Search results for: adjusted odds ratio
Commenced in January 2007
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Edition: International
Paper Count: 5102

Search results for: adjusted odds ratio

5042 Diagnostic Performance of Mean Platelet Volume in the Diagnosis of Acute Myocardial Infarction: A Meta-Analysis

Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame

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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.

Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain

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5041 COVID-19 Teaches Probability Risk Assessment

Authors: Sean Sloan

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Probability Risk Assessments (PRA) can be a difficult concept for students to grasp. So in searching for different ways to describe PRA to relate it to their lives; COVID-19 came up. The parallels are amazing. Soon students began analyzing acceptable risk with the virus. This helped them to quantify just how dangerous is dangerous. The original lesson was dismissed and for the remainder of the period, the probability of risk, and the lethality of risk became the topic. Spreading events such as a COVID carrier on an airline became analogous to single fault casualties such as a Tsunami. Odds of spreading became odds of backup-diesel-generator failure – like with Fukashima Daiichi. Fatalities of the disease became expected fatalities due to radiation spread. Quantification from this discussion took it from hyperbole and emotion into one where we could rationally base guidelines. It has been one of the most effective educational devices observed.

Keywords: COVID, education, probability, risk

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5040 Combination of Work and Family Demands Correlated with the Severity of Wrist Musculoskeletal Disorders among Nurses

Authors: Hsien Hwa Kuo, Lin Wen Chun, Lin Wen Chun, Hsien Wen Kuo

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Objective: Nurses represent an important occupational group frequently affected by wrist musculoskeletal disorders (WMSDs) due to a heavy workload, working shifts, poor posture, giving shots, making beds, lifting patients, bending their waist and insufficient rest time every day. However, lack of research reported nurses whether workload in household correlated with the severity of WMSDs. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire including the demographic information, workplace condition and nine body parts of musculoskeletal disorders. Results: 17.9% and 23.9% of severity and symptoms in WMSDs among nurses with children were significant higher than among nurses without children (1​2.4% and 15.9%). Based on multiple logistic regression models adjusted for age, work duration, job title and body mass index (BMI), we found that heavy workload in hospital had higher odds ratio (OR) of the severity and symptoms of WMSD among nurses with children (OR= 8.67 and OR= 4.30, p<0.05) compared to nurses without children (OR= 1.94 and OR= 1.70). Conclusion: The severity and symptoms of WMSDs among nurses significantly correlated with workload in hospital among nurses with children. If women are at greater risk because of the combination of their work and family demands, synergistic effect of WMSDs was found among nurses. Comment: Women's domestic work, especially once they become mothers, they invest more time and energy caring for children, helping others, and doing housework. Thus domestic work, per se, may be a risk factor for wrist musculoskeletal problems, and, more importantly, it may constrain women's ability to protect themselves from the effects of their paid work. If nurses with more domestic work periodically make efforts to physical activity or modify inappropriate posture, their WMSDs symptoms will be alleviated.

Keywords: musculoskeletal disorders, nurse, NMQ, WMSDs

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5039 Matching Law in Autoshaped Choice in Neural Networks

Authors: Giselle Maggie Fer Castañeda, Diego Iván González

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The objective of this work was to study the autoshaped choice behavior in the Donahoe, Burgos and Palmer (DBP) neural network model and analyze it under the matching law. Autoshaped choice can be viewed as a form of economic behavior defined as the preference between alternatives according to their relative outcomes. The Donahoe, Burgos and Palmer (DBP) model is a connectionist proposal that unifies operant and Pavlovian conditioning. This model has been used for more than three decades as a neurobehavioral explanation of conditioning phenomena, as well as a generator of predictions suitable for experimental testing with non-human animals and humans. The study consisted of different simulations in which, in each one, a ratio of reinforcement was established for two alternatives, and the responses (i.e., activations) in each of them were measured. Choice studies with animals have demonstrated that the data generally conform closely to the generalized matching law equation, which states that the response ratio equals proportionally to the reinforcement ratio; therefore, it was expected to find similar results with the neural networks of the Donahoe, Burgos and Palmer (DBP) model since these networks have simulated and predicted various conditioning phenomena. The results were analyzed by the generalized matching law equation, and it was observed that under some contingencies, the data from the networks adjusted approximately to what was established by the equation. Implications and limitations are discussed.

Keywords: matching law, neural networks, computational models, behavioral sciences

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5038 A Comparison between Five Indices of Overweight and Their Association with Myocardial Infarction and Death, 28-Year Follow-Up of 1000 Middle-Aged Swedish Employed Men

Authors: Lennart Dimberg, Lala Joulha Ian

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Introduction: Overweight (BMI 25-30) and obesity (BMI 30+) have consistently been associated with cardiovascular (CV) risk and death since the Framingham heart study in 1948, and BMI was included in the original Framingham risk score (FRS). Background: Myocardial infarction (MI) poses a serious threat to the patient's life. In addition to BMI, several other indices of overweight have been presented and argued to replace FRS as more relevant measures of CV risk. These indices include waist circumference (WC), waist/hip ratio (WHR), sagittal abdominal diameter (SAD), and sagittal abdominal diameter to height (SADHtR). Specific research question: The research question of this study is to evaluate the interrelationship between the various body measurements, BMI, WC, WHR, SAD, and SADHtR, and which measurement is strongly associated with MI and death. Methods: In 1993, 1,000 middle-aged Caucasian, randomly selected working men of the Swedish Volvo-Renault cohort were surveyed at a nurse-led health examination with a questionnaire, EKG, laboratory tests, blood pressure, height, weight, waist, and sagittal abdominal diameter measurements. Outcome data of myocardial infarction over 28 years come from Swedeheart (the Swedish national myocardial infarction registry) and the Swedish death registry. The Aalen-Johansen and Kaplan–Meier methods were used to estimate the cumulative incidences of MI and death. Multiple logistic regression analyses were conducted to compare BMI with the other four body measurements. The risk for the various measures of obesity was calculated with outcomes of accumulated first-time myocardial infarction and death as odds ratios (OR) in quartiles. The ORs between the 4th and the 1st quartile of each measure were calculated to estimate the association between the body measurement variables and the probability of cumulative incidences of myocardial infarction (MI) over time. Double-sided P values below 0.05 will be considered statistically significant. Unadjusted odds ratios were calculated for obesity indicators, MI, and death. Adjustments for age, diabetes, SBP, and the ratio of total cholesterol/HDL-C and blue/white collar status were performed. Results: Out of 1000 people, 959 subjects had full information about the five different body measurements. Of those, 90 participants had a first MI, and 194 persons died. The study showed that there was a high and significant correlation between the five different body measurements, and they were all associated with CVD risk factors. All body measurements were significantly associated with MI, with the highest (OR=3.6) seen for SADHtR and WC. After adjustment, all but SADHtR remained significant with weaker ORs. As for all-cause mortality, WHR (OR=1.7), SAD (OR=1.9), and SADHtR (OR=1.6) were significantly associated, but not WC and BMI. However, after adjustment, only WHR and SAD were significantly associated with death, but with attenuated ORs.

