Search results for: European treatment and outcome study score

Authors: Dorota Witkowska, Paweł Gosek, Lukasz Swiecicki, Wojciech Jernajczyk, Bruce J. West, Miroslaw Latka

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In clinical practice, the selection of an antidepressant often degrades to lengthy trial-and-error. In this work we employ a normalized wavelet power of alpha waves as a biomarker of antidepressant treatment response. This novel EEG metric takes into account both non-stationarity and intersubject variability of alpha waves. We recorded resting, 19-channel EEG (closed eyes) in 22 inpatients suffering from unipolar (UD, n=10) or bipolar (BD, n=12) depression. The EEG measurement was done at the end of the short washout period which followed previously unsuccessful pharmacotherapy. The normalized alpha wavelet power of 11 responders was markedly different than that of 11 nonresponders at several, mostly temporoparietal sites. Using the prediction of treatment response based on the normalized alpha wavelet power, we achieved 81.8% sensitivity and 81.8% specificity for channel T4.

Keywords: alpha waves, antidepressant, treatment outcome, wavelet

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Authors: Tamar Lazariashvili

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The paper examines the market of bioproducts in the world and in Georgia. The experience of European countries in the field of production of bioproducts is shown, the level of interest of the population in these products is presented, and the tendency of the demand for them to grow is evaluated. Objectives. The purpose of the research is to identify modern challenges and develop recommendations for development opportunities based on the analysis of the European and local market of organic products. Methodologies. General and specific methods are used in the research process: comparative analysis, induction, deduction. A desk study has been conducted. Findings. It has been revealed that the production of organic products in Georgia is significantly behind the European requirements, in the market of organic products of Georgia there is a formation of a layer of consumers who are in favor of healthy food and are ready to pay a different price. Conclusions. Based on the analysis of the bioproducts market, appropriate recommendations are proposed, namely, the introduction of innovative technologies; financial and legal support by the state; provision of consulting services on the tax system; Elimination of asymmetric information in the market and others.

Keywords: bioproducts market, European experience, production of bioproducts, layer of consumers.

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Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

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Authors: Hao-Hsi Tseng, Hsin-Yun Lee

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The Most Advantageous Tender (MAT) has been criticized for its susceptibility to dictatorial situations and for its processing of same score, same rank issues. This study applies the four criteria from Arrow's Impossibility Theorem to construct a mechanism for revealing illegitimate scores in scoring methods. While commonly be used to improve on problems resulting from extreme scores, ranking methods hide significant defects, adversely affecting selection fairness. To address these shortcomings, this study relies mainly on the overall evaluated score method, using standardized scores plus normal cumulative distribution function conversion to calculate the evaluation of vender preference. This allows for free score evaluations, which reduces the influence of dictatorial behavior and avoiding same score, same rank issues. Large-scale simulations confirm that this method outperforms currently used methods using the Impossibility Theorem.

Keywords: Arrow’s impossibility theorem, cumulative normal distribution function, most advantageous tender, scoring method

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Authors: Eglė Bilevičiūtė, Vidmantas Egidijus Kurapka, Snieguolė Matulienė, Sigutė Stankevičiūtė

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The Council of European Union (EU Council) has stressed on several occasions the need for a concerted, comprehensive and effective solution to delinquency problems in EU communities. In the context of establishing a European Forensic Science Area and the development of forensic science infrastructure in Europe, EU Council believes that forensic science can significantly contribute to the efficiency of law enforcement, crime prevention and combating crimes. Lithuanian scientists have consolidated to implement a project named “Conception of the vision for European Forensic Science 2020 implementation in Lithuania” (the project is funded for the period of 1 March 2014 - 31 December 2016) with the objective to create a conception of implementation of the vision for European Forensic Science 2020 in Lithuania by 1) evaluating the current status of Lithuania’s forensic system and opportunities for its improvement; 2) analysing achievements and knowledge in investigation of crimes listed in conclusions of EU Council on the vision for European Forensic Science 2020 including creation of a European Forensic Science Area and the development of forensic science infrastructure in Europe: trafficking in human beings, organised crime and terrorism; 3) analysing conceptions of criminalistics, which differ in different EU member states due to the variety of forensic schools, and finding means for their harmonization. Apart from the conception of implementation of the vision for European Forensic Science 2020 in Lithuania, the project is expected to suggest provisions that will be relevant to other EU countries as well. Consequently, the presented conception of implementation of vision for European Forensic Science 2020 in Lithuania could initiate a project for a common vision of European Forensic Science and contribute to the development of the EU as an area of freedom, security and justice. The article presents main ideas of the project of the conception of the vision for European Forensic Science 2020 of EU Council and analyses its legal background, as well as prospects of and challenges for its implementation in Lithuania and the EU.

