Search results for: early head start

Authors: Amel M. A. Osman, Roy Mahony, Lisa Dann, McKenna S.

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Background: Computed Tomography (CT) is a significant source of radiation in the pediatric population. A new head injury (HI) pathway was introduced in 2021, which altered the previous process of HI being jointly admitted with general pediatrics and surgery to admit these patients under the Emergency Medicine Team. Admitted patients included those with positive CT findings not requiring immediate neurosurgical intervention and those who did not meet current criteria for urgent CT brain as per NICE guidelines but were still symptomatic for prolonged observations. This approach aims to decrease the number of CT scans performed. The main aim is to assess the variation in CT scanning rates since the change in the admitting process. A retrospective review of patients presenting to CHI PECU with HI over 6-month period (01/01/19-31/05/19) compared to a 6-month period post introduction of the new pathway (01/06/2022-31/12/2022). Data was collected from the electronic record databases, symphony, and PACS. Results: In 2019, there were 869 presentations of HI, among which 32 (3.68%) had CT scans performed. 2 (6.25%) of those scanned had positive findings. In 2022, there were 1122 HI presentations, with 47 (4.19%) CT scans performed and positive findings in 5 (10.6%) cases. 57 patients were admitted under the new pathway for observation, with 1 having a CT scan following admission. Conclusion: Quantitative lifetime radiation risks for children are not negligible. While there was no statistically significant reduction in CTs performed amongst HIs presenting to our department, a significant group met the criteria for admission under the PECU consultant for prolonged monitoring. There was also a greater proportion of abnormalities on CT scans performed in 2022, demonstrating improved patient selection for imaging. Further data analysis is ongoing to determine if those who were admitted would have previously been scanned under the old pathway.

Keywords: head injury, CT, admission, guidline

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Authors: Sumaira Ashraf, Elisabete G.S. Félix, Zélia Serrasqueiro

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Traditional financial distress prediction models performed well to predict bankrupt and insolvent firms of the developed markets. Previous studies particularly focused on the predictability of financial distress, financial failure, and bankruptcy of firms. This paper contributes to the literature by extending the definition of financial distress with the inclusion of early warning signs related to quotation of face value, dividend/bonus declaration, annual general meeting, and listing fee. The study used five well-known distress prediction models to see if they have the ability to predict early warning signs of financial distress. Results showed that the predictive ability of the models varies over time and decreases specifically for the sample with early warning signs of financial distress. Furthermore, the study checked the differences in the predictive ability of the models with respect to the financial crisis. The results conclude that the predictive ability of the traditional financial distress prediction models decreases for the firms with early warning signs of financial distress and during the time of financial crisis. The study developed a new model comprising significant variables from the five models and one new variable earning response. This new model outperforms the old distress prediction models before, during and after the financial crisis. Thus, it can be used by researchers, organizations and all other concerned parties to indicate early warning signs for the emerging markets.

Keywords: financial distress, emerging market, prediction models, Z-Score, logit analysis, probit model

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Authors: Behrooz Nikahval, Mohammad Saeed Ahrari-Khafi, Sakineh Behroozpoor, Saeed Nazifi

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Osteoarthritis (OA) is a progressive and degenerative condition of the articular cartilage and other joints’ structures. It is essential to diagnose this condition as early as possible. The present research was performed to measure the Osteoprotegrin (OPG) and Tumor Necrosis Factor α (TNF-α) in synovial fluid and blood serum of dogs with surgically transected cruciate ligament as a model of OA, to evaluate if measuring of these parameters can be used as a way of early diagnosis of OA. In the present study, four mature, clinically healthy dogs were selected to investigate the effect of experimental OA, on OPG and TNF-α as a way of early detection of OA. OPG and TNF-α were measured in synovial fluid and blood serum on days 0, 14, 28, 90 and 180 after surgical transaction of cranial cruciate ligament in one stifle joint. Statistical analysis of the results showed that there was a significant increase in TNF-α in both synovial fluid and blood serum. OPG showed a decrease two weeks after OA induction. However, it fluctuated afterward. In conclusion, TNF-α could be used in both synovial fluid and blood serum as a way of early detection of OA; however, further research still needs to be conducted on OPG values in OA detection.