Keywords: BMI, death, epidemiology, myocardial infarction, risk factor, sagittal abdominal diameter, sagittal abdominal diameter to height, waist circumference, waist-hip ratio

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5037 Improvement of Healthcare Quality and Psychological Stress Relieve for Transition Program in Intensive Care Units

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

Abstract:

Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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5036 The Influence of Feedgas Ratio on the Ethene Hydroformylation using Rh-Co Bimetallic Catalyst Supported by Reduced Graphene Oxide

Authors: Jianli Chang, Yusheng Zhang, Yali Yao, Diane Hildebrandt, Xinying Liu

Abstract:

The influence of feed-gas ratio on the ethene hydroformylation over an Rh-Co bimetallic catalyst supported by reduced graphene oxide (RGO) has been investigated in a tubular fixed bed reactor. Argon was used as balance gas when the feed-gas ratio was changed, which can keep the partial pressure of the other two kinds of gas constant while the ratio of one component in feed-gas was changed. First, the effect of single-component gas ratio on the performance of ethene hydroformylation was studied one by one (H₂, C₂H₄ and CO). Then an optimized ratio was found to obtain a high selectivity to C₃ oxygenates. The results showed that: (1) 0.5%Rh-20%Co/RGO is a promising heterogeneous catalyst for ethene hydroformylation. (2) H₂ and CO have a more significant influence than C₂H₄ on selectivity to oxygenates. (3) A lower H₂ ratio and a higher CO ratio in feed-gas can lead to a higher selectivity to oxygenates. (4) The highest selectivity to oxygenates, 61.70%, was obtained at the feed-gas ratio CO: C₂H₄: H₂ = 4: 2: 1.

Keywords: ethene hydroformylation, reduced graphene oxide, rhodium cobalt bimetallic catalyst, the effect of feed-gas ratio

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5035 Eating Disorders and Eating Behaviors in Morbid Obese Women with and without Type 2 Diabetes

Authors: Azadeh Mottaghi, Zeynab Shakeri

Abstract:

Background: Eating disorders (ED) are group of psychological disorders that significantly impair physical health and psychosocial function. EDconsists wide range of morbidity such as loss of eating control, binge eating disorder(BED), night eating syndrome (NES), and bulimia nervosa. Eating behavior is a wide range term that includes food choices, eating patterns, eating problems. In this study, current knowledge will be discussed aboutcomparison of eating disorders and eating behaviors in morbid obese women with and without type 2 diabetes. Methods: 231 womenwith morbid obesity were included in the study.Loss of eating control, Binge eating disorder and Bulimia nervosa, Night eating syndrome, and eating behaviors and psychosocial factorswere assessed. SPSS version 20 was used for statistical analysis. A p-value of <0.05 was considered significant. Results: There was a significant difference between women with and without diabetes in case of binge eating disorder (76.3% vs. 47.3%, p=0.001). Women with the least Interpersonal support evaluation list (ISEL) scores had a higher risk of eating disorders, and it is more common among diabetics (29.31% vs. 30.45%, p= 0.050). There was no significant difference between depression level and BDI score among women with or without diabetes. Although 38.5% (n=56) of women with diabetes and 50% (n=71) of women without diabetes had minimal depression. The logistic regression model has shown that women without diabetes had lower odds of exhibiting BED (OR=0.28, 95% CI 0.142-0.552).Women with and without diabetes with high school degree (OR=5.54, 95% CI 2.46-9.45, P= 0.0001 & OR=6.52, 95% CI 3.15-10.56, respectively) and moderate depression level (OR=2.03, 95% CI 0.98-3.95 & OR=3.12, 95% CI 2.12-4.56, P= 0.0001) had higher odds of BED. Conclusion: The result of the present study shows that the odds of BED was lower in non-diabetic women with morbid obesity. Women with morbid obesity who had high school degree and moderate depression level had more odds for BED.

Keywords: eating disorders binge eating disorder, night eating syndrome, bulimia nervosa, morbid obesity

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5034 Prenatal Can Reduce the Burden of Preterm Birth and Low Birthweight from Maternal Sexually Transmitted Infections: US National Data

Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

Abstract:

We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

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5033 Group Sequential Covariate-Adjusted Response Adaptive Designs for Survival Outcomes

Authors: Yaxian Chen, Yeonhee Park

Abstract:

Driven by evolving FDA recommendations, modern clinical trials demand innovative designs that strike a balance between statistical rigor and ethical considerations. Covariate-adjusted response-adaptive (CARA) designs bridge this gap by utilizing patient attributes and responses to skew treatment allocation in favor of the treatment that is best for an individual patient’s profile. However, existing CARA designs for survival outcomes often hinge on specific parametric models, constraining their applicability in clinical practice. In this article, we address this limitation by introducing a CARA design for survival outcomes (CARAS) based on the Cox model and a variance estimator. This method addresses issues of model misspecification and enhances the flexibility of the design. We also propose a group sequential overlapweighted log-rank test to preserve type I error rate in the context of group sequential trials using extensive simulation studies to demonstrate the clinical benefit, statistical efficiency, and robustness to model misspecification of the proposed method compared to traditional randomized controlled trial designs and response-adaptive randomization designs.