Keywords: EUROVIFOR, standardization, vision for European Forensic Science 2020, Lithuania

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Authors: Tatia Tavkhelidze

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The European agenda on multiculturalism has undermined Muslim communities through cultural repulsion. Muslims have been labeled as primitive and dangerous people. They experience discrimination at university, workplace, or in the public sphere on a daily basis. Keeping this in view, the proposed research argues that the coining of Muslimness as a problem in modern European societies indicates the crisis of multiculturalism and it could be explained by the anthropological theory of cultural othering. To prove this assumption, the research undertakes a content analysis of modern policy discourse about Muslims and Islam in different European countries (e.g. France, Austria, Denmark, and Hungary). It focuses on the speech of populist politicians, right-wing party leaders and state officials. The research findings are of great significance as they elucidate that the European societies forgot to respect their own values of toleration, religious liberty and democracy; and undermine the European motto 'unity in diversity.

Keywords: assimilation, islamophobia, multiculturalism, populism

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Authors: Wangxu Xia

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BACKGROUND BI-RADS 4 lesions raise the possibility of malignancy that warrant further clinical and radiologic work-up. This study aimed to evaluate the predictive performance of diffusion-weighted imaging(DWI) and microcalcifications on mammography for predicting malignancy of BI-RADS 4 lesions. In addition, the predictive performance of DWI combined with microcalcifications was alsocompared with the Kaiser score. METHODS During January 2021 and June 2023, 144 patients with 178 BI-RADS 4 lesions underwent conventional MRI, DWI, and mammography were included. The lesions were dichotomized intobenign or malignant according to the pathological results from core needle biopsy or surgical mastectomy. DWI was performed with a b value of 0 and 800s/mm2 and analyzed using theapparent diffusion coefficient, and a Kaiser score > 4 was considered to suggest malignancy. Thediagnostic performances for various diagnostic tests were evaluated with the receiver-operatingcharacteristic (ROC) curve. RESULTS The area under the curve (AUC) for DWI was significantly higher than that of the of mammography (0.86 vs 0.71, P<0.001), but was comparable with that of the Kaiser score (0.86 vs 0.84, P=0.58). However, the AUC for DWI combined with mammography was significantly highthan that of the Kaiser score (0.93 vs 0.84, P=0.007). The sensitivity for discriminating malignant from benign BI-RADS 4 lesions was highest at 89% for Kaiser score, but the highest specificity of 83% can be achieved with DWI combined with mammography. CONCLUSION DWI combined with microcalcifications on mammography could discriminate malignant BI-RADS4 lesions from benign ones with a high AUC and specificity. However, Kaiser score had a better sensitivity for discrimination.

Keywords: MRI, DWI, mammography, breast disease

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Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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Authors: Chinelo Igwenagu

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Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

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Authors: Bara M. Yousef

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Kingdome of Saudi Arabia (KSA). High numbers of traffic accidents with sever, moderate and mild level of impairments admits to Sultan bin Abdulaziz humanitarian city. Over a period of 4 months the city received 111 male and 79 female subjects with CP, who received 4-6 weeks of rehabilitation and using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings shed the light on the fact that nearly 85% of people at admission got better after rehabilitation program services at individual sever moderate and mild and has arrange of (59 out of 128 WeeFIM score) and by the time of discharge they leave the city with better FIM score close to (72 out of 128 WeeFIM score) for the entire study sample. WeeFIM score is providing fair evidence to rehabilitation specialists to assess their outcomes. However there is a need to implement other instruments and compare it to WeeFIM in order to reach better outcomes at discharge level.

