Search results for: marginal likelihood evidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4480

Search results for: marginal likelihood evidence

4210 Diagnostic Performance of Mean Platelet Volume in the Diagnosis of Acute Myocardial Infarction: A Meta-Analysis

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

Abstract:

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

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

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4209 Utility of CT Perfusion Imaging for Diagnosis and Management of Delayed Cerebral Ischaemia Following Subarachnoid Haemorrhage

Authors: Abdalla Mansour, Dan Brown, Adel Helmy, Rikin Trivedi, Mathew Guilfoyle

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Introduction: Diagnosing delayed cerebral ischaemia (DCI) following aneurysmal subarachnoid haemorrhage (SAH) can be challenging, particularly in poor-grade patients. Objectives: This study sought to assess the value of routine CTP in identifying (or excluding) DCI and in guiding management. Methods: Eight-year retrospective neuroimaging study at a large UK neurosurgical centre. Subjects included a random sample of adult patients with confirmed aneurysmal SAH that had a CTP scan during their inpatient stay, over a 8-year period (May 2014 - May 2022). Data collected through electronic patient record and PACS. Variables included age, WFNS scale, aneurysm site, treatment, the timing of CTP, radiologist report, and DCI management. Results: Over eight years, 916 patients were treated for aneurysmal SAH; this study focused on 466 patients that were randomly selected. Of this sample, 181 (38.84%) had one or more CTP scans following brain aneurysm treatment (Total 318). The first CTP scan in each patient was performed at 1-20 days following ictus (median 4 days). There was radiological evidence of DCI in 83, and no reversible ischaemia was found in 80. Findings were equivocal in the remaining 18. Of the 103 patients treated with clipping, 49 had DCI radiological evidence, in comparison to 31 of 69 patients treated with endovascular embolization. The remaining 9 patients are either unsecured aneurysms or non-aneurysmal SAH. Of the patients with radiological evidence of DCI, 65 had a treatment change following the CTP directed at improving cerebral perfusion. In contrast, treatment was not changed for (61) patients without radiological evidence of DCI. Conclusion: CTP is a useful adjunct to clinical assessment in the diagnosis of DCI and is helpful in identifying patients that may benefit from intensive therapy and those in whom it is unlikely to be effective.

Keywords: SAH, vasospasm, aneurysm, delayed cerebral ischemia

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4208 Shared Decision-Making in Holistic Healthcare: Integrating Evidence-Based Medicine and Values-Based Medicine

Authors: Ling-Lang Huang

Abstract:

Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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4207 Mental Health Clinicians’ Perceptions of Nature-Based Interventions Within Community Mental Health Services: Evidence from Australia

Authors: Rachel Tambyah, Katarzyna Olcoń, Julaine Allan, Pete Destry, Thomas Astell-Burt

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The rising social and financial burden of mental illness indicates an urgent need to explore interventions that can be used as well as or instead of traditional treatments. Although there is growing evidence of the positive mental health outcomes of spending time in nature, the implementation of nature-based interventions (NBIs) within mental health services remains minimal. Based on interviews with mental health clinicians in Australia, this study demonstrated that clinicians supported the use of NBIs and would promote them to their clients.

Keywords: nature, nature-based interventions, mental health, mental health services, mental health clinicians

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4206 The Relationship between Investment and Dividend in a Condition of Cash Flow Uncertainly: Evidence from Iran

Authors: Moridi Fatemeh, Dasineh Mehdi, Jafari Narges

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The aim of this study was to investigate the relationship between dividends and investment in a condition of cash flow uncertainty. Previous studies have also found some evidence that there is N-shaped relationship between dividends and investment given different levels of cash uncertainly. Thus, this study examines this relationship over the period 2009-2014 in Tehran Stock Exchange (TSE). Based on our sample and new variables, we found reverse N-shaped relationship in different levels of cash flow uncertainly. This shape was descending in cash flow certainly and uncertainly but it is ascending in medial position.

