Search results for: significant events
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17516

Search results for: significant events

17336 The Relationship Between Spirituality and Quality of Life in Patients with Spinal Cord Injury, Iran

Authors: Khadije Khazaeli, Farzane Saberi

Abstract:

Spinal cord injury is one of the traumatic events which has a great impact on the quality of life. spirituality has been used to improve many disorders and abnormalities in recent years and positive results have been seen; accordingly, the present study investigated the relationship between spirituality and quality of life in these patients. This study is a cross-sectional study of the correlation type was conducted on 100 people with spinal cord injury in Isfahan province in 2016 by the available sample method. Spirituality was assessed through the Spiritual Attitude Questionnaire and quality of life through the World Health Organization Quality of Life Questionnaire. Pearson correlation and regression tests were used to analyze the data. The results of this study showed that spirituality has a significant relationship with the quality of life of patients with spinal cord injury. It was also proved that all sub-units of spirituality, including attitude and spiritual ability, can affect all components of quality of life. The findings suggest that spirituality, along with other factors, can lead to a significant improvement in quality of life and, ultimately, general health of patients with SCI.

Keywords: spinal cord injury, quality of life, spirituality, patients

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17335 Transferable Knowledge: Expressing Lessons Learnt from Failure to Outsiders

Authors: Stijn Horck

Abstract:

Background: The value of lessons learned from failure increases when these insights can be put to use by those who did not experience the failure. While learning from others has mostly been researched between individuals or teams within the same environment, transferring knowledge from the person who experienced the failure to an outsider comes with extra challenges. As sense-making of failure is an individual process leading to different learning experiences, the potential of lessons learned from failure is highly variable depending on who is transferring the lessons learned. Using an integrated framework of linguistic aspects related to attributional egotism, this study aims to offer a complete explanation of the challenges in transferring lessons learned from failures that are experienced by others. Method: A case study of a failed foundation established to address the information needs for GPs in times of COVID-19 has been used. An overview of failure causes and lessons learned were made through a preliminary analysis of data collected in two phases with metaphoric examples of failure types. This was followed up by individual narrative interviews with the board members who have all experienced the same events to analyse the individual variance of lessons learned through discourse analysis. This research design uses the researcher-as-instrument approach since the recipient of these lessons learned is the author himself. Results: Thirteen causes were given why the foundation has failed, and nine lessons were formulated. Based on the individually emphasized events, the explanation of the failure events mentioned by all or three respondents consisted of more linguistic aspects related to attributional egotism than failure events mentioned by only one or two. Moreover, the learning events mentioned by all or three respondents involved lessons learned that are based on changed insight, while the lessons expressed by only one or two are more based on direct value. Retrospectively, the lessons expressed as a group in the first data collection phase seem to have captured some but not all of the direct value lessons. Conclusion: Individual variance in expressing lessons learned to outsiders can be reduced using metaphoric or analogical explanations from a third party. In line with the attributional egotism theory, individuals separated from a group that has experienced the same failure are more likely to refer to failure causes of which the chances to be contradicted are the smallest. Lastly, this study contributes to the academic literature by demonstrating that the use of linguistic analysis is suitable for investigating the knowledge transfer from lessons learned after failure.

Keywords: failure, discourse analysis, knowledge transfer, attributional egotism

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17334 Study and Simulation of a Sever Dust Storm over West and South West of Iran

Authors: Saeed Farhadypour, Majid Azadi, Habibolla Sayyari, Mahmood Mosavi, Shahram Irani, Aliakbar Bidokhti, Omid Alizadeh Choobari, Ziba Hamidi

Abstract:

In the recent decades, frequencies of dust events have increased significantly in west and south west of Iran. First, a survey on the dust events during the period (1990-2013) is investigated using historical dust data collected at 6 weather stations scattered over west and south-west of Iran. After statistical analysis of the observational data, one of the most severe dust storm event that occurred in the region from 3rd to 6th July 2009, is selected and analyzed. WRF-Chem model is used to simulate the amount of PM10 and how to transport it to the areas. The initial and lateral boundary conditions for model obtained from GFS data with 0.5°×0.5° spatial resolution. In the simulation, two aerosol schemas (GOCART and MADE/SORGAM) with 3 options (chem_opt=106,300 and 303) were evaluated. Results of the statistical analysis of the historical data showed that south west of Iran has high frequency of dust events, so that Bushehr station has the highest frequency between stations and Urmia station has the lowest frequency. Also in the period of 1990 to 2013, the years 2009 and 1998 with the amounts of 3221 and 100 respectively had the highest and lowest dust events and according to the monthly variation, June and July had the highest frequency of dust events and December had the lowest frequency. Besides, model results showed that the MADE / SORGAM scheme has predicted values and trends of PM10 better than the other schemes and has showed the better performance in comparison with the observations. Finally, distribution of PM10 and the wind surface maps obtained from numerical modeling showed that the formation of dust plums formed in Iraq and Syria and also transportation of them to the West and Southwest of Iran. In addition, comparing the MODIS satellite image acquired on 4th July 2009 with model output at the same time showed the good ability of WRF-Chem in simulating spatial distribution of dust.

Keywords: dust storm, MADE/SORGAM scheme, PM10, WRF-Chem

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17333 Role of Social Media in Imparting Climate Change through Diffusion of Innovation

Authors: Zahra Ali Abbasi, Syed Muhammad Saqib Saleem

Abstract:

This research explores the relationship between social media and awareness about climate change amongst the university students of Lahore, Pakistan. The aim is to understand how the people of Pakistan perceive climate change, especially on the social media. A deductive and quantitative method is applied on the research to find out the awareness of climate change in the people using social media. For this purpose, a survey method is used, to analyze the response from 167 online respondents through stratified random sampling technique. The relation between multiple variables including awareness about important climatic events like Paris agreement, GreenTube, Smog in Lahore, Floods in Pakistan and other eminent incidents of climate change and social media are calculated by analyzing social media as a source to impart information about climate change. The results show that as people get aware of climate change, they post about different national and international events/incidents of climate which reveal a significant relationship between respondents' awareness about climate change and their posting and sharing of content about climate change. Another test indicates that respondents’ post/share/comment (impart) information about climate change when there is a shift in the climate both globally and nationally. However, the significance of both these correlations has been found to be negligible. Social media being an independent platform holds greater influencing power, hence, as consumers of the environment the users hold the responsibility of producing and sharing content at a global platform about climate. However, matters of politics, economy and religion seem to have overshadowed the significance of climate.

