NPV Values Research Articles

Clinical biomarkers to predict preoperative lymph node metastasis in endometrial cancer

Background/Aim: Although the evaluation of preoperative lymph node metastasis is very important for the appropriate approach of the surgeon, it cannot be determined precisely. We aimed to investigate preoperative systemic inflammatory markers and the value of CA 125 in the prediction of lymph node metastasis (LNM) in epithelial endometrial carcinoma. Methods: In our retrospective cohort study, 327 patients were pathologically diagnosed with epithelial endometrial carcinoma and underwent surgical staging including lymphadenectomy. We investigated preoperative serum CA 125, neutrophil/lymphocyte (NLR) and thrombocyte/lymphocyte (PLR) values and their relationship with LNM. ROC analysis was performed to these variables for prediction of LNM. Results: There was a significant difference between histological type (P=0.021), myometrial invasion (P<0.001), lymphovascular space invasion (LVSI) (P<0.001), and peritoneal cytology (P=0.001) in those with and without LNM. Among the NLR, PLR and CA 125 values, only CA 125 was significantly higher in the LN positive group compared to the LN negative group (P=0.516, P=0.408 and P=0.001, respectively). The optimal CA 125 cut-off value in the preoperative diagnosis of LNM was ≥39.0 U/ml. The diagnostic sensitivity, specificity, PPV, NPV, and accuracy values of CA 125 were 77%, 82%, 48%, 94%, and 81%, respectively. Conclusion: While preoperative CA 125 value was a significant predictor for LNM in epithelial endometrial cancers, we did not detect this relationship in NLR, PLR and systemic inflammatory markers.

Prediction of squamous cell carcinoma cases from squamous cell hyperplasia in throat lesions using CT radiomics model.

Objectives:To differentiate squamous cell hyperplasia (SCH) (benign) from squamous cell carcinoma (SCC) malignant) using textural features extracted from CT images and thereby, facilitate the preoperative medical diagnosis and treatment of throat cancers without the need for sample biopsies.Methods:In total, 100 throat cancer patients were selected for this retrospective study. The cases were collected from the Second Hospital of Jilin University, Changchun, China, from June 2017 to January 2019. The patients were separated into a training and validation cohort consisting of 70 and 30 cases, respectively. The Artificial Intelligence Kit software (A.K. software) was used to extract the radiomics features from the CT images. These features were further processed using the minimum redundancy maximum relevance (mRMR) and least absolute shrinkage and selection operator (LASSO) methods to obtain a subset of optimal features. The radiomics model was validated based on area-under-the-curve (AUC) values, accuracy, specificity, and sensitivity using the R-studio software.Results:The diagnostic accuracy, specificity, PPV, NPV, and AUC values obtained for the training cohort was 0.91, 0.9, 0.93, 0.9, and 0.96 CT angiography (CTA), 0.93, 0.93, 0.95, 0.90, and 0.96 computed tomography normal (CTN), and 0.92, 0.87, 0.91, 0.96, and 0.96 CT venogram (CTV). These values were subsequently confirmed in the validation cohort.Conclusion:The radiomics-based prediction model proposed in this study successfully differentiated between SCH and SCC throat cancers using CT imaging, thereby facilitating the development of accurate preoperative diagnosis based on specific biomarkers and cancer phenotypes.

Determination of optimal production rate under price uncertainty—Sari Gunay gold mine, Iran

Due to the long life, most mining projects face the risk of the parameters such as mineral price, grade, and cost. Uncertainty can lead to unfavorable results of the decisions made by managers and mining investors. Therefore, this paper aims to determine the Sari Gunay gold mine’s production planning, considering the certainty and uncertainty over the mineral price. Finally, the proposed planning will lead to the allocation of fixed or variable production rates throughout the mine life. These findings were assessed by Taylor and Zwiagin methods with 22 different scenarios in all conditions, including (a) price certainty and uncertainty such as daily price, 3- and 5-year average, Monte Carlo simulation, and binomial tree; (b) decreasing, increasing, and fixed production rates; and (c) mine life conditions. The scenarios evaluated under the price certainty conditions (scenarios 1 to 12) have lower NPV values than those under the price uncertainty conditions. This is because the price is fixed throughout the mine life. Due to historical price data and high fluctuations of estimated prices, this method’s NPV values fluctuate more than other scenarios evaluated by the Monte Carlo simulation. The binomial tree method scenarios have the lowest NPV value’s fluctuation because the fluctuation of the estimated prices is controlled, and the highest NPV values are related to this method. Out of the 22 scenarios, scenario 17 has the highest NPV value ($512,642,774). According to this scenario, the mine plan is determined, and the annual production rate is reduced to 3,241,977 tons in the first year and 270,165 tons in the last year with the Taylor life of 12 years.