Keywords: Cerepral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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Authors: Joe Collins, Matthias Rother

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Background: Oral non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of joint pain during and post-exercise. However, oral NSAIDs increase the risk of systemic side effects, even in healthy individuals, and retard recovery from muscle soreness. TDT 064 (Flexiseq®), a topical formulation containing ultra-deformable drug-free Sequessome™ vesicles, has demonstrated equivalent efficacy to oral celecoxib in reducing osteoarthritis-associated joint pain and stiffness. TDT 064 does not cause NSAID-related adverse effects. We describe clinical study data and a case report on the effectiveness of TDT 064 in reducing joint pain after exercise. Methods: Participants with a pain score ≥3 (10-point scale) 12–16 hours post-exercise were randomized to receive TDT 064 plus oral placebo, TDT 064 plus oral ketoprofen, or ketoprofen in ultra-deformable phospholipid vesicles plus oral placebo. Results: In the 168 study participants, pain scores were significantly higher with oral ketoprofen plus TDT 064 than with TDT 064 plus placebo in the 7 days post-exercise (P = 0.0240) and recovery from muscle soreness was significantly longer (P = 0.0262). There was a low incidence of adverse events. These data are supported by clinical experience. A 24-year-old male professional rugby player suffered a traumatic lisfranc fracture in March 2014 and underwent operative reconstruction. He had no relevant medical history and was not receiving concomitant medications. He had undergone anterior cruciate ligament reconstruction in 2008. The patient reported restricted training due to pain (score 7/10), stiffness (score 9/10) and poor function, as well as pain when changing direction and running on consecutive days. In July 2014 he started using TDT 064 twice daily at the recommended dose. In November 2014 he noted reduced pain on running (score 2-3/10), decreased morning stiffness (score 4/10) and improved joint mobility and was able to return to competitive rugby without restrictions. No side effects of TDT 064 were reported. Conclusions: TDT 064 shows efficacy against exercise- and injury-induced joint pain, as well as that associated with osteoarthritis. It does not retard muscle soreness recovery after exercise compared with an oral NSAID, making it an alternative approach for the treatment of joint pain during and post-exercise.

Keywords: exercise, joint pain, TDT 064, phospholipid vesicles

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Authors: Ahmad Shahfarhat, Ashraf Mohammadzade, Reza Saeedi, Hadi Hesari

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Background: Mothers of infants admitted at NICU are vulnerable to depression (affecting 10 to 20% of mothers during the first year after delivery) As you know, about half of women with prominent postpartum depression (PPD) symptoms are not diagnosed. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD. In this study, we checked EPDS score of 12 or more on the second day (D2), discharge, day 28(D28), and day42 (D42) postpartum to determine the risk factors as well as the prevalence of PPD in a sample of mothers of NICU admitted neonates. Methods: A sample of 682 women used the EPDS on admission and at discharge. An assessment for PPD was performed on D28 and D42 by a telephone interview. Results: On admission, the average score on EPDS was 9.72 (SD = 4.4), and 27.4% of women (187) had an EPDS score ≥12. On Discharge, 4weeks and 6weeks postpartum the average score was ordinary 9.34 (SD = 3.8), 9.12 (SD = 3.7), 8.52(SD = 3.36), and (173)25.4 %,( 141)23.3 %,( 88)15.3% of women presented with PPD. a positive correlation was found between scores on EPDS on admission and D42 (P = 0.001). An analysis shows that mothers of twins (P = 0.001) and higher age mothers (P=0.001) are significantly associated with PPD. Conclusion: Women with EPDS score more than 12 and/or older will benefit from a closer follow-up during the rest of the post-partum period, and it is better to be under psychological support.

Keywords: NICU, depression, pregnancy, mothers

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Authors: Volkan Gulsen

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This paper attempts to indicate the main class dynamics of the Brexit process in a Gramscian theoretical framework. It further aims to point out the influence of the withdrawal of the United Kingdom on the European Union class structure. It defines the unification process of the European Union as a passive revolution. In that way, the Brexit process has been described as a moment of negation in the European Union history of class struggle. It will be argued that the withdrawal of the United Kingdom has already altered the European class structure from the embedded neoliberal structure to a more corporate-liberal one.

Keywords: brexit, gramsci, passive revolution, post-neoliberalism

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Authors: Yuan-Hsiang Chang, Zhong-Xian Peng, Li-Der Jeng

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Music has always been an integral part of human’s daily lives. But, for the most people, reading musical score and turning it into melody is not easy. This study aims to develop an Automatic music score recognition system using digital image processing, which can be used to read and analyze musical score images automatically. The technical approaches included: (1) staff region segmentation; (2) image preprocessing; (3) note recognition; and (4) accidental and rest recognition. Digital image processing techniques (e.g., horizontal /vertical projections, connected component labeling, morphological processing, template matching, etc.) were applied according to musical notes, accidents, and rests in staff notations. Preliminary results showed that our system could achieve detection and recognition rates of 96.3% and 91.7%, respectively. In conclusion, we presented an effective automated musical score recognition system that could be integrated in a system with a media player to play music/songs given input images of musical score. Ultimately, this system could also be incorporated in applications for mobile devices as a learning tool, such that a music player could learn to play music/songs.