Keywords: cox model, log-rank test, optimal allocation ratio, overlap weight, survival outcome

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5032 The Simple Two-Step Polydimethylsiloxane (PDMS) Transferring Process for High Aspect Ratio Microstructures

Authors: Shaoxi Wang, Pouya Rezai

Abstract:

High aspect ratio is the necessary parts of complex microstructures. Some methods available to achieve high aspect ratio requires expensive materials or complex process; others is difficult to research simple high aspect ratio structures. The paper presents a simple and cheap two-step Polydimethylsioxane (PDMS) transferring process to get high aspect ratio single pillars, which only requires covering the PDMS mold with Brij@52 surface solution. The experimental results demonstrate the method efficiency and effective.

Keywords: high aspect ratio, microstructure, PDMS, Brij

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5031 Insufficient Sleep as a Risk Factor for Substance Use Among Adolescents: The Mediating Role of Depressive Symptoms

Authors: Aaron Kim, Nydia Hernandez

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Despite the known deficits in sleep duration among adolescents and the increasing prevalence of substance use behaviors among this group, relatively little is known about how insufficient sleep is related to various substance use behaviors and the underlying mechanisms. Informed by the literature suggesting the predictive role of insufficient sleep for substance use and depressive symptoms, we hypothesized that adolescents who lack sufficient sleep during school nights would report a higher level of depressive symptoms and substance use than their counterparts with sufficient sleep. We also hypothesized that depressive symptoms would explain the association of insufficient sleep with substance use, suggesting that mental health plays an important role as a mechanism between insufficient sleep and substance use. This study used the data drawn from the 2019 Youth Risk Behavior Surveillance System Data, which includes a nationally representative sample of U.S. high school students (N=13,677, 49.4% Female, 9th-12th graders). Self-report measures of insufficient sleep (sleeping<7 h on an average school night), depressive symptoms (yes/no), any past 30-day use of cigarette (yes/no), e-cigarette (yes/no), alcohol (yes/no), and marijuana (yes/no). Among the total sample, 47.9% of students reported that they did not have sufficient sleep on school nights, indicating sleeping less than 7 hours. Regarding depressive symptoms, 36.7% of students reported feeling sad or hopeless almost every day for two weeks or more in a row during the past 12 months. Also, the percentages of students who reported one or more times of cigarette use, e-cigarette use, alcohol use, and marijuana use in the past month were 5.32%, 30.11%, 26.83%, and 21.65%, respectively. For bivariate associations among these study variables, insufficient sleep was positively associated with other variables: depressive symptoms (r=.08, p<.001), cigarette use (r=.03, p<.001), e-cigarette use (r=.04, p<.001), alcohol use (r=.07, p<.001), and marijuana use (r=.08, p<.001). After controlling for students’ characteristics (i.e., age, gender, race/ethnicity, grades), sleeping less than 7 hours on school nights (vs. sleeping more than 7 hours) was significantly associated with the past 30-day use of alcohol and marijuana, whereas cigarette and e-cigarette uses were not. That is, the students who reported having an insufficient sleep on school nights had higher odds of alcohol (Odds Ratio [OR]=1.15, 95% Confidence Interval [CI]=1.014-1.301) and marijuana use (OR=1.36, 95% CI=1.132-1.543). In a subsequent analysis including depressive symptoms together with insufficient sleep, the association of insufficient sleep with alcohol use (OR=1.13, 95% CI=1.011-1.297) and marijuana use (OR=1.33, 95% CI=1.130-1.521) were attenuated and explained by depressive symptoms. Depressive symptoms significantly increased the odds of alcohol use by 32.2% (OR=1.32, 95% CI=1.131-1.557) and marijuana use by 202.1% (OR=2.02, 95% CI=1.672-2.502). These findings together suggest that insufficient sleep may contribute to increased risks of substance uses among adolescents. The current study also shows that psychological disorders of adolescents play important roles in understanding the association between insufficient sleep and substance use, suggesting insufficient sleep is related to substance use indirectly through depressive symptoms. This study indicates the importance of sleep deprivation among adolescents and screening for insufficient sleep in preventing/intervening in substance use.

Keywords: adolescents, depressive symptoms, sleep, substance use

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5030 Drying Kinects of Soybean Seeds

Authors: Amanda Rithieli Pereira Dos Santos, Rute Quelvia De Faria, Álvaro De Oliveira Cardoso, Anderson Rodrigo Da Silva, Érica Leão Fernandes Araújo

Abstract:

The study of the kinetics of drying has great importance for the mathematical modeling, allowing to know about the processes of transference of heat and mass between the products and to adjust dryers managing new technologies for these processes. The present work had the objective of studying the kinetics of drying of soybean seeds and adjusting different statistical models to the experimental data varying cultivar and temperature. Soybean seeds were pre-dried in a natural environment in order to reduce and homogenize the water content to the level of 14% (b.s.). Then, drying was carried out in a forced air circulation oven at controlled temperatures of 38, 43, 48, 53 and 58 ± 1 ° C, using two soybean cultivars, BRS 8780 and Sambaíba, until reaching a hygroscopic equilibrium. The experimental design was completely randomized in factorial 5 x 2 (temperature x cultivar) with 3 replicates. To the experimental data were adjusted eleven statistical models used to explain the drying process of agricultural products. Regression analysis was performed using the least squares Gauss-Newton algorithm to estimate the parameters. The degree of adjustment was evaluated from the analysis of the coefficient of determination (R²), the adjusted coefficient of determination (R² Aj.) And the standard error (S.E). The models that best represent the drying kinetics of soybean seeds are those of Midilli and Logarítmico.