Keywords: climate change, diffusion of innovation, environment, social media, Pakistan

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17332 Posttraumatic Stress and Comorbid Emotional and Behavioral Problems in Sri Lankan Adolescents

Authors: Thyagi Ponnamperuma

Abstract:

Background: Comorbidity between posttraumatic stress disorder (PTSD) and other psychological problems is common. Recent studies focused to investigate the underlying relationship between PTSD and comorbid psychopathologies. Among adolescents, higher rates of emotional and behavioral problems (EBP) have been reported following trauma, often coexisted with PTSD. The current study, thus, examined the relationship of posttraumatic stress symptoms to EBP in adolescents exposed to a variety of traumatic events. Further, the study investigated the relationship of trauma and comorbid PTSS to the self-perceived negative impact of EBP on daily functioning. Methods: Participants were 729 Sri Lankan adolescents (age 12 to 16 years; 54.9% female) living in areas impacted in varying degrees by the 2004 tsunami. In 2008, school-based screening was conducted and completed measures of, trauma exposure, PTSS, EBP, and related functional impairment. Results: Participants reported a high prevalence of trauma exposure (n = 438), including interpersonal violence (n = 155). DSM-IV criteria for full or partial PTSD were met by 23.7% of the trauma-exposed sample. Across all participants, 13.4% and 16.7% displayed clinically relevant levels of EBP and functional impairment, respectively. Among the trauma-exposed, 7% met criteria for both EBP and PTSD. EBP total scores and caseness were significantly higher in trauma-exposed adolescents with PTSD than in either those without PTSD or the non-traumatized control group. In subscale analysis, higher prevalence of serious emotional, conduct, and hyperactivity problems were reported in the PTSD positive group; the PTSD negative group did not differ significantly from the control group on any of the problem scales. In regression analyses, PTSS (β = .28, p < .001) and interpersonal violence (β = .13, p = .033) were significant predictors of EBP, cumulative trauma (β = .11, p = .076) showed no significant effect. Further, PTSS exacerbated the impact of EBP on daily functioning (β = 0.29, p = .023). Conclusion: PTSS were closely linked to EBP in adolescents, even years after the traumatic experience. PTSD and emotional and behavioral problems together pose a heightened risk for impaired daily functioning. Longitudinal studies are needed to clarify the causal pathway.

Keywords: adolescents, comorbidity, emotional and behavioral problems, functional impairment, posttraumatic stress, traumatic events

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17331 Water Ingress into Underground Mine Voids in the Central Rand Goldfields Area, South Africa-Fluid Induced Seismicity

Authors: Artur Cichowicz

Abstract:

The last active mine in the Central Rand Goldfields area (50 km x 15 km) ceased operations in 2008. This resulted in the closure of the pumping stations, which previously maintained the underground water level in the mining voids. As a direct consequence of the water being allowed to flood the mine voids, seismic activity has increased directly beneath the populated area of Johannesburg. Monitoring of seismicity in the area has been on-going for over five years using the network of 17 strong ground motion sensors. The objective of the project is to improve strategies for mine closure. The evolution of the seismicity pattern was investigated in detail. Special attention was given to seismic source parameters such as magnitude, scalar seismic moment and static stress drop. Most events are located within historical mine boundaries. The seismicity pattern shows a strong relationship between the presence of the mining void and high levels of seismicity; no seismicity migration patterns were observed outside the areas of old mining. Seven years after the pumping stopped, the evolution of the seismicity has indicated that the area is not yet in equilibrium. The level of seismicity in the area appears to not be decreasing over time since the number of strong events, with Mw magnitudes above 2, is still as high as it was when monitoring began over five years ago. The average rate of seismic deformation is 1.6x1013 Nm/year. Constant seismic deformation was not observed over the last 5 years. The deviation from the average is in the order of 6x10^13 Nm/year, which is a significant deviation. The variation of cumulative seismic moment indicates that a constant deformation rate model is not suitable. Over the most recent five year period, the total cumulative seismic moment released in the Central Rand Basin was 9.0x10^14 Nm. This is equivalent to one earthquake of magnitude 3.9. This is significantly less than what was experienced during the mining operation. Characterization of seismicity triggered by a rising water level in the area can be achieved through the estimation of source parameters. Static stress drop heavily influences ground motion amplitude, which plays an important role in risk assessments of potential seismic hazards in inhabited areas. The observed static stress drop in this study varied from 0.05 MPa to 10 MPa. It was found that large static stress drops could be associated with both small and large events. The temporal evolution of the inter-event time provides an understanding of the physical mechanisms of earthquake interaction. Changes in the characteristics of the inter-event time are produced when a stress change is applied to a group of faults in the region. Results from this study indicate that the fluid-induced source has a shorter inter-event time in comparison to a random distribution. This behaviour corresponds to a clustering of events, in which short recurrence times tend to be close to each other, forming clusters of events.

Keywords: inter-event time, fluid induced seismicity, mine closure, spectral parameters of seismic source

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17330 The Effects of Extreme Precipitation Events on Ecosystem Services

Authors: Szu-Hua Wang, Yi-Wen Chen

Abstract:

Urban ecosystems are complex coupled human-environment systems. They contain abundant natural resources for producing natural assets and attract urban assets to consume natural resources for urban development. Urban ecosystems provide several ecosystem services, including provisioning services, regulating services, cultural services, and supporting services. Rapid global climate change makes urban ecosystems and their ecosystem services encountering various natural disasters. Lots of natural disasters have occurred around the world under the constant changes in the frequency and intensity of extreme weather events in the past two decades. In Taiwan, hydrological disasters have been paid more attention due to the potential high sensitivity of Taiwan’s cities to climate change, and it impacts. However, climate change not only causes extreme weather events directly but also affects the interactions among human, ecosystem services and their dynamic feedback processes indirectly. Therefore, this study adopts a systematic method, solar energy synthesis, based on the concept of the eco-energy analysis. The Taipei area, the most densely populated area in Taiwan, is selected as the study area. The changes of ecosystem services between 2015 and Typhoon Soudelor have been compared in order to investigate the impacts of extreme precipitation events on ecosystem services. The results show that the forest areas are the largest contributions of energy to ecosystem services in the Taipei area generally. Different soil textures of different subsystem have various upper limits of water contents or substances. The major contribution of ecosystem services of the study area is natural hazard regulation provided by the surface water resources areas. During the period of Typhoon Soudelor, the freshwater supply in the forest areas had become the main contribution. Erosion control services were the main ecosystem service affected by Typhoon Soudelor. The second and third main ecosystem services were hydrologic regulation and food supply. Due to the interactions among ecosystem services, fresh water supply, water purification, and waste treatment had been affected severely.