Keywords: osteoarthritis, osteoprotegrin, tumor necrosis factor α, synovial fluid, serum, dog

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Authors: Fahimeh Ghorbani, Alam Saleh

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Ideology, politics and art have always been omnipresent patterns of Islam since its early age. The Islamic empire, expanded from China to Andalusia, has instrumentalized art and architecture to enhance political legitimacy of different dynasties or states throughout its history. Quranic verses utilized to convey ideological messages in the major mosques and mausoleums. Iranians had already been employing art and architecture to propagate their political legitimacy prior to Islam. The land of Iran and its art with strong civilizational pre-Islamic history has been profoundly politicized since the rise of Islam in the region. Early Islamic period in Iran has witnessed introduction of a new architectural language, new formulas for spatial configuration in built spaces, as well as new system of architectural decoration. Studying Iran’s Early Islamic architecture helps in better understanding the process of socio-political identity making of Iranian-Islamic culture, and thus art and architecture. This period also set the stage for formation of glorious architectural movements through Persianate world in later periods. During the Early Islamic period in Iran, the innovative combination of Islamic ideology and Iranian Architecture created formidable ideological tools in politicizing art in the region and beyond. As such, this paper aims to investigate the political history and architectural legacy from late Sassanid to Early Islamic period, delves into the ways in which Early Islamic architecture played role in transforming Persian concepts of kingship, administration, and social organization. In so doing, the study focuses on the Perso-Islamic architectural synthesis under the Samanids and Seljuk dynasty as case studies. The paper also explores how the newly introduced Islamic architecture has been employed to address the question of political legitimacy and to propagate states’ political agenda in early Islamic Iran (650-1250). As for the existing literature, despite its uniqueness and significance, Early Islamic architecture of Iran has received little scholarly attention. However, there exists a sizeable body of scholarship on socio-historic condition of the land of Iran during Early Islamic period which provide a solid base for the project. Methodologically speaking, the authors look into the subject through various lenses. They will conduct historic and archival research in libraries, private collections, and archives in Iran and the related neighbouring countries in Persian, Arabic and English. The methods of visual and formal analysis are applied to examine architectural features of the period. There are also a high number of intriguing, yet poorly examined, published and unpublished documents, old plans, drawings and photos of monuments preserved in Cultural Heritage of Iran Organization which will be consulted.

Keywords: Iran, Islamic architecture, early Islamic Iran, early Islamic architecture, politicized art, political legitimacy, propaganda, aesthetics

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Authors: Diriba Dereje

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Background: Cardiac and renal disease are the most prevalent chronic non-communicable diseases (CNCD) affecting the community in a significant manner. The best and recommended method in halting CNCD is by working on prevention as early as possible. This is only possible if early surrogate markers are identified. As part of the stated solution, this study will identify an association between microalbuminuria (an early surrogate marker of renal and cardiac disease) and lung function test among adult in the community. Objective: The main aim of this study was to assess an association between microalbuminuria (an early surrogate marker of renal and cardiac disease) and lung function test among adult in the community. Methodology: Community based cross sectional study was conducted among 384 adult in Jimma town. A systematic sampling technique was used in selecting participants to the study. In searching for the possible association, binary and multivariate logistic regression and t-test was conducted. Finally, the association between microalbuminuria and lung function test was well stated in the form of figures and written description. Result and Conclusion: A significant association was found between microalbuminuria and different lung function test parameters.

Keywords: microalbuminuria, lung function, association, test

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Authors: Linta Rose, Prasad K. Bhaskaran