Keywords: curve of drying seeds, Glycine max L., moisture ratio, statistical models

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5029 Adaptation to Repeated Eccentric Exercise Assessed by Double to Single Twitch Ratio

Authors: Damian Janecki, Anna Jaskólska, Jarosław Marusiak, Artur Jaskólski

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The aim of this study was to assess double to single twitch ratio after two bouts of eccentric exercise of the elbow flexors. Maximal isometric torque, single and double twitch responses and low-frequency fatigue were assessed on the elbow flexors in 19 untrained male volunteers before, immediately after, 24 and 48 hours following two bouts of eccentric exercise consisted of 30 repetitions of lowering a dumbbell adjusted to ~75% of each individual's maximal isometric torque. Maximal isometric torque and electrically evoked responses decreased significantly in all measurements after the first bout of eccentric exercise (P<0.05). In measurements performed at 24 and 48 hours after the second bout both maximal voluntary isometric torque and electrically evoked contractions were significantly higher than in measurements performed after the fist bout (P<0.05). Although low-frequency fatigue significantly increased up to 48 hours after each bout of eccentric exercise, its values at 24 and 48 hours after the second bout were significantly lower than at respective time points after the first bout (P<0.05). Smaller changes in double to single twitch ratio at 24 and 48 hours after the second bout of eccentric exercise reflects repeated bout effect that confers protection against subsequent exercise-induced muscle damage.

Keywords: biceps brachii, electrical stimulation, lenghtening contractions, repeated bout effect

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5028 The Road to Tunable Structures: Comparison of Experimentally Characterised and Numerical Modelled Auxetic Perforated Sheet Structures

Authors: Arthur Thirion

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Auxetic geometries allow the generation of a negative Poisson ratio (NPR) in conventional materials. This behaviour allows materials to have certain improved mechanical properties, including impact resistance and altered synclastic behaviour. This means these structures have significant potential when it comes to applications as chronic wound dressings. To this end, 6 different "perforated sheet" structure types were 3D printed. These structures all had variations of key geometrical features included cell length and angle. These were tested in compression and tension to assess their Poisson ratio. Both a positive and negative Poisson ratio was generated by the structures depending on the loading. The a/b ratio followed by θ has been shown to impact the Poisson ratio significantly. There is still a significant discrepancy between modelled and observed behaviour.

Keywords: auxetic materials, 3D printing, negative Poisson's ratio, tunable Poisson's ratio

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5027 Enhanced Methane Production from Waste Paper through Anaerobic Co-Digestion with Macroalgae

Authors: Cristina Rodriguez, Abed Alaswad, Zaki El-Hassan, Abdul G. Olabi

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This study investigates the effect on methane production from the waste paper when co-digested with macroalgal biomass as a source of nitrogen. Both feedstocks were previously mechanically pretreated in order to reduce their particle size. Methane potential assays were carried out at laboratory scale in batch mode for 28 days. The study was planned according to two factors: the feedstock to inoculum (F/I) ratio and the waste paper to macroalgae (WP/MA) ratio. The F/I ratios checked were 0.2, 0.3 and 0.4 and the WP/MA ratios were 0:100, 25:75, 50:50, 75:25 and 100:0. The highest methane yield (608 ml/g of volatile solids (VS)) was achieved at an F/I ratio of 0.2 and a WP/MA ratio of 50:50. The methane yield at a ratio WP/MA of 50:50 is higher than for single compound, while for ratios WP/MA of 25:75 and 75:25 the methane yield decreases compared to biomass mono-digestion. This behavior is observed for the three levels of F/I ratio being more noticeable at F/I ratio of 0.3. A synergistic effect was found for the WP/MA ratio of 50:50 and all F/I ratios and for WP/MA=50:50 and F/I=0.2. A maximum increase of methane yield of 49.58% was found for a co-digestion ratio of 50:50 and an F/I ratio of 0.4. It was concluded that methane production from waste paper improves significantly when co-digested with macroalgae biomass. The methane yields from co-digestion were also found higher that from macroalgae mono-digestion.

Keywords: anaerobic co-digestion, biogas, macroalgae, waste paper

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5026 Risk Factors Associated with Dengue Fever Outbreak in Diredawa Administration City, Ethiopia, October 2015: A Case Control Study

Authors: Luna Degife, Desalegn Belay, Yoseph Worku, Tigist Tesfaye, Assefa Tufa, Abyot Bekele, Zegeye Hailemariam, Abay Hagos

Abstract:

Half of the world’s population is at risk of Dengue Fever (DF), a highly under-recognized and underreported mosquito-borne viral disease with high prevalence in the tropical and subtropical regions. Globally, an estimated 50 to 200 million cases and 20, 000 DF deaths occur annually as per the world health organization report. In Ethiopia, the first outbreak occurred in 2013 in Diredawa administration city. Afterward, three outbreaks have been reported from the eastern part of the country. We received a report of the fifth DF outbreak for Ethiopia and the second for Diredawa city on October 4, 2015. We conducted the investigation to confirm the outbreak, identify the risk factors for the repeatedly occurrence of the disease and implement control measures. We conducted un- matched case-control study and defined a suspected DF case as any person with fever of 2-7 days and 2 or more of the following: a headache, arthralgia, myalgia, rash, or bleeding from any part of the body. Controls were residents of Diredawa city without DF symptoms. We interviewed 70 Cases and 140 controls from all health facilities in Diredawa city from October 7 to 15; 2015. Epi Info version 7.1.5.0 was used to analyze the data and multivariable logistic regression was conducted to assess risk factors for DF. Sixty-nine blood samples were collected for Laboratory confirmation.The mean age for cases was 23.7±9.5 standard deviation (SD) and for controls 31.2±13 SD. Close contact with DF patient (Adjusted odds ratio (AOR)=5.36, 95% confidence interval(CI): 2.75-10.44), nonuse of long-lasting insecticidal nets (AOR=2.74, 95% CI: 1.06-7.08) and availability of stagnant water in the village (AOR=3.61, 95% CI:1.31-9.93) were independent risk factors associated with higher rates of the disease. Forty-two samples were tested positive. Endemicity of DF is becoming a concern for Diredawa city after the first outbreak. Therefore, effective vector control activities need to be part of long-term preventive measures.