Techno-economic study of compound parabolic collector in solar water heating system in the northern hemisphere

Abstract The auxiliary requirement of a solar water heating system is an index of the end-user's cost and, thus, the feasibility of the system. Within this study several locations worldwide with high and low solar radiations and electricity prices in latitudes of 0, 15, 30, 45 and 60°N have been selected and the effect of employing a Compound Parabolic Collector (CPC) on the yearly auxiliary energy saving of a solar water heating system has been investigated numerically and compared with the energy performance of a typical flat plat collector. The yearly solar radiation in selected locations ranges from 2509 to 852 kWh/m2. Electricity prices also vary from 0.04 to 0.28 USD/kWh. According to results, in all selected locations, CPC shows an advantage over flat plate collectors in auxiliary power consumption. The yearly auxiliary heating rate decreased maximum by 27% in Shambat in Sudan and minimum by 5% in Chongqing in China. As solar radiation increases, the advantage of CPC becomes more meaningful. Regarding costs and economic feasibility of CPC, maximum net present values are all achieved in the locations with the highest electricity prices and not very high discount rates. Selected locations in Japan and Italy with maximum NPV values of 1,981 and 1,811 UDS, respectively, have the highest electricity rates of 0.28 and 0.27 USD/kWh, in respect. In both countries, the discount rate is relatively low and about 0.3. Moreover, among the selected locations, NPV of investment on CPC in Gabon, Guatemala, USA, Japan and Sweden with low levels of solar radiation, between 974 and 1,942 kWh/m2, is between 832 and 1,981 USD at the end of the project’s life time and justifies the employment of this type of solar collector in sites with high energy prices, even though not much solar radiation is available. It could be concluded that in locations with high electricity prices and not very much discount rates, even in cases of relatively low solar radiation, investment in CPC would yield the highest profits.

Operating Profitableness of Investment Projects. In a Searching a Fictional Rate

An investment project is considered as a borrowing project with two participants, an investor and a recipient, each of which has its own profitability. The concept of operating profitableness of participants is described, according to which the IRR is determined by the ratio of the discounted amounts of interest payments and loan indebtedness previously allocated from the project payment stream. This establishes the economic meaning of IRR as a ratio of income to the resources used to obtain it. It is shown that in projects with a single (simple or multifold) IRR value, the operational profitableness of participants is determined by this value, but at different intervals of the change in the discount rate. The concept of real profitability of participants is introduced, which, with positive NPV values, is identified as the profitability of the investor, and with negative values, as the profitability of the recipient. Indicators of real profitability of project participants with a single IRR value are built. The possibility of constructing indicators of operational and real profitability of participants in projects with multiple IRR values is discussed.

Accuracy of affordable instruments for hearing screening in adults and the elderly.

To evaluate the accuracy of affordable instruments for hearing screening of adults and the elderly. This study was carried out with users of a Hearing Health Service of the Unified Health System. All were screened with the MoBASA smartphone application, the Telehealth audiometer (TH) and the electronic version of the Hearing Handicap Inventory for the Elderly - screening version - eHHIE-S. The examiners were blinded to the results of the screening tests and pure tone audiometry (PTA). Hearing impairment was considered for those with a PTA quadritonal mean greater than 40 dB in the best ear. Sensitivity, specificity and positive and negative predictive values (PPV and NPV, respectively) were calculated. The Kappa index was used as an agreement indicator between the PTA and the screening results. The sample consisted of 80 individuals between 18 and 94 years old (55.18 ± 20.21). In the PTA test, 21 individuals (26.25%) had typical hearing and 59 (73.75%) hearing loss. In the hearing screening tests, sensitivity, specificity, PPV and NPV values greater than 75% were observed with the MoBASA as well as in terms of sensitivity and NPV of the TH and the eHHIE-S. The TH and the eHHIE-S specificity and PPV were less than 75%. The Kappa index indicated a substantial agreement (0.6) between the PTA and the MoBASA screening results. The TH and the eHHIE-S showed regular agreement (0.3). MoBASA proved to be an accurate method for hearing screening of adults and the elderly with disabling hearing loss.