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Water-level information along the coast is very important for disaster management, navigation, planning shoreline management, coastal engineering and protection works, port and harbour activities, and for a better understanding of near-shore ocean dynamics. The water-level variation along a coast attributes from various factors like astronomical tides, meteorological and hydrological forcing. The study area is the Head Bay of Bengal which is highly vulnerable to flooding events caused by monsoons, cyclones and sea-level rise. The study aims to explore the extent to which wind and surface pressure can influence water-level elevation, in view of the low-lying topography of the coastal zones in the region. The ADCIRC hydrodynamic model has been customized for the Head Bay of Bengal, discretized using flexible finite elements and validated against tide gauge observations. Monthly mean climatological wind and mean sea level pressure fields of ERA Interim reanalysis data was used as input forcing to simulate water-level variation in the Head Bay of Bengal, in addition to tidal forcing. The output water-level was compared against that produced using tidal forcing alone, so as to quantify the contribution of meteorological forcing to water-level. The average contribution of meteorological fields to water-level in January is 5.5% at a deep-water location and 13.3% at a coastal location. During the month of July, when the monsoon winds are strongest in this region, this increases to 10.7% and 43.1% respectively at the deep-water and coastal locations. The model output was tested by varying the input conditions of the meteorological fields in an attempt to quantify the relative significance of wind speed and wind direction on water-level. Under uniform wind conditions, the results showed a higher contribution of meteorological fields for south-west winds than north-east winds, when the wind speed was higher. A comparison of the spectral characteristics of output water-level with that generated due to tidal forcing alone showed additional modes with seasonal and annual signatures. Moreover, non-linear monthly mode was found to be weaker than during tidal simulation, all of which point out that meteorological fields do not cause much effect on the water-level at periods less than a day and that it induces non-linear interactions between existing modes of oscillations. The study signifies the role of meteorological forcing under fair weather conditions and points out that a combination of multiple forcing fields including tides, wind, atmospheric pressure, waves, precipitation and river discharge is essential for efficient and effective forecast modelling, especially during extreme weather events.

Keywords: ADCIRC, head Bay of Bengal, mean sea level pressure, meteorological forcing, water-level, wind

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Authors: M. Haruna, O. O. Onafowokan, G. Holt, K. Anderson, R. G. Middleton

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Background: Requirements for satisfactory outcomes following total hip arthroplasty (THA) include restoration of femoral offset, version, and leg length. Various techniques have been described for restoring these biomechanical parameters, with leg length restoration being the most predominantly described. We describe a “quartered head technique” (QHT) which uses a stepwise series of femoral head osteotomies to identify and preserve the centre of rotation of the femoral head during THA in order to ensure reconstruction of leg length, offset and stem version, such that hip biomechanics are restored as near to normal as possible. This study aims to identify whether using the QHT during hip arthroplasty effectively restores leg length and femoral offset to within acceptable parameters. Methods: A retrospective review of 206 hips was carried out, leaving 124 hips in the final analysis. Power analysis indicated a minimum of 37 patients required. All operations were performed using an anterolateral approach by a single surgeon. All femoral implants were cemented, collarless, polished double taper CPT® stems (Zimmer, Swindon, UK). Both cemented, and uncemented acetabular components were used (Zimmer, Swindon, UK). Leg length, version, and offset were assessed intra-operatively and reproduced using the QHT. Post-operative leg length and femoral offset were determined and compared with the contralateral native hip, and the difference was then calculated. For the determination of leg length discrepancy (LLD), we used the method described by Williamson & Reckling, which has been shown to be reproducible with a measurement error of ±1mm. As a reference, the inferior margin of the acetabular teardrop and the most prominent point of the lesser trochanter were used. A discrepancy of less than 6mm LLD was chosen as acceptable. All peri-operative radiographs were assessed by two independent observers. Results: The mean absolute post-operative difference in leg length from the contralateral leg was +3.58mm. 84% of patients (104/124) had LLD within ±6mm of the contralateral limb. The mean absolute post-operative difference in offset from contralateral leg was +3.88mm (range -15 to +9mm, median 3mm). 90% of patients (112/124) were within ±6mm offset of the contralateral limb. There was no statistical difference noted between observer measurements. Conclusion: The QHT provides a simple, inexpensive yet effective method of maintaining femoral leg length and offset during total hip arthroplasty. Combining this technique with pre-operative templating or other techniques described may enable surgeons to reduce even further the discrepancies between pre-operative state and post-operative outcome.

Keywords: leg length discrepancy, technical tip, total hip arthroplasty, operative technique

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Authors: Sehreen Moorat, Mussarat Lakho

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A method of artificial intelligence using digital mammograms data has been proposed in this paper for detection of breast cancer. Many researchers have developed techniques for the early detection of breast cancer; the early diagnosis helps to save many lives. The detection of breast cancer through mammography is effective method which detects the cancer before it is felt and increases the survival rate. In this paper, we have purposed image processing technique for enhancing the image to detect the graphical table data and markings. Texture features based on Gray-Level Co-Occurrence Matrix and intensity based features are extracted from the selected region. For classification purpose, neural network based supervised classifier system has been used which can discriminate between benign and malignant. Hence, 68 digital mammograms have been used to train the classifier. The obtained result proved that automated detection of breast cancer is beneficial for early diagnosis and increases the survival rates of breast cancer patients. The proposed system will help radiologist in the better interpretation of breast cancer.