Keywords: dengue fever, Diredawa, outbreak, risk factors, second

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5025 Positron Emission Tomography Parameters as Predictors of Pathologic Response and Nodal Clearance in Patients with Stage IIIA NSCLC Receiving Trimodality Therapy

Authors: Andrea L. Arnett, Ann T. Packard, Yolanda I. Garces, Kenneth W. Merrell

Abstract:

Objective: Pathologic response following neoadjuvant chemoradiation (CRT) has been associated with improved overall survival (OS). Conflicting results have been reported regarding the pathologic predictive value of positron emission tomography (PET) response in patients with stage III lung cancer. The aim of this study was to evaluate the correlation between post-treatment PET response and pathologic response utilizing novel FDG-PET parameters. Methods: This retrospective study included patients with non-metastatic, stage IIIA (N2) NSCLC cancer treated with CRT followed by resection. All patients underwent PET prior to and after neoadjuvant CRT. Univariate analysis was utilized to assess correlations between PET response, nodal clearance, pCR, and near-complete pathologic response (defined as the microscopic residual disease or less). Maximal standard uptake value (SUV), standard uptake ratio (SUR) [normalized independently to the liver (SUR-L) and blood pool (SUR-BP)], metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured pre- and post-chemoradiation. Results: A total of 44 patients were included for review. Median age was 61.9 years, and median follow-up was 2.6 years. Histologic subtypes included adenocarcinoma (72.2%) and squamous cell carcinoma (22.7%), and the majority of patients had the T2 disease (59.1%). The rate of pCR and near-complete pathologic response within the primary lesion was 28.9% and 44.4%, respectively. The average reduction in SUVmₐₓ was 9.2 units (range -1.9-32.8), and the majority of patients demonstrated some degree of favorable treatment response. SUR-BP and SUR-L showed a mean reduction of 4.7 units (range -0.1-17.3) and 3.5 units (range –1.7-12.6), respectively. Variation in PET response was not significantly associated with histologic subtype, concurrent chemotherapy type, stage, or radiation dose. No significant correlation was found between pathologic response and absolute change in MTV or TLG. Reduction in SUVmₐₓ and SUR were associated with increased rate of pathologic response (p ≤ 0.02). This correlation was not impacted by normalization of SUR to liver versus mediastinal blood pool. A threshold of > 75% decrease in SUR-L correlated with near-complete response, with a sensitivity of 57.9% and specificity of 85.7%, as well as positive and negative predictive values of 78.6% and 69.2%, respectively (diagnostic odds ratio [DOR]: 5.6, p=0.02). A threshold of >50% decrease in SUR was also significantly associated pathologic response (DOR 12.9, p=0.2), but specificity was substantially lower when utilizing this threshold value. No significant association was found between nodal PET parameters and pathologic nodal clearance. Conclusions: Our results suggest that treatment response to neoadjuvant therapy as assessed on PET imaging can be a predictor of pathologic response when evaluated via SUV and SUR. SUR parameters were associated with higher diagnostic odds ratios, suggesting improved predictive utility compared to SUVmₐₓ. MTV and TLG did not prove to be significant predictors of pathologic response but may warrant further investigation in a larger cohort of patients.

Keywords: lung cancer, positron emission tomography (PET), standard uptake ratio (SUR), standard uptake value (SUV)

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5024 Variations of the Modal Characteristics of the Feeding Stage with Different Preloaded Linear Guide

Authors: Jui-Pui Hung, Yong-Run Chen, Wei-Cheng Shih, Chun-Wei Lin

Abstract:

This study was aimed to assess the variations of the modal characteristics of the feeding stage with different linear guide modulus. The dynamic characteristics of the feeding stage were characterized in terms of the modal stiffness, modal frequency and modal damping, which are assessed from the vibration tests. According to the experimental measurements, the actual preload of the linear guide modulus was found to deviate from the rated values as setting in factory. This may be due to the assemblage errors of guide modules. For the stage with linear guides, the dynamic stiffness was affected to change by the preload set on the rolling balls. The variation of the dynamic stiffness at first and second modes is 20.8 and 10.5%, respectively when the linear guide preload is adjusted from medium and high amount. But the modal damping ratio is reduced by 8.97 and 9.65%, respectively. For high-frequency mode, the modal stiffness increases by 171.2% and the damping ratio reduced by 34.4%. Current results demonstrate the importance in the determining the preloaded amount of linear guide modulus in practical application.

Keywords: contact stiffness, feeding stage, linear guides, modal characteristics, pre-load

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5023 Effect of Si/Al Ratio on SSZ-13 Crystallization and Its Methanol-To-Olefins Catalytic Properties

Authors: Zhiqiang Xu, Hongfang Ma, Haitao Zhang, Weixin Qian, Weiyong Ying

Abstract:

SSZ-13 materials with different Si/Al ratio were prepared by varying the composition of aluminosilicate precursor solutions upon hydrothermal treatment at 150 °C. The Si/Al ratio of the initial system was systematically changed from 12.5 to infinity in order to study the limits of Al composition in precursor solutions for constructing CHA structure. The intermediates and final products were investigated by complementary techniques such as XRD, HRTEM, FESEM, and chemical analysis. NH3-TPD was used to study the Brønsted acidity of SSZ-13 samples with different Si/Al ratios. The effect of the Si/Al ratio on the precursor species, ultimate crystal size, morphology and yield was investigated. The results revealed that Al species determine the nucleation rate and the number of nuclei, which is tied to the morphology and yield of SSZ-13. The size of SSZ-13 increased and the yield decreased as the Si/Al ratio was improved. Varying Si/Al ratio of the initial system is a facile, commercially viable method of tailoring SSZ-13 crystal size and morphology. Furthermore, SSZ-13 materials with different Si/Al ratio were tested as catalysts for the methanol to olefins (MTO) reaction at 350 °C. SSZ-13 with the Si/Al ratio of 35 shows the best MTO catalytic performance.