Keywords: dividends, investment, nonlinear relationship, uncertainty of cash flow

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4205 Initial Settlers and Gender Norms: Evidence From the United States

Authors: Joanne Haddad

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The distinctive traits of early settlers at initial stages of institutional development may be crucial for cultural formation. In 1973, the cultural geographer Wilbur Zelinsky postulated this in his doctrine of “first effective settlement”. There is however little empirical evidence supporting the role of early settlers in shaping culture over the long run. This paper tests this hypothesis by relating early settlers’ culture to within state variation in gender norms in the United States. Settlers’ culture is captured using past female labor force participation, women’s suffrage, and financial rights at their place of origin. The paper documents the distinctive characteristics of settlers’ populations and provide suggestive evidence in support of the transmission of gender norms across space and time. Results from this analysis show that women’s labor supply is higher, in both the short and long run, in U.S. counties that historically hosted a larger settler population originating from places with favorable gender attitudes. Findings from this study shed new light on the importance of the characteristics of immigrants and their place of origin for cultural formation in hosting societies.

Keywords: female labor force participation, settlers, gender norms, cultural formation.

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4204 Cross Matching: An Improved Method to Obtain Comprehensive and Consolidated Evidence

Authors: Tuula Heinonen, Wilhelm Gaus

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At present safety, assessment starts with animal tests although their predictivity is often poor. Even after extended human use experimental data are often judged as the core information for risk assessment. However, the best opportunity to generate true evidence is to match all available information. Cross matching methodology combines the different fields of knowledge and types of data (e.g. in-vitro and in-vivo experiments, clinical observations, clinical and epidemiological studies, and daily life observations) and gives adequate weight to individual findings. To achieve a consolidated outcome, the information from all available sources is analysed and compared with each other. If single pieces of information fit together a clear picture becomes visible. If pieces of information are inconsistent or contradictory careful consideration is necessary. 'Cross' can be understood as 'orthographic' in geometry or as 'independent' in mathematics. Results coming from different sources bring independent and; therefore, they result in new information. Independent information gives a larger contribution to evidence than results coming repeatedly from the same source. A successful example of cross matching is the assessment of Ginkgo biloba where we were able to come to the conclusive result: Ginkgo biloba leave extract is well tolerated and safe for humans.

Keywords: cross-matching, human use, safety assessment, Ginkgo biloba leave extract

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4203 Electrophysiological Correlates of Statistical Learning in Children with and without Developmental Language Disorder

Authors: Ana Paula Soares, Alexandrina Lages, Helena Oliveira, Francisco-Javier Gutiérrez-Domínguez, Marisa Lousada

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From an early age, exposure to a spoken language allows us to implicitly capture the structure underlying the succession of the speech sounds in that language and to segment it into meaningful units (words). Statistical learning (SL), i.e., the ability to pick up patterns in the sensory environment even without intention or consciousness of doing it, is thus assumed to play a central role in the acquisition of the rule-governed aspects of language and possibly to lie behind the language difficulties exhibited by children with development language disorder (DLD). The research conducted so far has, however, led to inconsistent results, which might stem from the behavioral tasks used to test SL. In a classic SL experiment, participants are first exposed to a continuous stream (e.g., syllables) in which, unbeknownst to the participants, stimuli are grouped into triplets that always appear together in the stream (e.g., ‘tokibu’, ‘tipolu’), with no pauses between each other (e.g., ‘tokibutipolugopilatokibu’) and without any information regarding the task or the stimuli. Following exposure, SL is assessed by asking participants to discriminate between triplets previously presented (‘tokibu’) from new sequences never presented together during exposure (‘kipopi’), i.e., to perform a two-alternative-forced-choice (2-AFC) task. Despite the widespread use of the 2-AFC to test SL, it has come under increasing criticism as it is an offline post-learning task that only assesses the result of the learning that had occurred during the previous exposure phase and that might be affected by other factors beyond the computation of regularities embedded in the input, typically the likelihood two syllables occurring together, a statistic known as transitional probability (TP). One solution to overcome these limitations is to assess SL as exposure to the stream unfolds using online techniques such as event-related potentials (ERP) that is highly sensitive to the time-course of the learning in the brain. Here we collected ERPs to examine the neurofunctional correlates of SL in preschool children with DLD, and chronological-age typical language development (TLD) controls who were exposed to an auditory stream in which eight three-syllable nonsense words, four of which presenting high-TPs and the other four low-TPs, to further analyze whether the ability of DLD and TLD children to extract-word-like units from the steam was modulated by words’ predictability. Moreover, to ascertain if the previous knowledge of the to-be-learned-regularities affected the neural responses to high- and low-TP words, children performed the auditory SL task, firstly, under implicit, and, subsequently, under explicit conditions. Although behavioral evidence of SL was not obtained in either group, the neural responses elicited during the exposure phases of the SL tasks differentiated children with DLD from children with TLD. Specifically, the results indicated that only children from the TDL group showed neural evidence of SL, particularly in the SL task performed under explicit conditions, firstly, for the low-TP, and, subsequently, for the high-TP ‘words’. Taken together, these findings support the view that children with DLD showed deficits in the extraction of the regularities embedded in the auditory input which might underlie the language difficulties.