Keywords: medical imaging, cancer, processing, neural network

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Authors: Ebenezer Kwesi Armah-Ansah, Kenneth Fosu Oteng, Esther Selasi Avinu, Eugene Budu, Edward Kwabena Ameyaw

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Background: Maternal mortality, particularly in Benin, is a major public health concern in Sub-Saharan Africa. To provide a positive pregnancy experience and reduce maternal morbidities, all pregnant women must get appropriate and timely prenatal support. However, many pregnant women in developing countries, including Benin, begin antenatal care late. There is a paucity of empirical literature on the prevalence and predictors of early antenatal care visits in Benin. As a result, the purpose of this study is to investigate the prevalence and predictors of early antenatal care visits among women of productive age in Benin. Methods: This is a secondary analysis of the 2017/2018 Benin Demographic and Health Survey (BDHS) data. The study involved 6,919 eligible women. Data analysis was conducted using Stata version 14.2 for Mac OS. We adopted a multilevel logistic regression to examine the predictors of early ANC visits in Benin. The results were presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and p-value <0.05 to determine the significant associations. Results: The prevalence of early ANC visits among pregnant women in Benin was 57.03% [95% CI: 55.41-58.64]. In the final multilevel logistic regression, early ANC visit was higher among women aged 30-34 [aOR=1.60, 95% CI=1.17-2.18] compared to those aged 15-19, women with primary education [aOR=1.22, 95% CI=1.06-142] compared to the non-educated women, women who were covered by health insurance [aOR=3.03, 95% CI=1.35-6.76], women without a big problem in getting the money needed for treatment [aOR=1.31, 95% CI=1.16-1.49], distance to the health facility, not a big problem [aOR=1.23, 95% CI=1.08-1.41], and women whose partners had secondary/higher education [aOR=1.35, 95% CI=1.15-1.57] compared with those who were not covered by health insurance, had big problem in getting money needed for treatment, distance to health facility is a big problem and whose partners had no education respectively. However, women who had four or more births [aOR=0.60, 95% CI=0.48-0.74] and those in Atacora Region [aOR=0.50, 95% CI=0.37-0.68] had lower odds of early ANC visit. Conclusion: This study revealed a relatively high prevalence of early ANC visits among women of reproductive age in Benin. Women's age, educational status of women and their partners, parity, health insurance coverage, distance to health facilities, and region were all associated with early ANC visits among women of reproductive in Benin. These factors ought to be taken into account when developing ANC policies and strategies in order to boost early ANC visits among women in Benin. This will significantly reduce maternal and newborn mortality and help achieve the World Health Organization’s recommendation that all pregnant women should initiate early ANC visits within the first three months of pregnancy.

Keywords: antenatal care, Benin, maternal health, pregnancy, DHS, public health

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Authors: Rodrique Watong Tchounkeu

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This paper investigated the implementation and impact of inclusive education practices in early childhood settings (ages 3-6) with the overarching aim of fostering a diverse learning environment. The primary objectives were to assess the then-current state of inclusive practices, identify effective methodologies for accommodating diverse learning needs, and evaluate the outcomes of implementing inclusive education in early childhood settings. To achieve these objectives, a mixed-methods approach was employed, combining qualitative interviews with early childhood educators and parents, along with quantitative surveys distributed to a diverse sample of participants. The qualitative phase involved semi-structured interviews with 30 educators and 50 parents, selected through purposive sampling. The interviews aimed to gather insights into the challenges faced in implementing inclusive education, the strategies employed, and the perceived benefits and drawbacks. The quantitative phase included surveys administered to 300 early childhood educators across various settings, measuring their familiarity with inclusive practices, their perceived efficacy, and their willingness to adapt teaching methods. The results revealed a significant gap between the theoretical understanding and practical implementation of inclusive education in early childhood settings. While educators demonstrated a high level of theoretical knowledge, they faced challenges in effectively translating these concepts into practice. Parental perspectives highlighted the importance of collaboration between educators and parents in supporting inclusive education. The surveys indicated a positive correlation between educators' familiarity with inclusive practices and their willingness to adapt teaching methods, emphasizing the need for targeted professional development. The implications of this study suggested the necessity for comprehensive training programs for early childhood educators focused on the practical implementation of inclusive education strategies. Additionally, fostering stronger partnerships between educators and parents was crucial for creating a supportive learning environment for all children. By addressing these findings, this research contributed to the advancement of inclusive education practices in early childhood settings, ultimately leading to more inclusive and effective learning environments for diverse groups of young learners.