Keywords: crystallization, MTO, Si/Al ratio, SSZ-13

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5022 Relationship between Readability of Paper-Based Braille and Character Spacing

Authors: T. Nishimura, K. Doi, H. Fujimoto, T. Wada

Abstract:

The Number of people with acquired visual impairments has increased in recent years. In specialized courses at schools for the blind and in Braille lessons offered by social welfare organizations, many people with acquired visual impairments cannot learn to read adequately Braille. One of the reasons is that the common Braille patterns for people visual impairments who already has mature Braille reading skill being difficult to read for Braille reading beginners. In addition, there is the scanty knowledge of Braille book manufacturing companies regarding what Braille patterns would be easy to read for beginners. Therefore, it is required to investigate a suitable Braille patterns would be easy to read for beginners. In order to obtain knowledge regarding suitable Braille patterns for beginners, this study aimed to elucidate the relationship between readability of paper-based Braille and its patterns. This study focused on character spacing, which readily affects Braille reading ability, to determine a suitable character spacing ratio (ratio of character spacing to dot spacing) for beginners. Specifically, considering beginners with acquired visual impairments who are unfamiliar with reading Braille, we quantitatively evaluated the effect of character spacing ratio on Braille readability through an evaluation experiment using sighted subjects with no experience of reading Braille. In this experiment, ten sighted adults took the blindfold were asked to read test piece (three Braille characters). Braille used as test piece was composed of five dots. They were asked to touch the Braille by sliding their forefinger on the test piece immediately after the test examiner gave a signal to start the experiment. Then, they were required to release their forefinger from the test piece when they perceived the Braille characters. Seven conditions depended on character spacing ratio was held (i.e., 1.2, 1.4, 1.5, 1.6, 1.8, 2.0, 2.2 [mm]), and the other four depended on the dot spacing (i.e., 2.0, 2.5, 3.0, 3.5 [mm]). Ten trials were conducted for each conditions. The test pieces are created using by NISE Graphic could print Braille adjusted arbitrary value of character spacing and dot spacing with high accuracy. We adopted the evaluation indices for correct rate, reading time, and subjective readability to investigate how the character spacing ratio affects Braille readability. The results showed that Braille reading beginners could read Braille accurately and quickly, when character spacing ratio is more than 1.8 and dot spacing is more than 3.0 mm. Furthermore, it is difficult to read Braille accurately and quickly for beginners, when both character spacing and dot spacing are small. For this study, suitable character spacing ratio to make reading easy for Braille beginners is revealed.

Keywords: Braille, character spacing, people with visual impairments, readability

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5021 Application Difference between Cox and Logistic Regression Models

Authors: Idrissa Kayijuka

Abstract:

The logistic regression and Cox regression models (proportional hazard model) at present are being employed in the analysis of prospective epidemiologic research looking into risk factors in their application on chronic diseases. However, a theoretical relationship between the two models has been studied. By definition, Cox regression model also called Cox proportional hazard model is a procedure that is used in modeling data regarding time leading up to an event where censored cases exist. Whereas the Logistic regression model is mostly applicable in cases where the independent variables consist of numerical as well as nominal values while the resultant variable is binary (dichotomous). Arguments and findings of many researchers focused on the overview of Cox and Logistic regression models and their different applications in different areas. In this work, the analysis is done on secondary data whose source is SPSS exercise data on BREAST CANCER with a sample size of 1121 women where the main objective is to show the application difference between Cox regression model and logistic regression model based on factors that cause women to die due to breast cancer. Thus we did some analysis manually i.e. on lymph nodes status, and SPSS software helped to analyze the mentioned data. This study found out that there is an application difference between Cox and Logistic regression models which is Cox regression model is used if one wishes to analyze data which also include the follow-up time whereas Logistic regression model analyzes data without follow-up-time. Also, they have measurements of association which is different: hazard ratio and odds ratio for Cox and logistic regression models respectively. A similarity between the two models is that they are both applicable in the prediction of the upshot of a categorical variable i.e. a variable that can accommodate only a restricted number of categories. In conclusion, Cox regression model differs from logistic regression by assessing a rate instead of proportion. The two models can be applied in many other researches since they are suitable methods for analyzing data but the more recommended is the Cox, regression model.

Keywords: logistic regression model, Cox regression model, survival analysis, hazard ratio

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5020 Influence of Engaging Female Caregivers in Households with Adolescent Girls on Adopting Equitable Family Eating Practices: A Quasi-Experimental Study

Authors: Hanna Gulema, Meaza Demissie, Alemayehu Worku, Tesfaye Assebe Yadeta, Yemane Berhane

Abstract:

Background: In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA). Method: We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study’s outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the Mixed effect logistic regression model was used to examine the effect of the intervention. Result: The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06–4.09]) after controlling selected covariates, p-value 0.033. Conclusions: The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.

Keywords: family eating practice, social norm intervention, adolescence girls, caregiver

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5019 The Determination of Sodium/Potassium Ion Ratio in Selected Edible Leafy Vegetables in North-Eastern Nigeria

Authors: Raymond D. Uzoh, Philip K. Shallsuku, Christopher S. Vaachia

Abstract:

Selected edible leafy vegetables from North-eastern Nigeria were analysed for their sodium and potassium content in mg/100 g and the ratio Na+/K+ worked out. From experimental results, Venonia amydalina (bitter leaf) contained 150 mg (0.15 g) of sodium and 20500 mg (20.5 g) potassium with a ratio of 0.007, Brassica oleracea var capitata (cabbage) contained 300 mg (0.3 g) of sodium and 19000 mg (19 g) of potassium with a ration of 0.012. Others are Telfairia occidentalis (fluted pumpkin) with 400 mg (0.45 g) of sodium and 19500 mg (19.5 g) of potassium with a ratio of 0.020; Hibiscus sabdriffa (sorrel) has 200 mg (0.2 g) of sodium and 600 mg (0.6 g) of potassium with a ratio of 0.300; and Amarantus caudatus (spinach) contained 450 mg (0.45 g) of sodium and 23000 mg (23 g) of potassium with a ratio of 0.020. The presence of sodium and potassium in foods has become increasingly important as recent studies and dietary information gathered in this research has shown that sodium intake is not the sole consideration in elevated blood pressure but its considered as a ratio Na+/K+ fixed at 0.6. This ratio has been found to be a more important factor, suggesting that our diet should contain 67 % more potassium than sodium.