Keywords: ecosystem, extreme precipitation events, ecosystem services, solar energy synthesis

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17329 Re-Examining the Distinction between Odour Nuisance and Health Impact: A Community’s Campaign against Landfill Gas Exposure in Shongweni, South Africa

Authors: Colin David La Grange, Lisa Frost Ramsay

Abstract:

Hydrogen sulphide (H2S) is a minor component of landfill gas, but significant in its distinct odorous quality and its association with landfill-related community complaints. The World Health Organisation (WHO) provides two guidelines for H2S: a health guideline at 150 µg/m3 on a 24-hour average, and a nuisance guideline at 7 µg/m3 on a 30-minute average. Albeit a practical distinction for impact assessment, this paper highlights the danger of the apparent dualism between nuisance and health impact, particularly when it is used to dismiss community concerns of perceived health impacts at low concentrations of H2S, as in the case of a community battle against the impacts of a landfill in Shongweni, KwaZulu-Natal, South Africa. Here community members reported, using a community developed mobile phone application, a range of health symptoms that coincided with, or occurred subsequent to, odour events and localised H2S peaks. Local doctors also documented increased visits for symptoms of respiratory distress, eye and skin irritation, and stress after such odour events. Objectively measured H2S and other pollutant concentrations during these events, however, remained below WHO health guidelines. This case study highlights the importance of the physiological link between the experience of environmental nuisance and overall health and wellbeing, showing these to be less distinct than the WHO guidelines would suggest. The potential mechanisms of impact of an odorous plume, with key constituents at concentrations below traditional health thresholds, on psychologically and/or physiologically sensitised individuals are described. In the case of psychological sensitisation, previously documented mechanisms such as aversive conditioning and odour-triggered panic are relevant. Physiological sensitisation to environmental pollutants, evident as a seemingly disproportionate physical (allergy-type) response to either low concentrations or a short duration exposure of a toxin or toxins, remains extensively examined but still not well understood. The links between a heightened sensitivity to toxic compounds, accumulation of some compounds in the body, and a pre-existing or associated immunological stress disorder are presented as a possible explanation.

Keywords: immunological stress disorder, landfill odour, odour nuisance, odour sensitisation, toxin accumulation

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17328 Development of Electrochemical Biosensor Based on Dendrimer-Magnetic Nanoparticles for Detection of Alpha-Fetoprotein

Authors: Priyal Chikhaliwala, Sudeshna Chandra

Abstract:

Liver cancer is one of the most common malignant tumors with poor prognosis. This is because liver cancer does not exhibit any symptoms in early stage of disease. Increased serum level of AFP is clinically considered as a diagnostic marker for liver malignancy. The present diagnostic modalities include various types of immunoassays, radiological studies, and biopsy. However, these tests undergo slow response times, require significant sample volumes, achieve limited sensitivity and ultimately become expensive and burdensome to patients. Considering all these aspects, electrochemical biosensors based on dendrimer-magnetic nanoparticles (MNPs) was designed. Dendrimers are novel nano-sized, three-dimensional molecules with monodispersed structures. Poly-amidoamine (PAMAM) dendrimers with eight –NH₂ groups using ethylenediamine as a core molecule were synthesized using Michael addition reaction. Dendrimers provide added the advantage of not only stabilizing Fe₃O₄ NPs but also displays capability of performing multiple electron redox events and binding multiple biological ligands to its dendritic end-surface. Fe₃O₄ NPs due to its superparamagnetic behavior can be exploited for magneto-separation process. Fe₃O₄ NPs were stabilized with PAMAM dendrimer by in situ co-precipitation method. The surface coating was examined by FT-IR, XRD, VSM, and TGA analysis. Electrochemical behavior and kinetic studies were evaluated using CV which revealed that the dendrimer-Fe₃O₄ NPs can be looked upon as electrochemically active materials. Electrochemical immunosensor was designed by immobilizing anti-AFP onto dendrimer-MNPs by gluteraldehyde conjugation reaction. The bioconjugates were then incubated with AFP antigen. The immunosensor was characterized electrochemically indicating successful immuno-binding events. The binding events were also further studied using magnetic particle imaging (MPI) which is a novel imaging modality in which Fe₃O₄ NPs are used as tracer molecules with positive contrast. Multicolor MPI was able to clearly localize AFP antigen and antibody and its binding successfully. Results demonstrate immense potential in terms of biosensing and enabling MPI of AFP in clinical diagnosis.

Keywords: alpha-fetoprotein, dendrimers, electrochemical biosensors, magnetic nanoparticles

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17327 Series "H154M" as a Unit Area of the Region between the Lines and Curves

Authors: Hisyam Hidayatullah

Abstract:

This world events consciously or not realize everything has a pattern, until the events of the universe according to the Big Bang theory of the solar system which makes so regular in the rotation. The author would like to create a results curve area between the quadratic function y=kx2 and line y=ka2 using GeoGebra application version 4.2. This paper can provide a series that is no less interesting with Fourier series, so that will add new material about the series can be calculated with sigma notation. In addition, the ranks of the unique natural numbers of extensive changes in established areas. Finally, this paper provides analytical and geometric proof of the vast area in between the lines and curves that give the area is formed by y=ka2 dan kurva y=kx2, x-axis, line x=√a and x=-√a make a series of numbers for k=1 and a ∈ original numbers. ∑_(i=0)^n=(4n√n)/3=0+4/3+(8√2)/3+4√3+⋯+(4n√n)/3. The author calls the series “H154M”.