Keywords: inclusive education, early childhood settings, diverse learning, young learners, practical implementation, parental collaboration

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Authors: Kettawa Boonprakarn, Jedsarid Sangkaphan, Bejapornd Deekhuntod, Nuntharat Suriyo

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This study aimed to investigate the existence of field corn networks on the Thailand-Burma border under the patron-client contract farming system. The data of this qualitative study were collected through in-depth interviews with nine key informants. The results of the study revealed that the existence of the field corn networks was associated with the relationship where farmers had to share their crops with protectors in the areas under the influence of the KNU (Karen National Union) and the DKBA (Democratic Karen Buddhist Army) or Burmese soldiers. A Mae Liang, the person who starts a network has a connection with a Thaokae, Luk Rai Hua Chai or the head of a group of farmers, and farmers. They are under the patron-client system with trust and loyalty that enable the head of the group and the farmers in the Burma border side to remain under the same Mae Liang even though the business has been passed down to later generations.

Keywords: existence, field-corn networks, patron-client system, contract farming

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Authors: Asier Romero Andonegi, Irati De Pablo Delgado

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The objective of this study is to explore the different methodological procedures that are used to obtain information on the early linguistic development of children. To this end, two different methodological procedures were carried out on the same sample: on the one hand, the MacArthur-Bates Communicative Development Inventories, in its adaptations in Spanish and Basque; and on the other hand, longitudinal observation through professional software: ELAN and CHAT. The sample consists of 8 Basque children/ages 16 to 30 months with different mother tongue (L1). The results show the usefulness of inventories in obtaining information on the development of early communication and language skills, but also their limitations mostly focused on the interpretive overvaluation of their children’s lexical development.

Keywords: early language development, language evaluation, lexicon, MacArthur-Bates communicative development inventories

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Authors: Abdul Rahim Razalli, Nordin Mamat, Lee Kean Low

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The objective of the study is to examine the acquisition of Bahasa Melayu hand coded and Malaysian Sign Language of hearing impaired children and the factors that influencing the acquisition of Malay language at early intervention. A qualitative research design was chosen to answer two research questions. Two sets of instruments have been used to obtain information of proficiency and factors that influence it. Five children with hearing problems, four teachers and three parents were selected as the respondents through purposive sampling technique. The findings show that pupils with hearing problems who mastered Bahasa Melayu hand coded have better acquisition of Bahasa Melayu as compared to those who acquired Malaysian Sign Language. The study also found that the parents, pupils, teachers and environmental factors have an impact on the acquisition of Bahasa Melayu hand coded. The implications of this study show that early intervention of Bahasa Melayu hand coded and the parents, pupils, teachers and environmental factors do help in the language proficiency of children with hearing problems. A more comprehensive study should be undertaken at a higher level to see the impact on an early intervention program for Malay language acquisition of hearing impaired children.

Keywords: Bahasa Melayu hand coded, Malaysian sign Language, hearing impaired children, early intervention

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Authors: Sanjoy Barua Chowdhury

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The aim of this paper is an attempt to analyze the concept of emptiness from the early Buddhist teachings to subsequent Buddhist developmental schools, namely, Madhyamaka and Yogācāra Schools, along with attempting to examine an insightful bridge between the Buddha’s major teaching on dependent origination and the notion of emptiness. The initial part of this qualitative research focuses on the etymological term of emptiness (śūnyatā) and the Buddha’s teaching of emptiness from the Early Buddhist standpoint. Next, this research will seek to explain the concept of emptiness in the Madhyamaka School and Yogācāra School. This study further demonstrates the eradication of suffering is meant of understanding the concept emptiness from an ultimate standpoint with special concerning to focus the connection to the Buddha’s central teaching Dependent Origination.