Keywords: vegetables, sodium, potassium, blood pressure, diet, foods

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5018 Value of Willingness to Pay for a Quality-Adjusted Life Years Gained in Iran; A Modified Chained-Approach

Authors: Seyedeh-Fariba Jahanbin, Hasan Yusefzadeh, Bahram Nabilou, Cyrus Alinia, Cyrus Alinia

Abstract:

Background: Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran’s general public, the cost-efectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting. Methods: We have measured this cost-efectiveness threshold with the participation of 2854 individuals from fve provinces, each representing an income quintile, using a modifed Time Trade-Of-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire. Results: Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confrmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts. Conclusions: In the health system of Iran, any intervention that is with the incremental cost-efectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-efective.

Keywords: willingness to Pay, QALY, chained-approach, cost-efectiveness threshold, Iran

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5017 Determinants of Repeated Abortion among Women of Reproductive Age Attending Health Facilities in Northern Ethiopia: A Case-Control Study

Authors: Henok Yebyo Henok, Araya Abrha Araya, Alemayehu Bayray Alemayehu, Gelila Goba Gelila

Abstract:

Background: Every year, an estimated 19–20 million unsafe abortions take place, almost all in developing countries, leading to 68,000 deaths and millions more injured many permanently. Many women throughout the world, experience more than one abortion in their lifetimes. Repeat abortion is an indicator of the larger problem of unintended pregnancy. This study aimed to identify determinants of repeat abortion in Tigray Region, Ethiopia. Methods: Unmatched case-control study was conducted in hospitals in Tigray Region, Northern Ethiopia, from November 2014 to June 2015. The sample included 105 cases and 204 controls, recruited from among women seeking abortion care at public hospitals. Clients having two or more abortions (“repeat abortion”) were taken as cases, and those who had a total of one abortion were taken as controls (“single abortion”). Cases were selected consecutive based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression analyses were calculated with 95% CI. Results: Mean age of cases was 24 years (±6.85) and 22 years (±6.25) for controls. 79.0% of cases had their sexual debut in less than 18 years of age compared to 57% of controls. 42.2% of controls and 23.8% of cases cited rape as the reason for having an abortion. Study participants who did not understand their fertility cycle and when they were most likely to conceive after menstruation (adjusted odds ratio [AOR]=2.0, 95% confidence interval [CI]: 1.1-3.7), having a previous abortion using medication(AOR=3.3, CI: 1.83, 6.11), having multiple sexual partners in the preceding 12 months (AOR=4.4, CI: 2.39,8.45), perceiving that the abortion procedure is not painful (AOR=2.3, CI: 1.31,4.26), initiating sexual intercourse before the age of 18 years (AOR=2.7, CI: 1.49, 5.23) and disclosure to a third-party about terminating the pregnancy (AOR=2.1, CI: 1.2,3.83) were independent predictors of repeat abortion. Conclusion: This study identified several factors correlated with women having repeat abortions. It may be helpful for the Government of Ethiopia to encourage women to delay sexual debut and decrease their number of sexual partners, including by promoting discussion within families about sexuality, to decrease the occurrence of repeated abortion.

Keywords: abortion, Ethiopia, repeated abortion, single abortion

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5016 The Incidence of Prostate Cancer in Previous Infected E. Coli Population

Authors: Andreea Molnar, Amalia Ardeljan, Lexi Frankel, Marissa Dallara, Brittany Nagel, Omar Rashid

Abstract:

Background: Escherichia coli is a gram-negative, facultative anaerobic bacteria that belongs to the family Enterobacteriaceae and resides in the intestinal tracts of individuals. E.Coli has numerous strains grouped into serogroups and serotypes based on differences in antigens in their cell walls (somatic, or “O” antigens) and flagella (“H” antigens). More than 700 serotypes of E. coli have been identified. Although most strains of E. coli are harmless, a few strains, such as E. coli O157:H7 which produces Shiga toxin, can cause intestinal infection with symptoms of severe abdominal cramps, bloody diarrhea, and vomiting. Infection with E. Coli can lead to the development of systemic inflammation as the toxin exerts its effects. Chronic inflammation is now known to contribute to cancer development in several organs, including the prostate. The purpose of this study was to evaluate the correlation between E. Coli and the incidence of prostate cancer. Methods: Data collected in this cohort study was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate patients infected with E.Coli infection and prostate cancer using the International Classification of Disease (ICD-10 and ICD-9 codes). Permission to use the database was granted by Holy Cross Health, Fort Lauderdale for the purpose of academic research. Data analysis was conducted through the use of standard statistical methods. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 81, 037 patients after matching in both infected and control groups, respectively. The two groups were matched by Age Range and CCI score. The incidence of prostate cancer was 2.07% and 1,680 patients in the E. Coli group compared to 5.19% and 4,206 patients in the control group. The difference was statistically significant by a p-value p<2.2x10-16 with an Odds Ratio of 0.53 and a 95% CI. Based on the specific treatment for E.Coli, the infected group vs control group were matched again with a result of 31,696 patients in each group. 827 out of 31,696 (2.60%) patients with a prior E.coli infection and treated with antibiotics were compared to 1634 out of 31,696 (5.15%) patients with no history of E.coli infection (control) and received antibiotic treatment. Both populations subsequently developed prostate carcinoma. Results remained statistically significant (p<2.2x10-16), Odds Ratio=0.55 (95% CI 0.51-0.59). Conclusion: This retrospective study shows a statistically significant correlation between E.Coli infection and a decreased incidence of prostate cancer. Further evaluation is needed in order to identify the impact of E.Coli infection and prostate cancer development.

