the traditional estimator of the headcount index.

Keywords: poverty line, poor, risk of poverty, Monte Carlo simulations, sample

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2838 Compression Index Estimation by Water Content and Liquid Limit and Void Ratio Using Statistics Method

Authors: Lizhou Chen, Abdelhamid Belgaid, Assem Elsayed, Xiaoming Yang


Compression index is essential in foundation settlement calculation. The traditional method for determining compression index is consolidation test which is expensive and time consuming. Many researchers have used regression methods to develop empirical equations for predicting compression index from soil properties. Based on a large number of compression index data collected from consolidation tests, the accuracy of some popularly empirical equations were assessed. It was found that primary compression index is significantly overestimated in some equations while it is underestimated in others. The sensitivity analyses of soil parameters including water content, liquid limit and void ratio were performed. The results indicate that the compression index obtained from void ratio is most accurate. The ANOVA (analysis of variance) demonstrates that the equations with multiple soil parameters cannot provide better predictions than the equations with single soil parameter. In other words, it is not necessary to develop the relationships between compression index and multiple soil parameters. Meanwhile, it was noted that secondary compression index is approximately 0.7-5.0% of primary compression index with an average of 2.0%. In the end, the proposed prediction equations using power regression technique were provided that can provide more accurate predictions than those from existing equations.

Keywords: compression index, clay, settlement, consolidation, secondary compression index, soil parameter

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2837 The Threshold Values of Soil Water Index for Landslides on Country Road No.89

Authors: Ji-Yuan Lin, Yu-Ming Liou, Yi-Ting Chen, Chen-Syuan Lin


Soil water index obtained by tank model is now commonly used in soil and sand disaster alarm system in Japan. Comparing with the rainfall trigging index in Taiwan, the tank model is easy to predict the slope water content on large-scale landslide. Therefore, this study aims to estimate the threshold value of large-scale landslide using the soil water index Sixteen typhoons and heavy rainfall events, were selected to establish the, to relationship between landslide event and soil water index. Finally, the proposed threshold values for landslides on country road No.89 are suggested in this study. The study results show that 95% landslide cases occurred in soil water index more than 125mm, and 30% of the more serious slope failure occurred in the soil water index is greater than 250mm. Beside, this study speculates when soil water index more than 250mm and the difference value between second tank and third tank less than -25mm, it leads to large-scale landslide more probably.

Keywords: soil water index, tank model, landslide, threshold values

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2836 A Novel Spectral Index for Automatic Shadow Detection in Urban Mapping Based on WorldView-2 Satellite Imagery

Authors: Kaveh Shahi, Helmi Z. M. Shafri, Ebrahim Taherzadeh


In remote sensing, shadow causes problems in many applications such as change detection and classification. It is caused by objects which are elevated, thus can directly affect the accuracy of information. For these reasons, it is very important to detect shadows particularly in urban high spatial resolution imagery which created a significant problem. This paper focuses on automatic shadow detection based on a new spectral index for multispectral imagery known as Shadow Detection Index (SDI). The new spectral index was tested on different areas of World-View 2 images and the results demonstrated that the new spectral index has a massive potential to extract shadows effectively and automatically.

Keywords: spectral index, shadow detection, remote sensing images, World-View 2

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2835 The Assessment of the Comparative Efficiency of Reforms through the Integral Index of Transformation

Authors: Samson Davoyan, Ashot Davoyan, Ani Khachatryan


The indexes (Global Competitiveness Index, Economic Freedom Index, Human Development Index, etc.) developed by different international and non-government organizations in time and space express the quantitative and qualitative features of different fields of various reforms implemented in different countries. The main objective of our research is to develop new methodology that we will use to create integral index based on many indexes and that will include many areas of reforms. To achieve our aim we have used econometric methods (regression model for panel data method). The basis of our methodology is the development of the new integral index based on quantitative assessment of the change of two main parameters: the score of the countries by different indexes and the change of the ranks of countries for following two periods of time. As a result of the usage of methods for analyzes we have defined the indexes that are used to create the new integral index and the scales for each of them. Analyzing quantitatively and qualitatively analysis through the integral index for more than 100 countries for 2009-2014, we have defined comparative efficiency that helps to conclude in which directions countries have implemented reforms more effectively compared to others and in which direction reforms have implemented less efficiently.

Keywords: development, rank, reforms, comparative, index, economic, corruption, social, program

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2834 The Proportion of Dysthymia Prevailing in Men and Women With Anxiety as Comorbidity

Authors: Yashvi Italiya


Dysthymia (DD) is a much-overlooked soft mood disorder and mostly confused with other forms of chronic depression. This research paper gives a spotlight to the DD prevailing in men and women. It also focuses on one of the comorbidities of Dysthymia, i.e., Anxiety. The comorbidities, hurdles in diagnosis, the ubiquity of the disorder, and the relation of Anxiety and DD are briefly described. Gender was the main focus here because the researcher of this paper found it as a research gap while doing the literature review. The study was done through secondary data obtained primarily from a questionnaire having Alpha 0.891 reliability. T-test method of data analysis was used to test the hypotheses. The result shows that the researcher failed to accept alternative hypothesis 1 (M1 > M2), while the alternative hypothesis 2 (M1 > M2) was accepted. The ratio of DD in women (M1) is not higher than that of men (M2) (hypothesis 1). But, women are more anxious than men (hypothesis 2). It was found that comorbid Anxiety is more widespread in one gender. It further plays a significant role in mixing up the symptoms. It was concluded that the dividing line between Dysthymia and MDD is still unclear for an accurate diagnosis. There is an essential need for spreading knowledge concerning the differences between the symptoms of DD and MDD so that the actual disorder can be identified, and proper help can be received from/provided by professionals.

Keywords: anxiety, comorbidity, dysthymia, gender, MDD

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2833 Sustainability Index for REDD-Plus Implementation in Central Kalimantan, Indonesia

Authors: Febrina Natalia, Noriyuki Tanaka, Mitsuru Osaki


Sustainability Index for REDD-plus implementation was constructed to evaluate the sustainability of different communities in 5 villages (Taruna Jaya, Tumbang Nusa, Marang, Terantang, and Seragam Jaya) in Central Kalimantan, Indonesia based on the main objectives of REDD-plus project (reducing emission from deforestation and forest degradation, increasing carbon stock, preserving biodiversity and sustaining forest management). This index was separately composed of 3 different components; (1) ecology, (2) economy, and (3) society. The index of sustainability was determined into four categories; 3,3-4,0 (excellent), 2,5-3,2 (good), 1,8-2,4 (fair), and 1,0-1,7 (poor). Overall, this technique aims to assist all stakeholders and local government in particular in providing information of villages’ sustainability index before implementing REDD-plus project that the assistance and benefits given to villages will be beneficial, effective and efficient.

Keywords: central kalimantan, Indonesia, REDD-plus, sustainability index

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2832 Discrimination between Defective and Non-Defective Coffee Beans Using a Laser Prism Spectrometer

Authors: A. Belay, B. Kebede


The concentration- and temperature-dependent refractive indices of solutions extracted from defective and non-defective coffee beans have been investigated using a He–Ne laser. The refractive index has a linear relationship with the presumed concentration of the coffee solutions in the range of 0.5–3%. Higher and lower values of refractive index were obtained for immature and non-defective coffee beans, respectively. The Refractive index of bean extracts can be successfully used to separate defective from non-defective beans.

Keywords: coffee extract, refractive index, temperature dependence

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