Keywords: development language disorder, statistical learning, transitional probabilities, word segmentation

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4202 A Note on Metallurgy at Khanak: An Indus Site in Tosham Mining Area, Haryana

Authors: Ravindra N. Singh, Dheerendra P. Singh

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Recent discoveries of Bronze Age artefacts, tin slag, furnaces and crucibles, together with new geological evidence on tin deposits in Tosham area of Bhiwani district in Haryana (India) provide the opportunity to survey the evidence for possible sources of tin and the use of bronze in the Harappan sites of north western India. Earlier, Afghanistan emerged as the most promising eastern source of tin utilized by Indus Civilization copper-smiths. Our excavations conducted at Khanak near Tosham mining area during 2014 and 2016 revealed ample evidence of metallurgical activities as attested by the occurrence of slag, ores and evidences of ashes and fragments of furnaces in addition to the bronze objects. We have conducted petrological, XRD, EDAX, TEM, SEM and metallography on the slag, ores, crucible fragments and bronze objects samples recovered from Khanak excavations. This has given positive indication of mining and metallurgy of poly-mettalic Tin at the site; however, it can only be ascertained after the detailed scientific examination of the materials which is underway. In view of the importance of site, we intend to excavate the site horizontally in future so as to obtain more samples for scientific studies.

Keywords: archaeometallurgy, problem of tin, metallography, indus civilization

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4201 Integrating Evidence Into Health Policy: Navigating Cross-Sector and Interdisciplinary Collaboration

Authors: Tessa Heeren

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The following proposal pertains to the complex process of successfully implementing health policies that are based on public health research. A systematic review was conducted by myself and faculty at the Cluj School of Public Health in Romania. The reviewed articles covered a wide range of topics, such as barriers and facilitators to multi-sector collaboration, differences in professional cultures, and systemic obstacles. The reviewed literature identified communication, collaboration, user-friendly dissemination, and documentation of processes in the execution of applied research as important themes for the promotion of evidence in the public health decision-making process. This proposal fits into the Academy Health National Health Policy conference because it identifies and examines differences between the worlds of research and politics. Implications and new insights for federal and/or state health policy: Recommendations made based on the findings of this research include using politically relevant levers to promote research (e.g. campaign donors, lobbies, established parties, etc.), modernizing dissemination practices, and reforms in which the involvement of external stakeholders is facilitated without relying on invitations from individual policy makers. Description of how evidence and/or data was or could be used: The reviewed articles illustrated shortcomings and areas for improvement in policy research processes and collaborative development. In general, the evidence base in the field of integrating research into policy lacks critical details of the actual process of developing evidence based policy. This shortcoming in logistical details creates a barrier for potential replication of collaborative efforts described in studies. Potential impact of the presentation for health policy: The reviewed articles focused on identifying barriers and facilitators that arise in cross sector collaboration, rather than the process and impact of integrating evidence into policy. In addition, the type of evidence used in policy was rarely specified, and widely varying interpretations of the definition of evidence complicated overall conclusions. Background: Using evidence to inform public health decision making processes has been proven effective; however, it is not clear how research is applied in practice. Aims: The objectives of the current study were to assess the extent to which evidence is used in public health decision-making process. Methods: To identify eligible studies, seven bibliographic databases, specifically, PubMed, Scopus, Cochrane Library, Science Direct, Web of Science, ClinicalKey, Health and Safety Science Abstract were screened (search dates: 1990 – September 2015); a general internet search was also conducted. Primary research and systematic reviews about the use of evidence in public health policy in Europe were included. The studies considered for inclusion were assessed by two reviewers, along with extracted data on objective, methods, population, and results. Data were synthetized as a narrative review. Results: Of 2564 articles initially identified, 2525 titles and abstracts were screened. Ultimately, 30 articles fit the research criteria by describing how or why evidence is used/not used in public health policy. The majority of included studies involved interviews and surveys (N=17). Study participants were policy makers, health care professionals, researchers, community members, service users, experts in public health.