1441. Using Carbapenem Resistance Levels to Discriminate Between Carbapenemase Producing and Non-Carbapenemase Producing Carbapenem Resistant Enterobacteriaceae

BackgroundCarbapenem-resistant Enterobacteriaceae (CRE) are a growing threat globally. Many CRE organisms carry plasmids that produce a carbapenemase enzyme (CP-CRE). Early detection of CP-CRE and aggressive infection prevention and control (IPC) measures are necessary to reduce transmission of resistant organisms and their plasmids. Many hospital laboratories do not test CRE for carbapenemase production. In Apr ‘18, the Philadelphia Department for Public Health (PDPH) established mandatory CRE reporting including isolate submission for mechanism testing at public health laboratories.MethodsWe analyzed trends of carbapenem resistance in CP and non-CP-CRE. We calculated sensitivity (Sen), specificity (Spe), positive and negative predictive values (PPV, NPV) at each level of carbapenem resistance to develop a predictive model with goal of effectively discriminating CP and non-CP CRE. ROC curves were plotted.ResultsFrom June,’18-Feb,’20, 351 CRE had genetic mechanism testing. 192 (54.7%) were Klebsiella pneumoniae, 53 (15.1%) were Enterobacter cloacae, 52 (14.8%) were E. coli, and the remaining 54 (15.4%) other Enterobacteriaceae.186 (53.0%) had a recorded minimum inhibitory concentration (MIC) for ertapenem, 191 (54.4%) for meropenem, 116 (33.0%) for imipenem, and 9 (2.6%) for doripenem. Doripenem was not further analyzed. The odds of being CP-CRE increased with increasing MIC. One standard dilution increase in MIC was associated with the following odds ratios (OR) of being CP-CRE: ertapenem OR 1.43 (95% CI: 1.11–1.83), imipenem OR 2.52 (95% CI: 1.7–3.793), meropenem, OR 2.20 (95% CI: 1.72–2.81). For each carbapenem, we calculated Sen, Spe, PPV, and NPV values for five MIC cut points; 0.5, 1, 2, 4, and 8 ug/ml, non-CP CRE defined as ≤ MIC cut point, CP-CRE defined as > cut point.Figure 1. ROC Curves Table 1. Sensitivity, Specificity, PPV, NPV of MIC Cut Points ConclusionThere were no MIC cut points that performed well in both Sen and Spe, however, for the purposes of IPC, correctly classifying CP CRE (Sen) is more important than correctly classifying non-CP CRE (Spe). MIC cut points that performed best were imipenem MIC of 1 ug/ml and meropenem MIC of 1 ug/ml, with Sen 98%, 94% respectively, PPV 85%, 84% respectively and NPV 88%, 76% respectively. When further testing is not available, MIC cut points may be used to infer CP production.Disclosures All Authors: No reported disclosures

STRATEGI PENGEMBANGAN USAHA BUDIDAYA TAMBAK YANG BERKELANJUTAN DI DESA LAWALLU KABUPATEN BARRU

This study aims to determine the level of socioeconomic feasibility of the pond cultivation business and formulate a sustainable development policy strategy for the pond cultivation business in the Lawallu village of Barru Regency. who works as a shrimp farmer in Lawallu Village. Analysis of the data used consists of business feasibility analysis (profit analysis, NPV, IRR, Net B / C, BEP), analysis of community social conditions and SWOT analysis.The results showed that the profit analysis was able to produce a large enough value based on the results of that the average net income or the benefits that could be generated from this aquaculture business could reach IDR. 21,165,179 per cycle and IDR. 84,660,714 per year. From the acquisition of each investment analysis shows the analysis of investment criteria obtained NPV values&gt; 0, net B / C&gt; 1 and IRR&gt; of the applicable interest rate (11%), so it can be concluded from the pond cultivation business in Lawallu Village Barru Regency has high feasibility to be developed. From the results of the analysis and discussion of the prospects for developing a pond aquaculture business in Lawallu Village by using a SWOT matrix based on internal and external factors that exist in a traditional pond business there are 9 strategies to be developed.