Keywords: emptiness, Madhyamaka, dependent origination, early Buddhism, Yogacara

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Authors: Gülay Dalgıç, Gildis Tachir

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Architectural design studios are ambiencein where architecture design is realized as a palpable product in architectural education. In the design studios that the architect candidate will use in the design processthe information, the methods of approaching the design problem, the solution proposals, etc., are set uptogetherwith the studio coordinators. The architectural design process, on the other hand, is complex and uncertain.Candidate architects work in a process that starts with abstre and ill-defined problems. This process starts with the generation of alternative solutions with the help of representation tools, continues with the selection of the appropriate/satisfactory solution from these alternatives, and then ends with the creation of an acceptable design/result product. In the studio ambience, many designs and thought relationships are evaluated, the most important step is the early design phase. In the early design phase, the first steps of converting the information are taken, and converted information is used in the constitution of the first design decisions. This phase, which positively affects the progress of the design process and constitution of the final product, is complex and fuzzy than the other phases of the design process. In this context, the aim of the study is to investigate the effects of face-to-face learning model and e-learning model on the early design phase. In the study, the early design phase was defined by literature research. The data of the defined early design phase criteria were obtained with the feedback graphics created for the architect candidates who performed e-learning in the first year of architectural education and continued their education with the face-to-face learning model. The findings of the data were analyzed with the common graphics program. It is thought that this research will contribute to the establishment of a contemporary architectural design education model by reflecting the evaluation of the data and results on architectural education.

Keywords: education modeling, architecture education, design education, design process

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Authors: Kangkang Tang

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A large amount of blast furnace slag is generated in China. Most ground granulated blast furnace slag (GGBS) however ends up in low-grade applications. Blast furnace slag, ground to an appropriate fineness, can be used as a partial replacement of cementitious material in concrete. The potential for using GGBS in structural concrete, e.g. concrete beams and columns, is investigated at Xi’an Jiaotong-Liverpool University (XJTLU). With 50% of CEM I replaced with GGBS, peak hydration temperatures determined in a suspended concrete slab reduced by 20%. This beneficiary effect has not been further improved with 70% of CEM I replaced with GGBS. Partial replacement of CEM I with GGBS also has a retardation effect on the early-age strength of concrete. More GGBS concrete mixes will be conducted to identify an ‘optimum’ replacement level which will lead to a reduced thermal loading, without significantly compromising the early-age strength of concrete.

Keywords: thermal effect, GGBS, concrete strength and testing, sustainability

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Authors: Dinesh Khanduja, Sahib Sartaj Singh

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In India, among the start ups, many new ventures fail and for the few that survive and grow, there are always numerous problems. In order to make these surviving units productive and cost effective-in today’s competitive environment, the traditional ways of supporting small enterprises and the related programs of governmental assistance need to be significantly transformed. In this context, ‘Business Incubation’ is emerging as one of the most innovative instruments to support small enterprise creation and development all over the world. Incubators, by providing on the-spot diagnosis and treatment of business problems, dramatically lower the early stage failure rate. In Europe, US and countries like China, Singapore, Thailand etc., the exceptionally fast growth of business incubators has baffled even the researchers. In this direction in India, following on the world pattern, several initiatives have been taken over the last decade to encourage the concept of business incubation. Besides profiling the existing ‘Business Incubators’ in India, the paper dwells upon a case study of SMEs in state of Punjab for exploring the relevance of business incubation for enhancing their productive capacity.