Keywords: cross-sector, dissemination, health policy, policy implementation

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4200 Effect of Low Level Laser for Athletic Achilles Tendinopathy: A Systematic Review

Authors: Sameh Eldaly, Rola Essam

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Objective: The purpose of this study was to determine the benefits of low-level laser therapy for Athletic Achilles Tendinopathy. Data sources: Search strategies were conducted on 2 Randomized control trial and one pilot study. Results: three trials (103 participants) were analyzed. Laser therapy associated to eccentric exercises, when compared to eccentric exercises and placebo, had low to very low certainty of evidence in pain and function assessment. Conclusion: those three trials evidenced low to very low effect of LLLT, and the results are insufficient to support the routine use LLLT for Achilles tendinopathy.

Keywords: achilles tendinopathy, evidence-based, low-level laser therapy, review

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4199 Beyond Cooking and Food Preparation: Examining the Material Culture of Medieval Cuisine in the Middle East

Authors: Shurouq Munzer

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This study investigates methods for inferring the presence of cooking activity at an archaeological site through the study of cooking tools, contextual evidence, and food preparation techniques. This paper examines the patterns of cooking utensils and categorizes the morphological features as well as the types of clay utilized in manufacturing such cooking utensils. Despite challenges in accessing such evidence due to its limited availability in books and excavations. The excavation results provide the point for evaluating progress in daily life and underscore the cultural, social, and economic significance of studying cooking activity at archaeological sites within their archaeological contexts.

Keywords: coarse ware, cooking utensils, ḥisba, waqif, muḥtasib, foodways, practice, cuisine, food preparation

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4198 Is There a Month Effect on the Deposits Interest Rates? Evidence from the Greek Banking Industry during the Period 2003-13

Authors: Konstantopoulos N., Samitas A., E. Vasileiou, Kinias I.

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This article introduces a new view on the month effect study. Applying a Markov Switching Regime model on data from the Greek Time Deposits (TDs) market for the time span January 2003 to October 2013, we examine if there is a month effect on the Greek banking industry. The empirical findings provide convincing evidence for a new king of monthly anomaly. The explanation for the specific abnormality may be the upward deposits window dressing. Further research should be done in order to examine if the specific calendar effect exists in other countries or it is only a Greek phenomenon.

Keywords: calendar anomalies, banking crisis, month effect, Greek banking industry

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4197 Climate Change and Migration in the Semi-arid Tropic and Eastern Regions of India: Exploring Alternative Adaptation Strategies

Authors: Gauri Sreekumar, Sabuj Kumar Mandal

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Contributing about 18% to India’s Gross Domestic Product, the agricultural sector plays a significant role in the Indian rural economy. Despite being the primary source of livelihood for more than half of India’s population, most of them are marginal and small farmers facing several challenges due to agro-climatic shocks. Climate change is expected to increase the risk in the regions that are highly agriculture dependent. With systematic and scientific evidence of changes in rainfall, temperature and other extreme climate events, migration started to emerge as a survival strategy for the farm households. In this backdrop, our present study aims to combine the two strands of literature and attempts to explore whether migration is the only adaptation strategy for the farmers once they experience crop failures due adverse climatic condition. Combining the temperature and rainfall information from the weather data provided by the Indian Meteorological Department with the household level panel data on Indian states belonging to the Eastern and Semi-Arid Tropics regions from the Village Dynamics in South Asia (VDSA) collected by the International Crop Research Institute for the Semi-arid Tropics, we form a rich panel data for the years 2010-2014. A Recursive Econometric Model is used to establish the three-way nexus between climate change-yield-migration while addressing the role of irrigation and local non-farm income diversification. Using Three Stage Least Squares Estimation method, we find that climate change induced yield loss is a major driver of farmers’ migration. However, irrigation and local level non-farm income diversification are found to mitigate the adverse impact of climate change on migration. Based on our empirical results, we suggest for enhancing irrigation facilities and making local non-farm income diversification opportunities available to increase farm productivity and thereby reduce farmers’ migration.