FINANCIAL EVALUATION OF SOME AGRICULTURAL INITIATIVE PROJECTS IN IRAQ

This research aims to identify the financial feasibility of some agricultural activities benefiting from the initiative's lending funds, as well as to show the impact of the agricultural initiative on those projects in terms of raising the financial feasibility of their establishment, in the light of the results of the evaluation criteria addressed in the research. Between the years 2009-2011, the financial accounts of the projects were monitored until 2018 to obtain cash flows for the studied projects. Some projects, despite their high investment costs, have been shown to be able to recover the funds invested in a relatively short period of time, and feed plants and similar projects have the potential to recover their costs in a relatively short period. The index of profitability index also showed that most of the productive activities generate a return that exceeds the dinar invested in close proportions, and loans have a significant role in raising the efficiency and profitability of some projects that the state wishes to revitalize despite the non-profit projects in the natural conditions. The NPV values ​​calculated using a discount factor of 10% in the studied projects were positive, indicating the feasibility of investing in these projects, with the exception of the dairy cattle breeding project, which has a net present value of about -8,730,905 dinars. Results came from the discounted profitability index standard. The project also achieved the largest value of the profitability index, as the value of the index reached about 2.408. The research recommended that the need to use lending funds for the agricultural initiative as a tool to raise the efficiency and feasibility of agricultural projects that would contribute to the process of agricultural development in Iraq.

Design of nano and micro fibrillated cellulose production processes from forest industrial wastes in a multiproduct biorefinery

The need to develop biobased materials from renewable feedstocks requires the previous design and assessment of the production processes of these promising new value-added products. Nano and micro- fibrillated cellulose (NFC and MFC, respectively) are two of these new products that could revolutionize the biobased industry. In the present work, the production of NFC and CMF was analyzed in a multiproduct biorefinery from eucalyptus sawdust. It was determined that it is possible to obtain 308 kg of NFC or MFC, 169 kg of xylose syrup, and about 220 kg of lignin per ton of dry sawdust. The investment required for the analyzed alternatives of NFC and MFC is between 40–44 million USD and the NPV values are between 30 and 60 million USD. The most attractive alternative is the production of NFC, xylose syrup, and lignin (alternative III of NFC). The most important production costs correspond to enzymes and energy (for NFC and MFC, respectively). Besides, it was determined that with the proposed schemes for a sawdust availability of < 20,000 dry ton per year, it is possible to obtain NPV values ˃ 0.

Wind Energy Feasibility Study of Seven Potential Locations in Indonesia

This study evaluated seven potential locations for wind energy in Indonesia. This study applied economic analysis using static analysis and the Monte Carlo simulation. The later was used to measure the financial indicators and then to analyze the sensitivity of economic uncertainties. The result findings show that in term of annual energy production volume among the seven selected locations, Jeneponto location has the highest value of 4,339,003.2 MWh with a capacity factor of 25.22% and Bantul location has the lowest value of 526,476 MWh with a capacity factor of 16.51%. According to economic uncertainty analysis, the highest NPV and attractive IRR values with high deviation standard values will be interesting to the risk-taking investors. Otherwise, the lowest NPV and IRR values fit the risk of avoiding-type investors due to its low deviation standard values. Based on sensitivity analysis, the increase of average NPV and IRR values of all seven locations are influenced positively by first 5-year of the selling price, which contributes approximately 30% and 50% of NPV and IRR’s percentage change. By contrast, the decrease in average NPV values of all seven locations is influenced by the discount rate, which contributes approximately 15% of NPV’s percentage change. Meanwhile, the decrease in average IRR is influenced by capital investment cost, which contributes approximately 20% of IRR’s percentage change. Policymakers can further consider the parameters mentioned above.