Keywords: connected component labeling, image processing, morphological processing, optical musical recognition

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Authors: Jesús Ulloa

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The creation, rise, and consolidation of far right-wing, ultranationalist, and eurosceptic parties in Europe after the Second World War pose a real threat towards the disintegration of the European Union. Starting more than thirty years ago with Jean-Marie Le Pen's FN and Margaret Thatcher's policies, to Marine Le Pen's current FN and anti-immigration proposals along with Nigel Farage's UKIP and their intentions to leave the European Union, the progress of right-wing parties should be noted, taking into account that they may have very important differences within their postures but that they also reach common ground in certain areas. The actual disintegration of the EU would represent an enormous failure of the new liberal world order. Through this essay, the roots of this political parties will be analyzed and the conclusion of whether the disintegration may become a reality or if the principles of cooperation and unity will prevail will be answered.

Keywords: eurosceptic, ultarnationalist, right-wing, European Union

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Authors: Petr Daniel Kovarik, Matt Kennedy, James Adams, Ajay Wilson, Andy Burns, Charles Kelly, Malcolm Jackson, Rahul Patil, Shahid Iqbal

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Introduction: Osteoradionecrosis (ORN) is a recognised toxicity of radiotherapy (RT) for head and neck cancer (HNC). Existing literature lacks any generally accepted definition and staging system for this toxicity. Objective: The objective is to analyse the outcome of the surgical and nonsurgical treatments of ORN. Material and Method: Data on 2303 patients treated for HNC with radical or adjuvant RT or RT-chemotherapy from January 2010 - December 2021 were retrospectively analysed. Median follow-up to the whole group of patients was 37 months (range 0–148 months). Results: ORN developed in 185 patients (8.1%). The location of ORN was as follows; mandible=170, maxilla=10, and extra oral cavity=5. Multiple ORNs developed in 7 patients. 5 patients with extra oral cavity ORN were excluded from treatment analysis as the management is different. In 180 patients with oral cavity ORN, median follow-up was 59 months (range 5–148 months). ORN healed in 106 patients, treatment failed in 74 patients (improving=10, stable=43, and deteriorating=21). Median healing time was 14 months (range 3-86 months). Notani staging is available in 158 patients with jaw ORN with no previous surgery to the mandible (Notani class I=56, Notani class II=27, and Notani class III=76). 28 ORN (mandible=27, maxilla=1; Notani class I=23, Notani II=3, Notani III=1) healed spontaneously with a median healing time 7 months (range 3–46 months). In 20 patients, ORN developed after dental extraction, in 1 patient in the neomandible after radical surgery as a part of the primary treatment. In 7 patients, ORN developed and spontaneously healed in irradiated bone with no previous surgical/dental intervention. Radical resection of the ORN (segmentectomy, hemi-mandibulectomy with fibula flap) was performed in 43 patients (all mandible; Notani II=1, Notani III=39, Notani class was not established in 3 patients as ORN developed in the neomandible). 27 patients healed (63%); 15 patients failed (improving=2, stable=5, deteriorating=8). The median time from resection to healing was 6 months (range 2–30 months). 109 patients (mandible=100, maxilla=9; Notani I=3, Notani II=23, Notani III=35, Notani class was not established in 9 patients as ORN developed in the maxilla/neomandible) were treated conservatively using a combination of debridement, antibiotics and Pentoclo. 50 patients healed (46%) with a median healing time 14 months (range 3–70 months), 59 patients are recorded with persistent ORN (improving=8, stable=38, deteriorating=13). Out of 109 patients treated conservatively, 13 patients were treated with Pentoclo only (all mandible; Notani I=6, Notani II=3, Notani III=3, 1 patient with neomandible). In total, 8 patients healed (61.5%), treatment failed in 5 patients (stable=4, deteriorating=1). Median healing time was 14 months (range 4–24 months). Extra orally (n=5), 3 cases of ORN were in the auditory canal and 2 in mastoid. ORN healed in one patient (auditory canal after 32 months. Treatment failed in 4 patients (improving=3, stable=1). Conclusion: The outcome of the treatment of ORN remains in general, poor. Every effort should therefore be made to minimise the risk of development of this devastating toxicity.