Keywords: business incubation, Technology Business Incubator (TBI), Rural Business Hub (RBH), entrepreneurship, Business Development Services (BDS), technology management

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Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

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Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

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Authors: Dario Barsi, Marina Ubaldi, Pietro Zunino, Robert Fink

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A design and optimization procedure is proposed and developed to provide the geometry of a high efficiency compact hydraulic propeller turbine for low head. For the preliminary design of the machine, classic design criteria, based on the use of statistical correlations for the definition of the fundamental geometric parameters and the blade shapes are used. These relationships are based on the fundamental design parameters (i.e., specific speed, flow coefficient, work coefficient) in order to provide a simple yet reliable procedure. Particular attention is paid, since from the initial steps, on the correct conformation of the meridional channel and on the correct arrangement of the blade rows. The preliminary geometry thus obtained is used as a starting point for the hydrodynamic optimization procedure, carried out using a CFD calculation software coupled with a genetic algorithm that generates and updates a large database of turbine geometries. The optimization process is performed using a commercial approach that solves the turbulent Navier Stokes equations (RANS) by exploiting the axial-symmetric geometry of the machine. The geometries generated within the database are therefore calculated in order to determine the corresponding overall performance. In order to speed up the optimization calculation, an artificial neural network (ANN) based on the use of an objective function is employed. The procedure was applied for the specific case of a propeller turbine with an innovative design of a modular type, specific for applications characterized by very low heads. The procedure is tested in order to verify its validity and the ability to automatically obtain the targeted net head and the maximum for the total to total internal efficiency.

Keywords: renewable energy conversion, hydraulic turbines, low head hydraulic energy, optimization design

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Authors: Ragini Verma, J. Ponmozhi

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The oral cavity is home to a wide variety of microorganisms that lead to various diseases and even oral cancer. Despite advancements in the diagnosis and detection at the initial phase, the situation hasn’t improved much. Saliva-on-a-chip is an innovative point-of-care platform for early diagnosis of oral cancer and other oral diseases in live and dead cells using a microfluidic device with a current perspective. Some of the major challenges, like real-time imaging of the oral cancer microbes, high throughput values, obtaining a high spatiotemporal resolution, etc. were faced by the scientific community. Integrated microfluidics and microscopy provide powerful approaches to studying the dynamics of oral pathology, microbe interaction, and the oral microenvironment. Here we have developed a saliva-on-chip (salivary microbes) device to monitor the effect on oral cancer. Adhesion of cancer-causing F. nucleatum; subsp. Nucleatum and Prevotella intermedia in the device was observed. We also observed a significant reduction in the oral cancer growth rate when mortality and morbidity were induced. These results show that this approach has the potential to transform the oral cancer and early diagnosis study.

Keywords: microfluidic device, oral cancer microbes, early diagnosis, saliva-on-chip

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Authors: Evren C. Eroglu, Ridvan Arslan

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Over the course of herbal production, various pretreatments are performed and some of which have serious effect on the bioactive properties. Especially in the production of herbal tea from fresh herbals, it is considered that elapsed time from blending to last product may affect the bioactive properties and antioxidant contents. Herbal infusion is basically prepared by mixing herbs with hot water for 10-20 min. During the brewing of these herbs, it is supposed to be significant decrease in the antioxidant and phenolics content. The first aim of this study was to evaluate the changes of vitamin C (VitC), total phenolic content (TPC) and antioxidant contents (AO) of two brassica varieties (brussel sprouts and white head cabbage) with different holding time after blending. Second aim of this study was to understand the effect of herbal infusion on VitC, TPC and AO contents. In this study, fresh samples were subjected to 0-30 min holding time after blending. Then, samples was immediately taken to -80 °C and freeze drying process was performed. Herbal infusion was performed for 20 minutes. According to results, VitC contents in brussel sprouts was not changed significantly (p=0.12). However, there was a significant decreasing of VitC content in cabbage sample (p=0.034). 20 min of brewing caused a significant decrement in VitC of brussel sprouts by approximately 76% (1071 ppm dw), while decline in cabbage VitC content was 87% (531 ppm dw). AO and TPC values of unprocessed cabbage control sample (13791.87 ppm FeSO4·7H2O eq. dw and 5301.85 ppm gallic acid eq. dw) were higher than brussel sprouts control samples (11571.75 ppm FeSO4·7H2O dw and 5202.76 ppm, respectively). The change in AO and TPC of both brussel sprouts and cabbage samples were not statistically significant at the end of 30 minutes holding time (p=0.24 and p=0.38). After 20 minutes of brewing, AO content in brussel sprouts significantly decreased by 44% (p ˂0.05). Although, the decreasing of AO in white head cabbage was statistically important (p=0.034), decreasing was just 8%. TPC values were found to decrease by 54% in cabbage, while it was 35% in brussel sprouts after herbal infusion. It was observed that 30 min holding time had no statistically important effect on TPC values of both cabbage and brussel sprouts. As a conclusion, herbal infusion has more or less effect on VitC, TPC and AO contents of samples. Therefore, it is important to decrease brewing time. Another result was that there were no significant differences in TPC and AO content of both samples when holding samples 30 min outside after blending. However, this process had significant effect on VitC content of white head cabbage.