SPREADSHEET BASED BUSINESS DECISION MAKING SYSTEM (CASE STUDY IN BONOROWO LAND, LAREN, LAMONGAN)

Bonorowo land in Laren Subdistricts, Lamongan Districts, is one of the areas that uses its land for rice, corn and kenaf cultivation. The agricultural sector in Laren does not yet have a detailed economic analysis. Farmers ignore the importance of considering initial capital and some “small” costs in this activities. Therefore, in this study, the calculation of business feasibility was carried out on rice, kenaf, and corn farmer groups in Bonorowo land, West Laren. Business feasibility analysis is conducted through calculation of the value of NPV, IRR, and IP. The calculation system uses a Microsoft Excel spreadsheet formula. The NPV, IRR, and PI values of corn cultivation are Rp. 524,182.40; 144.43%; and 2,9. The NPV, IRR, and PI values for kenaf cultivation are Rp. 1,145,532.39; 266.43%; and 5.15. The NPV, IRR, and PI values for rice cultivation are Rp. -495,085.78; -25.18%; and -0.79. The results of the economic analysis of the cultivation of rice, corn, and kenaf in Bonorowo land, Laren Subdistrict, show that rice cultivation has caused losses and is not feasible to continue.

Diagnostic role of NLR, MLR and PLR in patients with lipoma and liposarcoma

Aim: The aim of this study is to investigate the diagnostic role of Neutrophil-to-lymphocyte ratio (NLR), Monocyte-to-lymphocyte ratio (MLR) and Platelet-to-lymphocyte ratio (PLR) in patients with lipoma and liposarcoma.&#x0D; &#x0D; Material and Methods: Patients operated for lipoma and liposarcoma at our institution between 2015 and 2019 were included in this retrospective study. A total of 92 patients with 44 lipoma and 48 liposarcoma were included in this study. The results of the complete blood count before treatment were retrospectively analyzed. 94 patients with complete blood count results admitted to the same center for reasons other than fracture, infection or tumors with similar age and sex to the aforementioned study group were included as healthy controls.&#x0D; &#x0D; Results: The average age of lipoma, liposarcoma and control groups included in the study was 55.3 ± 11.6, 48.9 ± 14.7 and 52.1 ± 11.7, respectively. While 50% of lipomas are located on the thigh and 40.9% are on the shoulder, 72.9% of the liposarcomas are located on the thigh. NLR values of the liposarcoma group were significantly higher than the control group. It was observed that PLR values did not differ significantly between groups. It was noted that MLR values were statistically significantly higher in the liposarcoma group than in the lipoma group. A significant but weak AUC value (AUC = 0.620, p = 0.020) was obtained for NLR. When the cut-off value and sensitivity, specificity, + LHR, PPV and NPV values of these cut off values are examined, NLR 1.83 and above values; It pointed out that his predictability was poor in the diagnostic approach for liposarcoma.&#x0D; &#x0D; Conclusion: Consequently, lipoma and liposarcoma are the most common forms of benign and malignant soft tissue tumors. NLR and MLR may be valuable in the diagnosis of liposarcoma, but more studies are needed in this regard.

Feasibility and development strategy of milkfish (Chanos chanos) processing at small industries in Pangkep District

The milkfish business has the potential to be developed; therefore, it is not only be sold in fresh condition but also processed into other products with additional value. This study aims to analyze the prospect of developed milkfish processing in Pangkep district. The research was conducted in August 2018 until August 2019 in Bungoro, Labakkang, Pangkajene, Segeri, Mandalle dan Marang districts. The sampling method was taken by purposive sampling. The analysis of economic value was used to estimate the total economic value of the milkfish processing business. The feasibility analysis was used to determine whether the type of milkfish processing business was feasible or not to run. Analytical Hierarchy Process (AHP) was used to determine the priority strategy for the development of the milkfish processing business. The results show that there are five types of milkfish products developing in Pangkep district, including shredded milkfish, thornless milkfish, presto milkfish, bale kambu, and amplang milkfish. The analytical feasibility is conducted to show that the milkfish processing business in Pangkep district is feasible to be developed; however, the five types of processed products, milkfish shredded are more profitable to run. It shows the NPV, Net B/C, and IRR values, which are higher than other milkfish processed products. The development strategy of the milkfish processing business becomes the priority on the modality and marketing criteria. Improving the quality of human resources and developing distribution channels become a priority strategy in the development of milkfish processing businesses in Pangkep district.