Keywords: head and neck cancer, radiotherapy, osteoradionecrosis, treatment outcome

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Authors: Pawan Kumar, Dhananjoy Shaw

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Heart rate variability (HRV) is the physiological phenomenon of variation in the time interval between heartbeats and is alterable with fitness, age and different medical conditions including withdrawal/retirement from games/sports. Objectives of the study were to develop (a) percentile norms of heart rate variability (HRV) variables derived from time domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity (b) percentile norms of heart rate variability (HRV) variables derived from frequency domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity. The study was conducted on 430 males. Ages of the sample ranged from 30 to 35 years of same socio-economic status. Date was collected using ECG polygraphs. Data were processed and extracted using frequency domain analysis and time domain analysis. Collected data were computed with percentile from one to hundred. The finding showed that the percentile norms of heart rate variability (HRV) variables derived from time domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity namely, NN50 count (ranged from 1 to 189 score as percentile range). pNN50 count (ranged from .24 to 60.80 score as percentile range). SDNN (ranged from 17.34 to 167.29 score as percentile range). SDSD (ranged from 11.14 to 120.46 score as percentile range). RMMSD (ranged from 11.19 to 120.24 score as percentile range) and SDANN (ranged from 4.02 to 88.75 score as percentile range). The percentile norms of heart rate variability (HRV) variables derived from frequency domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity namely Low Frequency (Normalized Power) ranged from 20.68 to 90.49 score as percentile range. High Frequency (Normalized Power) ranged from 14.37 to 81.60 score as percentile range. LF/ HF ratio(ranged from 0.26 to 9.52 score as percentile range). LF (Absolute Power) ranged from 146.79 to 5669.33 score as percentile range. HF (Absolute Power) ranged from 102.85 to 10735.71 score as percentile range and Total Power (Absolute Power) ranged from 471.45 to 25879.23 score as percentile range. Conclusion: The analysis documented percentile norms for time domain analysis and frequency domain analysis for versatile use and evaluation.

Keywords: RMSSD, Percentile, SDANN, HF, LF

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Authors: Jeewantha Ranawaka, Gunawardane Kapila, Wijethunaga Mudiyanselage B. G. Jayathilake

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Introduction: Sweeping of the membranes is a fairly simple technique that may positively influence the shift from maintenance of pregnancy to the beginning of labor. Objective: To assess the effectiveness and acceptability of twice versus once-only membrane sweeping in uncomplicated primi gravid at 40 weeks of gestational age in a tertiary care hospital in Sri Lanka. Methods: A randomized controlled clinical trial was done in Ward 05 of Teaching Hospital, Kandy. The participants were primi-gravida with a singleton live fetus who was at 40 weeks of gestation with intact fetal membranes and with a Modified Bishop’s score <5. After randomization both groups received membrane sweeping at 40 weeks of gestation and the experimental group received membrane sweeping after 48 hours (40+2 days). The modified Bishop Score was assessed at 40+5 days. In two groups who did not go into natural labor at 40+5 days were managed according to the ward policy of cervical ripening and with labor induction at 40+5 days. Two different methods were used to assess discomfort and pain. Patient acceptability was assessed using recommendation to another patient and acceptance during next pregnancy. Perinatal, maternal and labour outcomes were assessed. Results: A change of the Bishops score was 67.3% (n= 31 of 46) in experimental group whereas in control group it was 57.5% (n= 38 of 66). (p = 0.21, OR-1.52, CI = 0.6 -3.34). Mean (SD) of Modified Bishop score was 6.36 (1.94) in experimental group and 6.03 (.84) in control group (p = 0.354). The probability of having the spontaneous onset of labour in experimental group was 61.6% (n=74 of 120) whereas in control group it was 45% (n= 54 of 120) (p=0.01, OR-1.966, CI = 1.17 – 3.28 NNT = 5.99). Recommending the method to another among experimental group was 75% (n= 90 of 120) whereas in control group it was 79.2% (n= 95 of 120) (p= 0.443). Accepting membrane Sweeping for subsequent pregnancy among experimental was 72.5% (n=87 of 120) whereas in control group was 72.5% (n=87 of 120) (p= 1.00) Need of formal induction of labour at 40+ 5 days in experimental group was 38.4% (n=46 of 120) whereas in control group was 61.6% (n=66 of 120) (p=0.01, OR=0.5, CI= 0.3 – 0.8, NNT=6). Neonatal outcome, labour outcome such as Cesarean -section rate, need for augmentation and maternal complications such as fever, Premature rupture of membrane, bleeding were comparable in two groups. Conclusions and Recommendations: It can be concluded that twice sweeping of membrane was effective to reduce the need of formal induction of labour and increase the chances of having spontaneous onset of labour (SOL) at 40+5 days without increasing maternal or fetal morbidity. Acceptability of twice sweeping is not different from sweeping once. Hence we recommend consideration of multiple membranes sweeping as first line for women at 40 weeks of gestation.