Keywords: climate change, migration, adaptation, mitigation

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4196 Reliability Assessment and Failure Detection in a Complex Human-Machine System Using Agent-Based and Human Decision-Making Modeling

Authors: Sanjal Gavande, Thomas Mazzuchi, Shahram Sarkani

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In a complex aerospace operational environment, identifying failures in a procedure involving multiple human-machine interactions are difficult. These failures could lead to accidents causing loss of hardware or human life. The likelihood of failure further increases if operational procedures are tested for a novel system with multiple human-machine interfaces and with no prior performance data. The existing approach in the literature of reviewing complex operational tasks in a flowchart or tabular form doesn’t provide any insight into potential system failures due to human decision-making ability. To address these challenges, this research explores an agent-based simulation approach for reliability assessment and fault detection in complex human-machine systems while utilizing a human decision-making model. The simulation will predict the emergent behavior of the system due to the interaction between humans and their decision-making capability with the varying states of the machine and vice-versa. Overall system reliability will be evaluated based on a defined set of success-criteria conditions and the number of recorded failures over an assigned limit of Monte Carlo runs. The study also aims at identifying high-likelihood failure locations for the system. The research concludes that system reliability and failures can be effectively calculated when individual human and machine agent states are clearly defined. This research is limited to the operations phase of a system lifecycle process in an aerospace environment only. Further exploration of the proposed agent-based and human decision-making model will be required to allow for a greater understanding of this topic for application outside of the operations domain.

Keywords: agent-based model, complex human-machine system, human decision-making model, system reliability assessment

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4195 Evidence-Based Practices in Education: A General Review of the Literature on Elementary Classroom Setting

Authors: Carolina S. Correia, Thalita V. Thomé, Andersen Boniolo, Dhayana I. Veiga

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Evidence-based practices (EBP) in education is a set of principles and practices used to raise educational policy, it involves the integration of professional expertise in education with the best empirical evidence in making decisions about how to deliver instruction. The purpose of this presentation is to describe and characterize studies about EBP in education in elementary classroom setting. Data here presented is part of an ongoing systematic review research. Articles were searched and selected from four academic databases: ProQuest, Scielo, Science Direct and Capes. The search terms were evidence-based practices or program effectiveness, and education or teaching or teaching practices or teaching methods. Articles were included according to the following criteria: The studies were explicitly described as evidence-based or discussed the most effective practices in education, they discussed teaching practices in classroom context in elementary school level. Document excerpts were extracted and recorded in Excel, organized by reference, descriptors, abstract, purpose, setting, participants, type of teaching practice, study design and main results. The total amount of articles selected were 1.185, 569 articles from Proquest Research Library; 216 from CAPES; 251 from ScienceDirect and 149 from Scielo Library. The potentially relevant references were 178, from which duplicates were removed. The final number of articles analyzed was 140. From 140 articles, are 47 theoretical studies and 93 empirical articles. The following research design methods were identified: longitudinal intervention study, cluster-randomized trial, meta-analysis and pretest-posttest studies. From 140 articles, 103 studies were about regular school teaching and 37 were on special education teaching practices. In several studies, used as teaching method: active learning, content acquisition podcast (CAP), precision teaching (PT), mediated reading practice, speech therapist programs and peer-assisted learning strategies (PALS). The countries of origin of the studies were United States of America, United Kingdom, Panama, Sweden, Scotland, South Korea, Argentina, Chile, New Zealand and Brunei. The present study in is an ongoing project, so some representative findings will be discussed, providing further acknowledgment on the best teaching practices in elementary classroom setting.