ANALISIS EKONOMI PEMBANGUNAN OBJEK WISATA EKOEDUWISATA DI DESA SWARANGAN KECAMATAN JORONG TANAH LAUT

Forest is a one of natural wealth, is a the gift finite value, because could absorb carbon dioxide, produce oxygen, source foodstuffs, producer drugs, and source community economy. Government regulations about right forest entrepreneur and collection Forest products and various intensive economy in development forest exploitation, not effective if made into from logging aspect, if the forest developed to be tourist attraction will produce economic value sustainable more helpful for society and also in terms of the environment. Aim from research this is generally calculate profit and loss in development tourist attraction based environment and education. In particular for knowing magnitude investation required and income expectations which is obtained from development ecotourism. Results that obtained that is NPV as big Rp2.682.836.034 &gt; 0, so it is declared feasible. Value IRR obtained is 37 percent, where if compared interest rate investation that is 10 percent, then this project prospective enough to development investment interest rate. Value IRR the value of 1,592 is obtained. While PP investment analysis will achieved on 3 years 9 months. If expenditure increased by 15 percent and fixed income, value NPV, IRR, BCR, and PP still showing safe and decent do it investation. If spending permanent but income decreases to 3 percent, NPV, BCR, IRR, and PP values still showing safe and worth the investment. Results from the median get value Rp 20,000 which becomes inner value WTP income costs from 100 respondents, whereas for average of WTP namely Rp19,955

Evaluation of time to positivity for blood culture combined with immature granulocytes, neutrophil-to-lymphocyte ratio, and CRP in identifying bloodstream coagulase-negative Staphylococci infection in pediatric patients.

ObjectiveTo evaluate the application value of time to positivity (TTP) for blood culture combined with inflammatory parameters that included immature granulocyte percentage (IG%), immature granulocyte count (IG#), C‐reactive protein (CRP), white blood cells (WBC) neutrophil percentage (NE%), and neutrophil‐to‐lymphocyte ratio (NLR), and to identify bloodstream infections from contamination with coagulase‐negative staphylococci (CoNS) in pediatric patients.MethodsData of 12 897 inpatients with blood culture CoNS were retrospectively collected and analyzed from January‐December 2019 at our hospital. According to pre‐defined criteria, they were divided into a CoNS infection group (132 cases) and a CoNS contamination group (124 cases). Infection with Staphylococcus aureus (SA, 27 cases) at the same period was considered a positive control group. ROC curve analysis assisted in determining the value of applying TTP combined with the above‐mentioned inflammatory parameters to distinguish CoNS infection from contamination.ResultsAmong the 256 strains of CoNS, Staphylococcus hominis (55.1%), Staphylococcus epidermidis (32.0%), and Staphylococcus capitis (7.0%) were common. There was no significant difference in the subspecies distribution between the infection and contamination groups. The TTP of the CoNS infection group was significantly lower than the contamination group (P < .05). IG%, IG#, CRP, NE%, and NLR were all higher in the infected group as compared to the contaminated group (P < .05), while WBC was similar among groups. There was also no statistical difference in those parameters when comparing the CoNS infection and SA groups. ROC analysis showed that TTP value in identifying CoNS infection from contamination was the highest with area under the curve (AUC) of 0.913, and the sensitivity and specificity were 0.827 and 0.852, respectively, at the optimal cutoff value of 23.9 hours. This was followed by IG% (AUC = 0.712), with an optimal critical value of 0.55%, and a sensitivity of 0.519 and specificity of 0.797. All the AUC values of IG#, CRP, NE%, and NLR were <0.7. A combination of TTP with IG%, CRP, and NLR improved the AUC, sensitivity, specificity, accuracy, PPV, and NPV values to 0.977, 0.922, 0.957, 91.8%, 92.2%, and 91.3%, respectively.ConclusionsTTP within 24 hours indicates likelihood of CoNS as the pathogenic agent in pediatric patient blood culture. The combination of TTP with IG% CRP and NLR might improve the diagnostic accuracy.