Keywords: acceptability, induction, labour, membrane sweeping

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Authors: Neal Rupani

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Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.

Keywords: education environment, surgery, post-graduate education, OREEM

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Authors: Rahaf Mandura

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Background: Idiopathic intracranial hypertension (IIH) is a disorder with elevated intracranial pressure (ICP) more than 250 mm H₂O, without evidence of meningeal inflammation, space-occupying lesion, or venous thrombosis. The aim of this research is to study the clinical profile, evaluation, management, and visual outcome in a hospital-based population of IIH cases in Jeddah. Methodology: This is a retrospective observational study that included the medical records of all patients referred to neuro-ophthalmology service for evaluation of papilledema. The medical records have been reviewed from October 2018 to February 2020 at Jeddah Eye Hospital (JEH), Saudi Arabia. A total of fifty-one patients presented with papilledema in the studied period. Forty-seven patients met our inclusion criteria and were included in the study. Results: Most of the patients were females (43, 91.5%) with a mean age of presentation of 30.83±11.40 years. The most common presenting symptom was headache (40 patients, 85.1%), followed by transient visual obscuration (20 patients, 42.6%), and reduced visual acuity (15 patients, 31.9%). All 47 patients were started on medical treatment with oral acetazolamide with four patients (8.5%) shifted to topiramate because of the lack of response or intolerance to acetazolamide while four patients (8.5%) underwent lumbar-peritoneal shunt because of inadequate control of the disease despite the treatment with medical therapy. For both eyes, the change in visual acuity across all assessment points was statistically significant. Nevertheless, there were no significant changes in the visual field findings among all of the compared assessment points. Conclusion: The present study has shown that IIH-related papilledema is common in young female patients with headaches, transient visual obscurations and reduced visual acuity. Those are the commonest symptoms in our IIH population. Medical treatment of IIH is significantly efficacious and should be considered in order to enhance the prognosis of IIH-related complications. Therefore, the visual status should be frequently monitored for these patients.

Keywords: idiopathic intracranial hypertension, intracranial hypertension, papilledema, headache

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Authors: Fuad M. Alkoot

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We aim at highlighting the benefits of classifier systems especially in supporting educational management decisions. The paper aims at using classifiers in an educational application where an outcome is predicted based on given input parameters that represent various conditions at the institute. We present a classifier system that is designed using a limited training set with data for only one semester. The achieved system is able to reach at previously known outcomes accurately. It is also tested on new input parameters representing variations of input conditions to see its prediction on the possible outcome value. Given the supervised expectation of the outcome for the new input we find the system is able to predict the correct outcome. Experiments were conducted on one semester data from two departments only, Switching and Mathematics. Future work on other departments with larger training sets and wider input variations will show additional benefits of classifier systems in supporting the management decisions at an educational institute.

Keywords: machine learning, pattern recognition, classifier design, educational management, outcome estimation

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Authors: Guillaume Leduc

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In this paper, we describe a broad setting under which the error of the approximation can be quantified, controlled, and for which convergence occurs at a speed of n⁻¹ for European and American options. We describe how knowledge of the error allows for arbitrarily fast acceleration of the convergence.

Keywords: random walk approximation, European and American options, rate of convergence, option pricing

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Authors: Nopadol Burananuth, Tawatpupisit Pattaradapa

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The objective of this research is to study opinion of staff responsible for Quality Assurance. Research sample is 50 staff at Suan Sunandha Rajabhat University related to Quality Assurance works from each faculty and organization within the university. Data were analyzed using the computer program. The statistics used in data analysis were frequency, percentage, mean and standard deviation. The results reveal that most of the respondents were female, 92%, aged between 31-40 years, 44%. Most of them have been working on Quality Assurance for 1-3 years, 44%. The staff opinion survey showed that the operation received the highest score. In terms of Planning, committee appointment and job descriptions received the highest mean score. For Checking, acknowledging the results and reviewing quality in education received the highest mean score. For Acting, participating in the meeting in order to revise approach to Quality Assurance received the highest mean score. For Doing, planning an internal quality assurance by assigning period, budget and responsibilities received the highest mean score.