Keywords: sequence, series, sigma notation, application GeoGebra

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17326 Assessing the Impacts of Long-Range Forest Fire Emission Transport on Air Quality in Toronto, Ontario, Using MODIS Fire Data and HYSPLIT Trajectories

Authors: Bartosz Osiecki, Jane Liu

Abstract:

Pollutants emitted from forest fires such as PM₂.₅ and carbon monoxide (CO) have been found to impact the air quality of distant regions through long-range transport. PM₂.₅ is of particular concern due to its transport capacity and implications for human respiratory and cardiovascular health. As such, significant increases in PM₂.₅ concentrations have been exhibited in urban areas downwind of fire sources. This study seeks to expand on this literature by evaluating the impacts of long-range forest fire emission transport on air quality in Toronto, Ontario, as a means of evaluating the vulnerability of this major urban center to distant fire events. In order to draw correlations between the fire event and air pollution episode in Toronto, MODIS fire count data and HYPLSIT trajectories are used to assess the date, location, and severity of the fire and track the trajectory of emissions (respectively). Forward and back-trajectories are run, terminating at the West Toronto air monitoring station. PM₂.₅ and CO concentrations in Toronto during September 2017 are found to be significantly elevated, which is likely attributable to the fire activity. Other sites in Ontario including Toronto (East, North, Downtown), Mississauga, Brampton, and Hamilton (Downtown) exhibit similar peaks in PM₂.₅ concentrations. This work sheds light on the non-local, natural factors influencing air quality in urban areas. This is especially important in the context of climate change which is expected to exacerbate intense forest fire events in the future.

Keywords: air quality, forest fires, PM₂.₅, Toronto

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17325 Meiji Centennial as a Media Event: Ideas for Upcoming Turkish Republic Centennial

Authors: Hasan Topacoglu

Abstract:

The Meiji Restoration was a chain of events that restored Japan in 1868 and considered as the beginning of Japanese Modernization by many scholars. In 1968, to honor its modern incarnation, Japan celebrated Meiji Centennial as one of the biggest Media Events in the country after the World War II. It was celebrated all around the country throughout the year following with a central event in Tokyo. Meanwhile, Japanese scholars started an opposition movement and claimed that Government was using this event to raise nationalism, pointing at Government’s statement on the meaning of Meiji. Most of the scholars, unfortunately, were hooked into the ideological problem of the Government’s way of planning and evaluated it as a failure. However, scholars missed out an important point that apart from the central event in Tokyo, each city planned its own event and celebrated it on a different date, also with a different theme. For example, Kyoto showed a regional characteristic and focused on Kyoto’s own culture, tradition etc., and highlighted a further past than 100 years. This was mainly because some areas/cities had a different ‘memory’ for Meiji Restoration than Tokyo which was reflected through the way they celebrated Meiji Centennial. On the other hand, 2023 will be the year of Turkish Republic Centennial. A year which will be marked by national and maybe even international events. Although an official committee has not been announced yet, The 2023 Vision, a list of goals has been released by the Government to coincide with the centenary of the Republic of Turkey in 2023 and there are some ongoing projects that are planned to be completed by then. By looking at the content of these projects, it is possible to say that Government is aiming to focus on Modernization through the Centennial. However, some of the projects are already showing some interesting characteristics such as the Istanbul New Airport whose design is inspired by Selimiye Mosque’s Islamic-Ottoman figure. It is true that Turkey and Japan have different historical backgrounds and the timeline of the Meiji Restoration and Foundation of Turkish Republic are different. Therefore, a particular comparison between these two events is not justified. However, they may have more in common than we are up to think because, each country marked the start of a new nation conceived on modern principles. For that reason, it is important to understand the similarities or differences between Meiji Centennial and Turkish Republic Centennial as a media event. This study introduces Meiji Centennial as a media event and analyses opposition movement along with the meaning of Meiji Centennial. Additionally, it explains regional characteristic differences and gives Kyoto as an example. Moreover, it introduces some of the ongoing Centennial projects in Turkey and analyses the meaning of the Turkish Republic Centennial through these projects. Without comparing Japan and Turkey, it explains the case of Japan but the discussion centers on deepening our understanding of Centennial as a Media Event and remarks some important aspects for Turkey’s upcoming Centennial events.

Keywords: media events, Meiji centennial, the 2023 vision, Turkish republic centennial

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17324 Exploring Disengaging and Engaging Behavior of Doctoral Students

Authors: Salome Schulze

Abstract:

The delay of students in completing their dissertations is a worldwide problem. At the University of South Africa where this research was done, only about a third of the students complete their studies within the required period of time. This study explored the reasons why the students interrupted their studies, and why they resumed their research at a later stage. If this knowledge could be utilised to improve the throughput of doctoral students, it could have significant economic benefits for institutions of higher education while at the same time enhancing their academic prestige. To inform the investigation, attention was given to key theories concerning the learning of doctoral students, namely the situated learning theory, the social capital theory and the self-regulated learning theory, based on the social cognitive theory of learning. Ten students in the faculty of Education were purposefully selected on the grounds of their poor progress, or of having been in the system for too long. The collection of the data was in accordance with a Finnish study, since the two studies had the same aims, namely to investigate student engagement and disengagement. Graphic elicitation interviews, based on visualisations were considered appropriate to collect the data. This method could stimulate the reflection and recall of the participants’ ‘stories’ with very little input from the interviewer. The interviewees were requested to visualise, on paper, their journeys as doctoral students from the time when they first registered. They were to indicate the significant events that occurred and which facilitated their engagement or disengagement. In the interviews that followed, they were requested to elaborate on these motivating or challenging events by explaining when and why they occurred, and what prompted them to resume their studies. The interviews were tape-recorded and transcribed verbatim. Information-rich data were obtained containing visual metaphors. The data indicated that when the students suffered a period of disengagement, it was sometimes related to a lack of self-regulated learning, in particular, a lack of autonomy, and the inability to manage their time effectively. When the students felt isolated from the academic community of practice disengagement also occurred. This included poor guidance by their supervisors, which accordingly deprived them of significant social capital. The study also revealed that situational factors at home or at work were often the main reasons for the students’ procrastinating behaviour. The students, however, remained in the system. They were motivated towards a renewed engagement with their studies if they were self-regulated learners, and if they felt a connectedness with the academic community of practice because of positive relationships with their supervisors and of participation in the activities of the community (e.g., in workshops or conferences). In support of their learning, networking with significant others who were sources of information provided the students with the necessary social capital. Generally, institutions of higher education cannot address the students’ personal issues directly, but they can deal with key institutional factors in order to improve the throughput of doctoral students. It is also suggested that graphic elicitation interviews be used more often in social research that investigates the learning and development of the students.