Comparison and development of machine learning tools for the prediction of chronic obstructive pulmonary disease in the Chinese population

BackgroundChronic obstructive pulmonary disease (COPD) is a major public health problem and cause of mortality worldwide. However, COPD in the early stage is usually not recognized and diagnosed. It is necessary to establish a risk model to predict COPD development.MethodsA total of 441 COPD patients and 192 control subjects were recruited, and 101 single-nucleotide polymorphisms (SNPs) were determined using the MassArray assay. With 5 clinical features as well as SNPs, 6 predictive models were established and evaluated in the training set and test set by the confusion matrix AU-ROC, AU-PRC, sensitivity (recall), specificity, accuracy, F1 score, MCC, PPV (precision) and NPV. The selected features were ranked.ResultsNine SNPs were significantly associated with COPD. Among them, 6 SNPs (rs1007052, OR = 1.671, P = 0.010; rs2910164, OR = 1.416, P < 0.037; rs473892, OR = 1.473, P < 0.044; rs161976, OR = 1.594, P < 0.044; rs159497, OR = 1.445, P < 0.045; and rs9296092, OR = 1.832, P < 0.045) were risk factors for COPD, while 3 SNPs (rs8192288, OR = 0.593, P < 0.015; rs20541, OR = 0.669, P < 0.018; and rs12922394, OR = 0.651, P < 0.022) were protective factors for COPD development. In the training set, KNN, LR, SVM, DT and XGboost obtained AU-ROC values above 0.82 and AU-PRC values above 0.92. Among these models, XGboost obtained the highest AU-ROC (0.94), AU-PRC (0.97), accuracy (0.91), precision (0.95), F1 score (0.94), MCC (0.77) and specificity (0.85), while MLP obtained the highest sensitivity (recall) (0.99) and NPV (0.87). In the validation set, KNN, LR and XGboost obtained AU-ROC and AU-PRC values above 0.80 and 0.85, respectively. KNN had the highest precision (0.82), both KNN and LR obtained the same highest accuracy (0.81), and KNN and LR had the same highest F1 score (0.86). Both DT and MLP obtained sensitivity (recall) and NPV values above 0.94 and 0.84, respectively. In the feature importance analyses, we identified that AQCI, age, and BMI had the greatest impact on the predictive abilities of the models, while SNPs, sex and smoking were less important.ConclusionsThe KNN, LR and XGboost models showed excellent overall predictive power, and the use of machine learning tools combining both clinical and SNP features was suitable for predicting the risk of COPD development.

ANALISIS KELAYAKAN FINANSIAL SISTEM PENGELOLAAN SAMPAH DI DESA PENEBEL KABUPATEN TABANAN

Waste is currently a major issue in the development of the current tourism paradigm towards sustainable tourism. Waste management is certainly needed to keep the environment clean and beautiful. Waste management does not only reach urban areas, but also includes rural areas. One of them is in the area of Penebel Village, Penebel District, Tabanan Regency. Penebel Village is currently conducting an independent waste management effort at the village level. The Penebel Village area currently consists of 9 banjar dinas which have a total population of 4,175 people. One effort has been made is to design a 3R Integrated Waste Management Site (TPST) within the Penebel Village. The study conducted is a financial feasibility analysis of the waste management system found in Penebel Village. Based on the results of a financial feasibility study on the waste management model in Penebel Village, the NPV value is Rp. 694,166,994,426, -&gt; 0 and the value of BCR is 2.58&gt; 1. Both NPV and BCR values are greater than the specified conditions, so the investment is declared NPV&gt; 0 and BCR&gt; 1.