Keywords: education quality assurance, administration, staff, Suan Sunandha Rajabhat University

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Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

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Authors: Sung Hyun Kim

Abstract:

Introduction: Sleep disturbance is common in children with developmental disorders (D.D.). Sleep disturbance has a variety of negative effects, such as behavior problems, medical problems, and even developmental problems in children with D.D. However, to our best knowledge, there has been no proper treatment for sleep disorders in children with D.D. Therefore, we conduct this study to know the positive effects of intensive rehabilitation therapy in children with D.D. on the degree of sleep disturbance. Method: We prospectively recruited 22 patients with a diagnosis of D.D. during the period of January 2022 through May 2022. The inclusion criteria were as follows: 1) a patient who would participate in the intensive rehabilitation therapy of our institution; 2) the age participant under 18 years at the time of assessment; 3) a child who has consented to participate in the study by signing the consent form by the legal guardian. We investigated the clinical characteristics of participants by the medical record, including sex, age, underlying diagnosis of D.D., and Gross Motor Function Measures (GMFM). Before starting the intensive rehabilitation therapy, we conducted a Sleep disturbance scale for children (SDSC). It contains 26 questions about children’s sleep, and those questions are grouped into six subscales, such as Disorders of initiating and maintaining sleep (DIMS), Sleep Breathing Disorders(SBD), Disorders of arousal(DOA), Sleep-Wake Transition Disorders(SWTD), Disorders of excessive somnolence(DOES) and Sleep Hyperhydrosis(SHY). We used the t-score, which was calculated by comparing the scores of normal children. Twenty two patients received 8 weeks of intensive rehabilitation, including daily physical and occupational therapy. After that, we did follow up with SDSC. The comparison between SDSC before and after intensive rehabilitation was calculated using the paired t-test, and P< 0.05 was considered statistically significant. Results: Demographic data and clinical characteristics of 22 patients are enrolled. Patients were 4.03 ± 2.91 years old, and of the total 22 patients, 14 (64%) were male, and 8 (36%) were female. Twelve patients(45%) were diagnosed with Cerebral palsy(C.P.), and the mean value of participants’ GMFM was 47.82 ± 20.60. Each mean value of SDSC’s subscales was also calculated. DIMS was 62.36 ± 13.72, SBD was 54.18 ± 8.39, DOA was 49.59 ± 7.01, SWTD was 58.95 ± 9.20, DOES was 53.09 ± 15.15, SHY was 52.14 ± 8.82, and the total was 59.86 ± 13.18. These values suggest that children with D.D. have sleep disorders. After 8 weeks of intensive rehabilitation treatment, the score of DIMS showed improvement(p=0.016), but not the other subscale and total score of SDSC. Conclusion: This result showed that intensive rehabilitation could be helpful to patients of D.D. with sleep disorders. Especially intensive rehabilitation therapy itself can be a meaningful treatment in inducing and maintaining sleep.

Keywords: sleep disorder, developmental delay, intensive rehabilitation therapy, cerebral palsy

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Authors: Mehrdad Ebrahimi, Oliver Schmitz, Axel Schmidt, Peter Czermak

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“Produced water” (PW) is any fossil water that is brought to the surface along with crude oil or natural gas. By far, PW is the largest waste stream by volume associated with oil and gas production operations. Due to the increasing volume of waste all over the world in the current decade, the outcome and effect of discharging PW on the environment has lately become a significant issue of environmental concerns. Therefore, there is a need for new technologies for PW treatment due to increase focus on water conservation and environmental regulation. The use of membrane processes for treatment of PW has several advantages over many of the traditional separation techniques. In oilfield produced water treatment with ceramic membranes, process efficiency is characterized by the specific permeate flux and by the oil separation performance. Apart from the membrane properties, the permeate flux during filtration of oily wastewaters is known to be strongly dependent on the constituents of the feed solution, as well as on process conditions, e.g. trans-membrane pressure (TMP) and cross-flow velocity (CFV). The research project presented in these report describes the application of different ceramic membrane filtration technologies for the efficient treatment of oil-field produced water and different model oily solutions.