Keywords: doctoral students, engaging and disengaging experiences, graphic elicitation interviews, student procrastination

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17323 Formal Implementation of Routing Information Protocol Using Event-B

Authors: Jawid Ahmad Baktash, Tadashi Shiroma, Tomokazu Nagata, Yuji Taniguchi, Morikazu Nakamura

Abstract:

The goal of this paper is to explore the use of formal methods for Dynamic Routing, The purpose of network communication with dynamic routing is sending a massage from one node to others by using pacific protocols. In dynamic routing connections are possible based on protocols of Distance vector (Routing Information Protocol, Border Gateway protocol), Link State (Open Shortest Path First, Intermediate system Intermediate System), Hybrid (Enhanced Interior Gateway Routing Protocol). The responsibility for proper verification becomes crucial with Dynamic Routing. Formal methods can play an essential role in the Routing, development of Networks and testing of distributed systems. Event-B is a formal technique consists of describing rigorously the problem; introduce solutions or details in the refinement steps to obtain more concrete specification, and verifying that proposed solutions are correct. The system is modeled in terms of an abstract state space using variables with set theoretic types and the events that modify state variables. Event-B is a variant of B, was designed for developing distributed systems. In Event-B, the events consist of guarded actions occurring spontaneously rather than being invoked. The invariant state properties must be satisfied by the variables and maintained by the activation of the events.

Keywords: dynamic rout RIP, formal method, event-B, pro-B

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17322 Prevalence of Adverse Events in Children and Adolescents on Antiretroviral Therapy: Examining the Pediatric Cohort in the Eastern Cape

Authors: Shannon Glaspy, Gerald Boon, Jack Lambert

Abstract:

Studies on AE of highly active antiretroviral therapy (HAART) in children and adolescents are rare. The aim of this study is to observe the frequency of treatment limiting adverse drug reactions against years on ARVs and specific ARV regimen. Methods: A retrospective cohort study was conducted in East London, South Africa. All patient files in the pediatric (0 – 18 years) ARV cohort were examined, selecting only those patients started on HAART. ARV regimen changes explicitly due to AE, age on ARV treatment onset, age of AE onset, and gender were extrapolated. Eligible subjects were obtained from patient folders, anonymized and cross-referenced with data obtained from electronic records. A total of 1120 patients [592 male (52.9%) and 528 female (47.1%)] were charted by incidence and year. Additional information was extrapolated in cases where the patient experienced lipodystrophy and lipoatrophy to include the number of years on ARVs prior to the onset of the AE. Results: Of the 1120 HIV infected children of the hospital cohort, a total of 105 (9.37%) AE (53.3% male) observed were deemed eligible for the study due to completeness of medical history and agreement between electronic records and paper files. The AE cited were as follows: lipoatrophy 62 (5.53% of all subjects), lipodystrophy 27 (2.41%), neuropathy 9 (0.8%), anemia 2 (0.17%), Steven Johnsons Syndrome 1 (0.08%), elevated LFTs 1 (0.8%), breast hypertrophy (0.08%), gastritis 1 (0.08%) and rash 1 (0.08%). The most prevalence ARV regimens associated with the onset of the AE are: D4T/3TC/EFV 72 cases (64.86% of all AE), D4T/3TC/LOPr 24 cases (21.62%). Lipoatrophy and lipodystrophy combined represent 84.76% (89 cases) of all adverse events documented in this cohort. Within the 60 cases of lipoatrophy, the average number of years on ARVs associated with an AE is 3.54, with 14 cases experiencing an AE between 0-2 years of HAART. Within the 29 cases of lipodystrophy, the average number of years on ARVs associated with an AE is 3.89, with 4 cases experiencing an AE between 0-2 years on HAART. The regimen D4T/3TC/EFV is associated with 43 cases (71.66%) of lipoatrophy and 21 cases (72.41%) of lipodystrophy. D4T/3TC/LOPr is associated with 15 cases (25%) of lipoatrophy and 7 cases (24.14%) of lipodystrophy. The frequency of AE associated with ARV regimens could be misrepresented due to prevalence of different 1st line regimens which were not captured in this study, particularly with the systematic change of 1st line drugs from D4T to ABC in 2010. Conclusion: In this descriptive study we found a 9.37% prevalence of AE were significant enough to be treatment limiting among our cohort. Lipoatrophy accounted for 59.04% of all documented AE. Overall, D4T/3TC/EFV was associated with 64.86% of all AE, 71.66% of lipoatrophy cases and 72.41% of lipodystrophy cases.

Keywords: ARV, adverse events, HAART, pediatric

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17321 Language as an Instrument of Manipulation and Political Control in Nigeria: The 2015 Presidential Election in Perspective

Authors: Abdulmalik Adamu

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This study is premised on the assumption that language, particularly, English plays a significant role in the acquisition of power in Nigeria. This is against the backdrop of the fact that for the first time in the political history of Nigeria, an opposition party succeeded in dethroning an incumbent President and ruling political party in an election. Therefore the main objective was to investigate the role of language, particularly English in the acquisition of political power in Nigeria. The corpus generated for this study consisted of excerpts from the media exchange between the spokespersons of the two dominant political parties at the time of the elections in 2015; Olisa Metuh of the Peoples Democratic Party (PDP) and Lai Mohammed of the All Progressive Party (APC). The excerpts were analysed using Critical Discourse Analysis (CDA) as a research tool. The findings revealed the acceptance of the first proposition that English facilitates the acquisition of political power in Nigeria and the rejection of the second proposition that English is an instrument for the exclusion of the populist from political events in Nigeria. The study, therefore, concluded that language, particularly English played a significant role in the acquisition of political power in Nigeria.