Keywords: best practices, children, evidence-based education, elementary school, teaching methods

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4194 Top-Down Influences to Multistable Perception: Evidence from Temporal Dynamics

Authors: Daria N. Podvigina, Tatiana V. Chernigovskaya

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We have studied the temporal characteristics of bistable perception of the stimuli of two types: one involves alterations in a perceived depth and another one has an ambiguous content. We used the Necker lattice and lines of shadowed circles ambiguously perceived either as spheres or holes as stimuli of the first type. The Winson figure (the Eskimo/Indian picture) was a stimulus of the second type. We have analyzed how often the reversals occurred (reversal rate) and for how long each of the two interpretations, or percepts, was observed during one presentation (stability durations). For all three ambiguous images the reversal rate and the stability durations had similar values, which provide another evidence for a significant role of top-down processes in multistable perception.

Keywords: multistable perception, perceived depth, reversal rate, top-down processes

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4193 Institutional Legitimacy and Professional Boundary: Western Medicine-Trained Doctors' Attitudes and Behaviors toward Traditional Chinese Medicine

Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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4192 Foreign Banks Taking More Risk: Evidence from Emerging Economies

Authors: Minghua Chen, Rui Wang

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This paper addresses the impact of foreign ownership on the risk-taking behavior of banks. Using bank-level panel data of more than 1,300 commercial banks in 32 emerging economies during 2000-2013, we find that foreign owned banks take on more risk than their domestic counterparts. We further examine several factors that may potentially contribute to foreign banks’ differentiated riskiness from four perspectives, namely, foreign banks’ informational disadvantages, agency problems, the contagious effect of parent banks’ financial conditions and the disparity between home and host markets. We find supportive evidence that these factors play a significant role in affecting foreign banks’ risk-taking.

Keywords: bank risk-taking, emerging economies, financial liberalization, foreign banks

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4191 Current and Emerging Pharmacological Treatment for Status Epilepticus in Adults

Authors: Mathew Tran, Deepa Patel, Breann Prophete, Irandokht Khaki Najafabadi

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Status epilepticus is a neurological disorder requiring emergent control with medical therapy. Based on guideline recommendations for adults with status epilepticus, the first-line treatment is to start a benzodiazepine, as they are quick at seizure control. The second step is to initiate a non-benzodiazepine anti-epileptic drug to prevent refractory seizures. Studies show that the anti-epileptic drugs are approximately equivalent in status epilepticus control once a benzodiazepine has been given. This review provides a brief overview of the management of status epilepticus based on evidence from the literature and evidence-based guidelines.

Keywords: neurological disorder, seizure, status epilepticus, benzo diazepines, antiepileptic agents

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4190 Valuing Non-Market Environmental Benefits of the Biodiversity Conservation Project

Authors: Huynh Viet Khai, Mitsuyasu Yabe

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The study investigated the economic value of biodiversity attributes that could provide policy-makers reliable information to estimate welfare losses due to biodiversity reductions and analyse the trade-off between biodiversity and economics. In order to obtain the non-market benefits of biodiversity conservation, an indirect utility function and willingness to pay for biodiversity attributes were applied using the approach of choice modelling with the analysis of conditional logit model. The study found that Mekong Delta residents accepted their willingness to pay for VND 913 monthly for a one percent increase in healthy vegetation, VND 360 for an additional mammal species and VND 2,440 to avoid the welfare losses of 100 local farmers.

Keywords: choice modelling, genetic resources, wetland conservation, marginal willingness to pay

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4189 Do European Hedge Fund Managers Time Market Liquidity?

Authors: Soumaya Ben Kheilifa, Dorra Mezzez Hmaied

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We propose two approaches to examine whether European hedge fund managers can time market liquidity. Using a sample of 1616 European hedge funds, we find evidence of liquidity timing. More importantly, this ability adds economic value to investors. Thus, it represents valuable managerial skill and a major source of European hedge funds’ performance. Also we show that the majority of these funds demonstrate liquidity timing ability especially during liquidity crisis. Finally, it emerged that our main evidence of liquidity timing remains significant after controlling for market timing and volatility timing.