Keywords: ceramic membrane, membrane fouling, oil rejection, produced water treatment

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Authors: Marcho Setiawan Handok, Samuel S. Lemma, Abdoulaye Fofana, Naseef Mansoor

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This paper is proposing a method to predict the outcome of the National Football League match with data from 2019 to 2022 and compare it with other popular models. The model uses open-source statistical data of each team, such as passing yards, rushing yards, fumbles lost, and scoring. Each statistical data has offensive and defensive. For instance, a data set of anticipated values for a specific matchup is created by comparing the offensive passing yards obtained by one team to the defensive passing yards given by the opposition. We evaluated the model’s performance by contrasting its result with those of established prediction algorithms. This research is using a neural network to predict the score of a National Football League match and then predict the winner of the game.

Keywords: game prediction, NFL, football, artificial neural network

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Authors: Lorenzo Maiorino, Fabio Fortuna, Giovanni Panebianco, Marco Sanzari, Gabriella Arcese, Valerio Maria Paolozzi

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It is well known that sport is a factor of social cohesion and the breaking down of barriers between people. From this point of view, the aim is to demonstrate how, through the (re)generation of sustainable structures, it is possible to give life to a new social, cultural, and economic pathway, where possible, in peripheral areas with problems of abandonment and degradation. The aim of this paper is, therefore, to study realities such as European programs and funds and to highlight the ways in which planning can be used to respond to critical issues such as urban decay, abandonment, and the mitigation of social differences. For this reason, the analysis will be carried out through the Multiannual Financial Framework (MFF) package, the Next Generation EU, the Recovery and Resilience Facility (RRF), the Cohesion Fund, the European Social Fund, and other managed funds. The procedure will rely on sources and data of unquestionable origin, and the relation to the object of study in question will be highlighted. The project lends itself to be ambitious and exploring a further aspect of the sports theme, which, as we know, is one of the foundations for a healthy society.

Keywords: sport, social inclusion, urban regeneration, sports facilities, European funds

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Authors: Karolína Vozková, Matěj Kuc

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This paper analyzes recent trends in cost efficiency of European cooperative banks using efficient frontier analysis. Our methodology is based on stochastic frontier analysis which is run on a set of 649 European cooperative banks using data between 2006 and 2015. Our results show that average inefficiency of European cooperative banks is increasing since 2008, smaller cooperative banks are significantly more efficient than the bigger ones over the whole time period and that share of net fee and commission income to total income surprisingly seems to have no impact on bank cost efficiency.

Keywords: cooperative banks, cost efficiency, efficient frontier analysis, stochastic frontier analysis, net fee and commission income

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Authors: Zsuzsa Szakaly

Abstract:

Several constitutions have explicit or implicit eternity clauses in the European Union, their classic roles were analyzed so far, albeit there are new possibilities emerging in relation to the identity of the constitutions of the Member States. The aim of the study is to look at the practice of the Constitutional Courts of the Member States in detail regarding eternity clauses where limiting constitutional amendment has practical bearing, and to examine the influence of such practice on Europeanization. There are some states that apply explicit eternity clauses embedded in the text of the constitution, e.g., Italy, Germany, and Romania. In other states, the Constitutional Court 'unearthed' the implicit eternity clauses from the text of the basic law, e.g., Slovakia and Croatia. By using comparative analysis to examine the explicit or implicit clauses of the concerned constitutions, taking into consideration the new trends of the judicial opinions of the Member States and the fresh scientific studies, the main questions are: How to wield the double-edged sword of eternity clauses? To support European Integration or to support the sovereignty of the Member State? To help Europeanization or to act against it? Eternity clauses can easily find themselves between a rock and a hard place, the law of the European Union and the law of a Member State, with more possible interpretations. As more and more Constitutional Courts started to declare elements of their Member States’ constitutional identities, these began to interfere with the eternity clauses. Will this trend eventually work against Europeanization? As a result of the research, it can be stated that a lowest common denominator exists in the practice of European Constitutional Courts regarding eternity clauses. The chance of a European model and the possibility of this model influencing the status quo between the European Union and the Member States will be examined by looking at the answers these courts have found so far.

Keywords: constitutional court, constitutional identity, eternity clause, European Integration

Procedia PDF Downloads 113