Keywords: language, power, politics, Critical Discourse Analysis (CDA)

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17320 Perceptual Organization within Temporal Displacement

Authors: Michele Sinico

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The psychological present has an actual extension. When a sequence of instantaneous stimuli falls in this short interval of time, observers perceive a compresence of events in succession and the temporal order depends on the qualitative relationships between the perceptual properties of the events. Two experiments were carried out to study the influence of perceptual grouping, with and without temporal displacement, on the duration of auditory sequences. The psychophysical method of adjustment was adopted. The first experiment investigated the effect of temporal displacement of a white noise on sequence duration. The second experiment investigated the effect of temporal displacement, along the pitch dimension, on temporal shortening of sequence. The results suggest that the temporal order of sounds, in the case of temporal displacement, is organized along the pitch dimension.

Keywords: time perception, perceptual present, temporal displacement, Gestalt laws of perceptual organization

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17319 A Deep Learning Approach to Real Time and Robust Vehicular Traffic Prediction

Authors: Bikis Muhammed, Sehra Sedigh Sarvestani, Ali R. Hurson, Lasanthi Gamage

Abstract:

Vehicular traffic events have overly complex spatial correlations and temporal interdependencies and are also influenced by environmental events such as weather conditions. To capture these spatial and temporal interdependencies and make more realistic vehicular traffic predictions, graph neural networks (GNN) based traffic prediction models have been extensively utilized due to their capability of capturing non-Euclidean spatial correlation very effectively. However, most of the already existing GNN-based traffic prediction models have some limitations during learning complex and dynamic spatial and temporal patterns due to the following missing factors. First, most GNN-based traffic prediction models have used static distance or sometimes haversine distance mechanisms between spatially separated traffic observations to estimate spatial correlation. Secondly, most GNN-based traffic prediction models have not incorporated environmental events that have a major impact on the normal traffic states. Finally, most of the GNN-based models did not use an attention mechanism to focus on only important traffic observations. The objective of this paper is to study and make real-time vehicular traffic predictions while incorporating the effect of weather conditions. To fill the previously mentioned gaps, our prediction model uses a real-time driving distance between sensors to build a distance matrix or spatial adjacency matrix and capture spatial correlation. In addition, our prediction model considers the effect of six types of weather conditions and has an attention mechanism in both spatial and temporal data aggregation. Our prediction model efficiently captures the spatial and temporal correlation between traffic events, and it relies on the graph attention network (GAT) and Bidirectional bidirectional long short-term memory (Bi-LSTM) plus attention layers and is called GAT-BILSTMA.

Keywords: deep learning, real time prediction, GAT, Bi-LSTM, attention

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17318 Cognitive Based Approach to Organizational Development

Authors: Tatiana V. Korsakova

Abstract:

The cognitive methodology in management is considered: Cognitive structuring - the formation of ideas about the functioning of a developing organization; Cognitive modeling - heuristic construction of existing actions (zone of successful actions); and Cognitive construct - the formation of filters for converting external information into specific events of managerial reality. The major findings of the study are the identification of areas of successful actions in the organization, harmonization of criteria for evaluating the effectiveness of company management, and the frame-description that indicates the connection of environmental elements with the elements of the organization. It is stated the development of specific events of managerial reality in the direction of the further development of the organization depends on the personal cognitive construct of the development-subjects when it is used in the zone of successful actions.

Keywords: cognitive construct, focus of applicability, knowledge corporate culture, zones of successful actions

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17317 Unveiling Drought Dynamics in the Cuneo District, Italy: A Machine Learning-Enhanced Hydrological Modelling Approach

Authors: Mohammadamin Hashemi, Mohammadreza Kashizadeh

Abstract:

Droughts pose a significant threat to sustainable water resource management, agriculture, and socioeconomic sectors, particularly in the field of climate change. This study investigates drought simulation using rainfall-runoff modelling in the Cuneo district, Italy, over the past 60-year period. The study leverages the TUW model, a lumped conceptual rainfall-runoff model with a semi-distributed operation capability. Similar in structure to the widely used Hydrologiska Byråns Vattenbalansavdelning (HBV) model, the TUW model operates on daily timesteps for input and output data specific to each catchment. It incorporates essential routines for snow accumulation and melting, soil moisture storage, and streamflow generation. Multiple catchments' discharge data within the Cuneo district form the basis for thorough model calibration employing the Kling-Gupta Efficiency (KGE) metric. A crucial metric for reliable drought analysis is one that can accurately represent low-flow events during drought periods. This ensures that the model provides a realistic picture of water availability during these critical times. Subsequent validation of monthly discharge simulations thoroughly evaluates overall model performance. Beyond model development, the investigation delves into drought analysis using the robust Standardized Runoff Index (SRI). This index allows for precise characterization of drought occurrences within the study area. A meticulous comparison of observed and simulated discharge data is conducted, with particular focus on low-flow events that characterize droughts. Additionally, the study explores the complex interplay between land characteristics (e.g., soil type, vegetation cover) and climate variables (e.g., precipitation, temperature) that influence the severity and duration of hydrological droughts. The study's findings demonstrate successful calibration of the TUW model across most catchments, achieving commendable model efficiency. Comparative analysis between simulated and observed discharge data reveals significant agreement, especially during critical low-flow periods. This agreement is further supported by the Pareto coefficient, a statistical measure of goodness-of-fit. The drought analysis provides critical insights into the duration, intensity, and severity of drought events within the Cuneo district. This newfound understanding of spatial and temporal drought dynamics offers valuable information for water resource management strategies and drought mitigation efforts. This research deepens our understanding of drought dynamics in the Cuneo region. Future research directions include refining hydrological modelling techniques and exploring future drought projections under various climate change scenarios.

Keywords: hydrologic extremes, hydrological drought, hydrological modelling, machine learning, rainfall-runoff modelling

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17316 Early Warning System of Financial Distress Based On Credit Cycle Index

Authors: Bi-Huei Tsai

Abstract:

Previous studies on financial distress prediction choose the conventional failing and non-failing dichotomy; however, the distressed extent differs substantially among different financial distress events. To solve the problem, “non-distressed”, “slightly-distressed” and “reorganization and bankruptcy” are used in our article to approximate the continuum of corporate financial health. This paper explains different financial distress events using the two-stage method. First, this investigation adopts firm-specific financial ratios, corporate governance and market factors to measure the probability of various financial distress events based on multinomial logit models. Specifically, the bootstrapping simulation is performed to examine the difference of estimated misclassifying cost (EMC). Second, this work further applies macroeconomic factors to establish the credit cycle index and determines the distressed cut-off indicator of the two-stage models using such index. Two different models, one-stage and two-stage prediction models, are developed to forecast financial distress, and the results acquired from different models are compared with each other, and with the collected data. The findings show that the two-stage model incorporating financial ratios, corporate governance and market factors has the lowest misclassification error rate. The two-stage model is more accurate than the one-stage model as its distressed cut-off indicators are adjusted according to the macroeconomic-based credit cycle index.