Diagnostic values of duodenal endoscopic markers in paediatric coeliac patients

Background and Study AimsThe recognition of suggestive endoscopic markers in the duodenum during open access endoscopy can help identifying patients who are likely to develop coeliac disease (CD). This study aims to determine the diagnostic accuracy of duodenal endoscopic markers for the diagnosis of CD. Patients and methodsAll children (0–15 years) who underwent oesophagogastroduodenoscopy (EGD) for any reason suggestive of CD at the paediatric department of Al-Assad University Hospital in Latakia, Syria during a 4-year period (from January 2010 to December 2013) were retrospectively included, in the study; this yielded a consecutive cohort without selection bias. The relevant data were obtained from the patients’ files. Four duodenal endoscopic markers, including scalloping, reduction of duodenal folds, nodular mucosal pattern, and scattered white spots, were evaluated. ResultsDuring the study period, 504 children underwent EGD of whom 123 (24.4%) were ultimately diagnosed with CD. At least one marker was observed in 200/504 children (39.6%) and the diagnostic values were as follows: Sensitivity (91%), specificity (76%), positive predictive value (56%), and negative predictive value (97%). Scalloping had the highest sensitivity and specificity of 89% and 96%, respectively. ConclusionCareful examination of the second and third parts of the duodenum during endoscopy can be helpful in identifying CD. Scalloping is the most common endoscopic marker, and the high NPV values of endoscopic markers should be interpreted cautiously, as the diagnosis of CD can be missed.

P773 Patient reported outcomes, partial MAYO score and SCCAI are equally accurate in predicting mucosal healing in UC: Preliminary results from a prospective study

Abstract Background Optimal management of patients with ulcerative colitis (UC) requires the accurate assessment of disease activity. Endoscopic evaluation is considered the gold standard approach, but it is invasive. We aimed to determine how strong patient reported outcomes, clinical scores and symptoms correlate with endoscopy for assessment of disease activity in UC patients. Methods One hundred and thirty-six patients were included prospectively (age: 48 (IQR: 38–61) years, duration 12 (4–19) years, 63 females, 53.7% extensive disease, 40.4% on biologicals) at the time of the colonoscopy. The 2 item patient reported outcome (PRO), partial MAYO, Simple Clinical Colitis Activity Index (SCCAI), Mayo endoscopic subscore (MES), Baron and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) scores were calculated. C reactive Protein (CRP) and fecal calprotectin (FCAL) was available in 58.1 and 33.8% of patients. 20.7% had clinical flare, treatment was escalated in 17.8% of patients. Sensitivity, specificity, PPV and NPV values were calculated, ROC analysis and K-statistics were performed. Results Rectal bleeding(RBS), stool frequency(SF) subscore of 0, or total PRO2 remission(RBS0 and SF≤1), partial MAYO(≤2) and SCCAI(≤2.5) remission were similarly associated to mucosal healing defined by MES(0 or ≤1) or Baron (0 or ≤1) scores (Table 1). PRO2 remission (AUCMES0/Baron0:0.747/0.715, AUCMES0-1/Baron0-1:0.867/0.863), SF AUCMES0/Baron0:0.731/0.703, AUCMES0-1/Baron0-1:0851/0.839), RBS(AUCMES0/Baron0:0.708/0.685, AUCMES0-1/Baron0-1:0.828/0.835) partial Mayo (AUCMES0/Baron0:0.792/0.755, AUCMES0-1/Baron0-1:0.917/0.903) and SCCAI (AUCMES0/Baron0:0.738/0.724, AUCMES0-1/Baron0-1:0.908/0.880) were similarly associated with mucosal healing in a ROC analysis. There was a string association between MES and Baron (k=0.798), while moderate agreement between UCEIS and MES (K=0.451) or Baron (K=0.499) scores. Agreement between CRP and clinical remission or endoscopic healing (MES/Baron) was poor (K~0.2), while agreement between FCAL (&amp;gt;100 or &amp;gt;250) and RBS-PRO2 remission (K&amp;gt;250:0.56–0.61) or MES/Baron 0 was moderate to good(K&amp;gt;100:0.54-0.53 and K&amp;gt;250:0.50–0.54) Conclusion We found no difference across accuracy of RBS, SF, PRO2, partial Mayo and SCCAI in predicting endoscopic healing. A strong association was found with high PPV for MES/Baron ≤1 and high NPV for MES/Baron 0. FCAL, but not CRP was associated to clinical and endoscopic remission.