Keywords: european hedge funds, liquidity timing ability, market liquidity, crisis

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4188 Digital Forensics Analysis Focusing on the Onion Router Browser Artifacts in Windows 10

Authors: Zainurrasyid Abdullah, Mohamed Fadzlee Sulaiman, Muhammad Fadzlan Zainal, M. Zabri Adil Talib, Aswami Fadillah M. Ariffin

Abstract:

The Onion Router (Tor) browser is a well-known tool and widely used by people who seeking for web anonymity when browsing the internet. Criminals are taking this advantage to be anonymous over the internet. Accessing the dark web could be the significant reason for the criminal in order for them to perform illegal activities while maintaining their anonymity. For a digital forensic analyst, it is crucial to extract the trail of evidence in proving that the criminal’s computer has used Tor browser to conduct such illegal activities. By applying the digital forensic methodology, several techniques could be performed including application analysis, memory analysis, and registry analysis. Since Windows 10 is the latest operating system released by Microsoft Corporation, this study will use Windows 10 as the operating system platform that running Tor browser. From the analysis, significant artifacts left by Tor browser were discovered such as the execution date, application installation date and browsing history that can be used as an evidence. Although Tor browser was designed to achieved anonymity, there is still some trail of evidence can be found in Windows 10 platform that can be useful for investigation.

Keywords: artifacts analysis, digital forensics, forensic analysis, memory analysis, registry analysis, tor browser, Windows 10

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4187 Evidence from the Field: The Case Study of Golitos as an Effective Soccer Program for Autism Spectrum Disorder Children

Authors: J. O. Alvarez, L. Y. Rivera

Abstract:

Physical activity can reduce symptomatology in children with autism spectrum disorder (ASD). The sport of soccer has been widely applied as a therapeutic method for ASD children. However, empirical results from soccer programs are not widely known. This paper presents the case study of Golitos, the only dedicated soccer program for children on the island of Puerto Rico, and analyzes its results in the reduction of ASD social and emotional symptoms. The paper shows evidence that suggests that program approach, content, and community-based elements can make a notable difference in the effectiveness of using soccer or sports as therapeutic methods for children with ASD.

Keywords: autism, soccer, program, community

Procedia PDF Downloads 105
4186 The Study on the Relationship between Momentum Profits and Psychological Factors: Evidence from Taiwan

Authors: Chih-Hsiang Chang

Abstract:

This study provides insight into the effects of investor sentiment, excess optimism, overconfidence, the disposition effect, and herding formation on momentum profits. This study contributes to the field by providing a further examination of the relationship between psychological factors and momentum profits. The empirical results show that there is no evidence of significant momentum profits in Taiwan’s stock market. Additionally, investor sentiment in Taiwan’s stock market significantly influences its momentum profits.

Keywords: momentum profits, psychological factors, herding formation, investor sentiment

Procedia PDF Downloads 357
4185 A Minimally Invasive Approach Using Bio-Miniatures Implant System for Full Arch Rehabilitation

Authors: Omid Allan

Abstract:

The advent of ultra-narrow diameter implants initially offered an alternative to wider conventional implants. However, their design limitations have restricted their applicability primarily to overdentures and cement-retained fixed prostheses, often with unpredictable long-term outcomes. The introduction of the new Miniature Implants has revolutionized the field of implant dentistry, leading to a more streamlined approach. The utilization of Miniature Implants has emerged as a promising alternative to the traditional approach that entails the traumatic sequential bone drilling procedures and the use of conventional implants for full and partial arch restorations. The innovative "BioMiniatures Implant System serves as a groundbreaking bridge connecting mini implants with standard implant systems. This system allows practitioners to harness the advantages of ultra-small implants, enabling minimally invasive insertion and facilitating the application of fixed screw-retained prostheses, which were only available to conventional wider implant systems. This approach streamlines full and partial arch rehabilitation with minimal or even no bone drilling, significantly reducing surgical risks and complications for clinicians while minimizing patient morbidity. The ultra-narrow diameter and self-advancing features of these implants eliminate the need for invasive and technically complex procedures such as bone augmentation and guided bone regeneration (GBR), particularly in cases involving thin alveolar ridges. Furthermore, the absence of a microcap between the implant and abutment eliminates the potential for micro-leakage and micro-pumping effects, effectively mitigating the risk of marginal bone loss and future peri-implantitis. The cumulative experience of restoring over 50 full and partial arch edentulous cases with this system has yielded an outstanding success rate exceeding 97%. The long-term success with a stable marginal bone level in the study firmly establishes these implants as a dependable alternative to conventional implants, especially for full arch rehabilitation cases. Full arch rehabilitation with these implants holds the promise of providing a simplified solution for edentulous patients who typically present with atrophic narrow alveolar ridges, eliminating the need for extensive GBR and bone augmentation to restore their dentition with fixed prostheses.