Keywords: Multinomial logit model, corporate governance, company failure, reorganization, bankruptcy

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17315 Efficacy and Safety of Probiotic Treatment in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Authors: Samir Malhotra, Rajan K. Khandotra, Rakesh K. Dhiman, Neelam Chadha

Abstract:

There is paucity of data about safety and efficacy of probiotic treatment on patient outcomes in cirrhosis. Specifically, it is important to know whether probiotics can improve mortality, hepatic encephalopathy (HE), number of hospitalizations, ammonia levels, quality of life, and adverse events. Probiotics may improve outcomes in patients with acute or chronic HE. However, it is also important to know whether probiotics can prevent development of HE, even in situations where patients do not have acute HE at the time of administration. It is also important to know if probiotics are useful as primary prophylaxis of HE. We aimed to conduct an updated systematic review and meta-analysis to evaluate the safety and efficacy of probiotics in patients with cirrhosis. We searched PubMed, Cochrane library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify randomised clinical trials comparing probiotics with other treatments in cirrhotics. Data was analyzed using MedCalc. Probiotics had no effect on mortality but significantly reduced HE (14 trials, 1073 patients, OR 0.371; 95% CI 0.282 to 0.489). There was not enough data to conduct a meta-analysis on outcomes like hospitalizations and quality of life. The effect on plasma ammonia levels was not significant (SMD -0.429; 95%CI -1.034 – 0.177). There was no difference in adverse events. To conclude, although the included studies had a high risk of bias, the available evidence does suggest a beneficial effect on HE. Larger studies with longer periods of follow-up are needed to determine if probiotics can reduce all-cause mortality.

Keywords: cirrhosis, hepatic encephalopathy, meta-analysis, probiotic

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17314 Quality of Care of Medical Male Circumcisions: A Non-Negotiable for Right to Care

Authors: Nelson Igaba, C. Onaga, S. Hlongwane

Abstract:

Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

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17313 The Information-Seeking Behaviour of Kuwaiti Judges (KJs)

Authors: Essam Mansour

Abstract:

The key purpose of this study is to show information-seeking behaviour of Kuwaiti Judges (KJs). Being one of the few studies about the information needs and information-seeking behaviour conducted in Arab and developing countries, this study is a pioneer one among many studies conducted in information seeking, especially with this significant group of information users. The authors tried to investigate this seeking behavior in terms of KJs' thoughts, perceptions, motivations, techniques, preferences, tools and barriers met when seeking information. The authors employed a questionnaire, with a response rate 77.2 percent. This study showed that most of KJs were likely to be older, educated and with a work experience ranged from new to old experience. There is a statistically reliable significant difference between KJs' demographic characteristics and some sources of information, such as books, encyclopedias, references and mass media. KJs were using information moderately to make a decision, to be in line with current events, to collect statistics and to make a specific/general research. The office and home were the most frequent location KJs were accessing information from. KJs' efficiency level of the English language is described to be moderately good, and a little number of them confirmed that their efficiency level of French was not bad. The assistance provided by colleagues, followed by consultants, translators, sectaries and librarians were found to be most strong types of assistance needed when seeking information. Mobile apps, followed by PCs, information networks (the Internet) and information databases were the highest technology tool used by KJs. Printed materials, followed by non-printed and audiovisual materials were the most preferred information formats KJs use. The use of languages, the recency of information and the place of information, the deficit role of the library to deliver information were at least significant barriers to KJs when seeking information.

Keywords: information users, information-seeking behaviour, information needs, judges, Kuwait

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17312 UEFA Super Cup: Economic Effects on Georgian Economy

Authors: Giorgi Bregadze

Abstract:

Tourism is the most viable and sustainable economic development option for Georgia and one of the main sources of foreign exchange earnings. Events are considered as one of the most effective ways to attract foreign visitors to the country, and, recently, the government of Georgia has begun investing in this sector very actively. This article stresses the necessity of research based economic policy in the tourism sector. In this regard, it is of paramount importance to measure the economic effects of the events which are subsidized by taxpayers’ money. The economic effect of events can be analyzed from two perspectives; financial perspective of the government and perspective of economic effects of the tourism administration. The article emphasizes more realistic and all-inclusive focus of the economic effect analysis of the tourism administration as it concentrates on the income of residents and local businesses, part of which generate tax revenues for the government. The public would like to know what the economic returns to investment are. In this article, the methodology used to describe the economic effects of UEFA Super Cup held in Tbilisi, will help to answer this question. Methodology is based on three main principles and covers three stages. Using the suggested methodology article estimates the direct economic effect of UEFA Super cup on Georgian economy. Although the attempt to make an economic effect analysis of the event was successful in Georgia, some obstacles and insufficiencies were identified during the survey. The article offers several recommendations that will help to refine methodology and improve the accuracy of the data. Furthermore, it is very important to receive the correct standard of measurement of events in Georgia. In this caseü non-ethical acts of measurement which are widely utilized by different research companies will not trigger others to show overestimated effects. It is worth mentioning that to author’s best knowledge, this is the first attempt to measure the economic effect of an event held in Georgia.