Keywords: E. Coli, prostate cancer, protective, microbiology

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5015 Predictors of Glycaemic Variability and Its Association with Mortality in Critically Ill Patients with or without Diabetes

Authors: Haoming Ma, Guo Yu, Peiru Zhou

Abstract:

Background: Previous studies show that dysglycemia, mostly hyperglycemia, hypoglycemia and glycemic variability(GV), are associated with excess mortality in critically ill patients, especially those without diabetes. Glycemic variability is an increasingly important measure of glucose control in the intensive care unit (ICU) due to this association. However, there is limited data pertaining to the relationship between different clinical factors and glycemic variability and clinical outcomes categorized by their DM status. This retrospective study of 958 intensive care unit(ICU) patients was conducted to investigate the relationship between GV and outcome in critically ill patients and further to determine the significant factors that contribute to the glycemic variability. Aim: We hypothesize that the factors contributing to mortality and the glycemic variability are different from critically ill patients with or without diabetes. And the primary aim of this study was to determine which dysglycemia (hyperglycemia\hypoglycemia\glycemic variability) is independently associated with an increase in mortality among critically ill patients in different groups (DM/Non-DM). Secondary objectives were to further investigate any factors affecting the glycemic variability in two groups. Method: A total of 958 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The glycemic variability was defined as the coefficient of variation (CV) of blood glucose. The main outcome was death during hospitalization. The secondary outcome was GV. The logistic regression model was used to identify factors associated with mortality. The relationships between GV and other variables were investigated using linear regression analysis. Results: Information on age, APACHE II score, GV, gender, in-ICU treatment and nutrition was available for 958 subjects. Predictors remaining in the final logistic regression model for mortality were significantly different in DM/Non-DM groups. Glycemic variability was associated with an increase in mortality in both DM(odds ratio 1.05; 95%CI:1.03-1.08,p<0.001) or Non-DM group(odds ratio 1.07; 95%CI:1.03-1.11,p=0.002). For critically ill patients without diabetes, factors associated with glycemic variability included APACHE II score(regression coefficient, 95%CI:0.29,0.22-0.36,p<0.001), Mean BG(0.73,0.46-1.01,p<0.001), total parenteral nutrition(2.87,1.57-4.17,p<0.001), serum albumin(-0.18,-0.271 to -0.082,p<0.001), insulin treatment(2.18,0.81-3.55,p=0.002) and duration of ventilation(0.006,0.002-1.010,p=0.003).However, for diabetes patients, APACHE II score(0.203,0.096-0.310,p<0.001), mean BG(0.503,0.138-0.869,p=0.007) and duration of diabetes(0.167,0.033-0.301,p=0.015) remained as independent risk factors of GV. Conclusion: We found that the relation between dysglycemia and mortality is different in the diabetes and non-diabetes groups. And we confirm that GV was associated with excess mortality in DM or Non-DM patients. Furthermore, APACHE II score, Mean BG, total parenteral nutrition, serum albumin, insulin treatment and duration of ventilation were significantly associated with an increase in GV in Non-DM patients. While APACHE II score, mean BG and duration of diabetes (years) remained as independent risk factors of increased GV in DM patients. These findings provide important context for further prospective trials investigating the effect of different clinical factors in critically ill patients with or without diabetes.

Keywords: diabetes, glycemic variability, predictors, severe disease

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5014 Comparative Study of Arch Bridges with Varying Rise to Span Ratio

Authors: Tauhidur Rahman, Arnab Kumar Sinha

Abstract:

This paper presents a comparative study of Arch bridges based on their varying rise to span ratio. The comparison is done between different steel Arch bridges which have variable span length and rise to span ratio keeping the same support condition. The aim of our present study is to select the optimum value of rise to span ratio of Arch bridge as the cost of the Arch bridge increases with the increasing of the rise. In order to fulfill the objective, several rise to span ratio have been considered for same span of Arch bridge and various structural parameters such as Bending moment, shear force etc have been calculated for different model. A comparative study has been done for several Arch bridges finally to select the optimum rise to span ratio of the Arch bridges. In the present study, Finite Element model for medium to long span, with different rise to span ratio have been modeled and are analyzed with the help of a Computational Software named MIDAS Civil to evaluate the results such as Bending moments, Shear force, displacements, Stresses, influence line diagrams, critical loads. In the present study, 60 models of Arch bridges for 80 to 120 m span with different rise to span ratio has been thoroughly investigated.

Keywords: arch bridge, analysis, comparative study, rise to span ratio

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5013 Dietary Pattern derived by Reduced Rank Regression is Associated with Reduced Cognitive Impairment Risk in Singaporean Older Adults

Authors: Kaisy Xinhong Ye, Su Lin Lim, Jialiang Li, Lei Feng

Abstract:

background: Multiple healthful dietary patterns have been linked with dementia, but limited studies have looked at the role of diet in cognitive health in Asians whose eating habits are very different from their counterparts in the west. This study aimed to derive a dietary pattern that is associated with the risk of cognitive impairment (CI) in the Singaporean population. Method: The analysis was based on 719 community older adults aged 60 and above. Dietary intake was measured using a validated semi-quantitative food-frequency questionnaire (FFQ). Reduced rank regression (RRR) was used to extract dietary pattern from 45 food groups, specifying sugar, dietary fiber, vitamin A, calcium, and the ratio of polyunsaturated fat to saturated fat intake (P:S ratio) as response variables. The RRR-derived dietary patterns were subsequently investigated using multivariate logistic regression models to look for associations with the risk of CI. Results: A dietary pattern characterized by greater intakes of green leafy vegetables, red-orange vegetables, wholegrains, tofu, nuts, and lower intakes of biscuits, pastries, local sweets, coffee, poultry with skin, sugar added to beverages, malt beverages, roti, butter, and fast food was associated with reduced risk of CI [multivariable-adjusted OR comparing extreme quintiles, 0.29 (95% CI: 0.11, 0.77); P-trend =0.03]. This pattern was positively correlated with P:S ratio, vitamin A, and dietary fiber and negatively correlated with sugar. Conclusion: A dietary pattern providing high P:S ratio, vitamin A and dietary fiber, and a low level of sugar may reduce the risk of cognitive impairment in old age. The findings have significance in guiding local Singaporeans to dementia prevention through food-based dietary approaches.

Keywords: dementia, cognitive impairment, diet, nutrient, elderly

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