Keywords: mini-implant, biominiatures, miniature implants, minimally invasive dentistry, full arch rehabilitation

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4184 An Efficient Robot Navigation Model in a Multi-Target Domain amidst Static and Dynamic Obstacles

Authors: Michael Ayomoh, Adriaan Roux, Oyindamola Omotuyi

Abstract:

This paper presents an efficient robot navigation model in a multi-target domain amidst static and dynamic workspace obstacles. The problem is that of developing an optimal algorithm to minimize the total travel time of a robot as it visits all target points within its task domain amidst unknown workspace obstacles and finally return to its initial position. In solving this problem, a classical algorithm was first developed to compute the optimal number of paths to be travelled by the robot amidst the network of paths. The principle of shortest distance between robot and targets was used to compute the target point visitation order amidst workspace obstacles. Algorithm premised on the standard polar coordinate system was developed to determine the length of obstacles encountered by the robot hence giving room for a geometrical estimation of the total surface area occupied by the obstacle especially when classified as a relevant obstacle i.e. obstacle that lies in between a robot and its potential visitation point. A stochastic model was developed and used to estimate the likelihood of a dynamic obstacle bumping into the robot’s navigation path and finally, the navigation/obstacle avoidance algorithm was hinged on the hybrid virtual force field (HVFF) method. Significant modelling constraints herein include the choice of navigation path to selected target points, the possible presence of static obstacles along a desired navigation path and the likelihood of encountering a dynamic obstacle along the robot’s path and the chances of it remaining at this position as a static obstacle hence resulting in a case of re-routing after routing. The proposed algorithm demonstrated a high potential for optimal solution in terms of efficiency and effectiveness.

Keywords: multi-target, mobile robot, optimal path, static obstacles, dynamic obstacles

Procedia PDF Downloads 264
4183 The Musician as the Athlete: Psychological Response to Injury

Authors: Shulamit Sternin

Abstract:

Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.

Keywords: athlete, injury, musician, psychological response

Procedia PDF Downloads 178
4182 An Extension of the Generalized Extreme Value Distribution

Authors: Serge Provost, Abdous Saboor

Abstract:

A q-analogue of the generalized extreme value distribution which includes the Gumbel distribution is introduced. The additional parameter q allows for increased modeling flexibility. The resulting distribution can have a finite, semi-infinite or infinite support. It can also produce several types of hazard rate functions. The model parameters are determined by making use of the method of maximum likelihood. It will be shown that it compares favourably to three related distributions in connection with the modeling of a certain hydrological data set.

Keywords: extreme value theory, generalized extreme value distribution, goodness-of-fit statistics, Gumbel distribution

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4181 The Marketing Mix in Small Sized Hotels: A Case of Pattaya, Thailand

Authors: Anyapak Prapannetivuth

Abstract:

The purpose of this research is to investigate the marketing mix that is perceived to be important for the small sized hotels in Pattaya. Unlike previous studies, this research provides insights through a review of the marketing activities performed by the small sized hotels. Nine owners and marketing manager of small sized hotels and resorts, all local Chonburi people, were selected for an in-depth interview. A snowball sampling process was employed. The research suggests that seven marketing mixes (e.g. Product, Price, Place, Promotion, People, Physical Evidence and Process) were commonly used by these hotels, however, three types – People, price and physical evidence were considered most important by the owners.

Keywords: marketing mix, marketing tools, small sized hotels, pattaya

Procedia PDF Downloads 254