Keywords: biased economic effect analysis, expenditure of local citizens, time switchers and casuals, UEFA super cup

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17311 Probabilistic Study of Impact Threat to Civil Aircraft and Realistic Impact Energy

Authors: Ye Zhang, Chuanjun Liu

Abstract:

In-service aircraft is exposed to different types of threaten, e.g. bird strike, ground vehicle impact, and run-way debris, or even lightning strike, etc. To satisfy the aircraft damage tolerance design requirements, the designer has to understand the threatening level for different types of the aircraft structures, either metallic or composite. Exposing to low-velocity impacts may produce very serious internal damages such as delaminations and matrix cracks without leaving visible mark onto the impacted surfaces for composite structures. This internal damage can cause significant reduction in the load carrying capacity of structures. The semi-probabilistic method provides a practical and proper approximation to establish the impact-threat based energy cut-off level for the damage tolerance evaluation of the aircraft components. Thus, the probabilistic distribution of impact threat and the realistic impact energy level cut-offs are the essential establishments required for the certification of aircraft composite structures. A new survey of impact threat to civil aircraft in-service has recently been carried out based on field records concerning around 500 civil aircrafts (mainly single aisles) and more than 4.8 million flight hours. In total 1,006 damages caused by low-velocity impact events had been screened out from more than 8,000 records including impact dents, scratches, corrosions, delaminations, cracks etc. The impact threat dependency on the location of the aircraft structures and structural configuration was analyzed. Although the survey was mainly focusing on the metallic structures, the resulting low-energy impact data are believed likely representative to general civil aircraft, since the service environments and the maintenance operations are independent of the materials of the structures. The probability of impact damage occurrence (Po) and impact energy exceedance (Pe) are the two key parameters for describing the statistic distribution of impact threat. With the impact damage events from the survey, Po can be estimated as 2.1x10-4 per flight hour. Concerning the calculation of Pe, a numerical model was developed using the commercial FEA software ABAQUS to backward estimate the impact energy based on the visible damage characteristics. The relationship between the visible dent depth and impact energy was established and validated by drop-weight impact experiments. Based on survey results, Pe was calculated and assumed having a log-linear relationship versus the impact energy. As the product of two aforementioned probabilities, Po and Pe, it is reasonable and conservative to assume Pa=PoxPe=10-5, which indicates that the low-velocity impact events are similarly likely as the Limit Load events. Combing Pa with two probabilities Po and Pe obtained based on the field survey, the cutoff level of realistic impact energy was estimated and valued as 34 J. In summary, a new survey was recently done on field records of civil aircraft to investigate the probabilistic distribution of impact threat. Based on the data, two probabilities, Po and Pe, were obtained. Considering a conservative assumption of Pa, the cutoff energy level for the realistic impact energy has been determined, which provides potential applicability in damage tolerance certification of future civil aircraft.

Keywords: composite structure, damage tolerance, impact threat, probabilistic

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17310 Next Generation UK Storm Surge Model for the Insurance Market: The London Case

Authors: Iacopo Carnacina, Mohammad Keshtpoor, Richard Yablonsky

Abstract:

Non-structural protection measures against flooding are becoming increasingly popular flood risk mitigation strategies. In particular, coastal flood insurance impacts not only private citizens but also insurance and reinsurance companies, who may require it to retain solvency and better understand the risks they face from a catastrophic coastal flood event. In this context, a framework is presented here to assess the risk for coastal flooding across the UK. The area has a long history of catastrophic flood events, including the Great Flood of 1953 and the 2013 Cyclone Xaver storm, both of which led to significant loss of life and property. The current framework will leverage a technology based on a hydrodynamic model (Delft3D Flexible Mesh). This flexible mesh technology, coupled with a calibration technique, allows for better utilisation of computational resources, leading to higher resolution and more detailed results. The generation of a stochastic set of extra tropical cyclone (ETC) events supports the evaluation of the financial losses for the whole area, also accounting for correlations between different locations in different scenarios. Finally, the solution shows a detailed analysis for the Thames River, leveraging the information available on flood barriers and levees. Two realistic disaster scenarios for the Greater London area are simulated: In the first scenario, the storm surge intensity is not high enough to fail London’s flood defences, but in the second scenario, London’s flood defences fail, highlighting the potential losses from a catastrophic coastal flood event.

Keywords: storm surge, stochastic model, levee failure, Thames River

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17309 Inter-Annual Variations of Sea Surface Temperature in the Arabian Sea

Authors: K. S. Sreejith, C. Shaji

Abstract:

Though both Arabian Sea and its counterpart Bay of Bengal is forced primarily by the semi-annually reversing monsoons, the spatio-temporal variations of surface waters is very strong in the Arabian Sea as compared to the Bay of Bengal. This study focuses on the inter-annual variability of Sea Surface Temperature (SST) in the Arabian Sea by analysing ERSST dataset which covers 152 years of SST (January 1854 to December 2002) based on the ICOADS in situ observations. To capture the dominant SST oscillations and to understand the inter-annual SST variations at various local regions of the Arabian Sea, wavelet analysis was performed on this long time-series SST dataset. This tool is advantageous over other signal analysing tools like Fourier analysis, based on the fact that it unfolds a time-series data (signal) both in frequency and time domain. This technique makes it easier to determine dominant modes of variability and explain how those modes vary in time. The analysis revealed that pentadal SST oscillations predominate at most of the analysed local regions in the Arabian Sea. From the time information of wavelet analysis, it was interpreted that these cold and warm events of large amplitude occurred during the periods 1870-1890, 1890-1910, 1930-1950, 1980-1990 and 1990-2005. SST oscillations with peaks having period of ~ 2-4 years was found to be significant in the central and eastern regions of Arabian Sea. This indicates that the inter-annual SST variation in the Indian Ocean is affected by the El Niño-Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) events.

Keywords: Arabian Sea, ICOADS, inter-annual variation, pentadal oscillation, SST, wavelet analysis

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17308 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

Abstract:

Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

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17307 Bivariate Time-to-Event Analysis with Copula-Based Cox Regression

Authors: Duhania O. Mahara, Santi W. Purnami, Aulia N. Fitria, Merissa N. Z. Wirontono, Revina Musfiroh, Shofi Andari, Sagiran Sagiran, Estiana Khoirunnisa, Wahyudi Widada

Abstract:

For assessing interventions in numerous disease areas, the use of multiple time-to-event outcomes is common. An individual might experience two different events called bivariate time-to-event data, the events may be correlated because it come from the same subject and also influenced by individual characteristics. The bivariate time-to-event case can be applied by copula-based bivariate Cox survival model, using the Clayton and Frank copulas to analyze the dependence structure of each event and also the covariates effect. By applying this method to modeling the recurrent event infection of hemodialysis insertion on chronic kidney disease (CKD) patients, from the AIC and BIC values we find that the Clayton copula model was the best model with Kendall’s Tau is (τ=0,02).

Keywords: bivariate cox, bivariate event, copula function, survival copula

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