Keywords: Antioxidant content, brussel sprouts, herbal infusion, total phenolic content, white head cabbage, vitamin c

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Authors: Tsedeke Lambore Gemecho, Ayele Taye Goshu

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The main objective of this study is to identify the determinants of the number of international migrants in a household and to compare regression models for count response. This study is done by collecting data from total of 2288 household heads of 16 randomly sampled districts in Hadiya and Kembata-Tembaro zones of Southern Ethiopia. The Poisson mixed models, as special cases of the generalized linear mixed model, is explored to determine effects of the predictors: age of household head, farm land size, and household size. Two ethnicities Hadiya and Kembata are included in the final model as dummy variables. Stepwise variable selection has indentified four predictors: age of head, farm land size, family size and dummy variable ethnic2 (0=other, 1=Kembata). These predictors are significant at 5% significance level with count response number of migrant. The Poisson mixed model consisting of the four predictors with random effects districts. Area specific random effects are significant with the variance of about 0.5105 and standard deviation of 0.7145. The results show that the number of migrant increases with heads age, family size, and farm land size. In conclusion, there is a significantly high number of international migration per household in the area. Age of household head, family size, and farm land size are determinants that increase the number of international migrant in households. Community-based intervention is needed so as to monitor and regulate the international migration for the benefits of the society.

Keywords: Poisson regression, GLM, number of migrant, Hadiya and Kembata Tembaro zones

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Zhidong Zhang, Zhi-Chao Zhang, Georgiana Duarte

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This study explored early adolescents’ anxious and depressed syndromes in Northeast China. Specifically, the study examined anxious and depressed behaviors and the relationship to education environments. The purpose is to examine how the elements of educational environments and the early adolescents’ behaviors as independent variables influence and possibly predict the early adolescents’ anxious/depressed problems. Achenbach System of Empirically Based Assessment (ASEBA), was the instrument, used in collection of data. A stratified sampling method was utilized to collect data from 2532 participants in seven schools. The results indicated that several background variables influenced anxious/depressed problem. Specifically, age, grade, sports activities and hobbies had a relationship with the anxious/depressed variable.

Keywords: anxious/depressed problems, CBCL, empirically-based assessment, internalizing problems

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Authors: A. Binnui, O. Kalinowska-Beszczynska, G. Shaw

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It is postulated that innovative deployment of entrepreneurial activities leads to firm's growth. This paper draws upon the key predictions of the core theories on entrepreneurship and innovation to formulate a conceptual framework which can be used to depict the casual chain of events from which entrepreneurs can manage more innovatively and ultimately deliver higher growth which benefits of the regional and national economies. It examines the key firm-based factors extracted from the theories, namely the characteristics of entrepreneurial hi-tech firms, characteristics of innovating firms, and firm growth dynamics that lead to enhanced economic growth. The framework postulates that the key determinants extracted such as entrepreneurial demographics, firm characteristic, skills and competencies, research and development, product/service characteristics, market development, financial of the firm and internationalization might lead to the survival and long term development of high-technology startups.

Keywords: innovative entrepreneurial activities, entrepreneuship, determinants, growth, hi-technology start-upws

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Authors: P. P. Chandrasekera, P. B. Hewavithana, S. Rosairo, M. H. M. N. Herath, D. M. R. D. Mirihella

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Periventricular Leukomalacia (PVL) is a White Matter Injury (WMI) of preterm neonatal brain. Objectives of the study were to assess the neuro-developmental outcome at one year of age and to determine a good protocol of cranial ultrasonography to detect PVL. Two hundred and sixty four preterm neonates were included in the study. Series of cranial ultrasound scans were done by using a dedicated neonatal head probe 4-10 MHz of Logic e portable ultrasound scanner. Clinical history of seizures, abnormal head growth (hydrocephalus or microcephaly) and developmental milestones were assessed and neurological examinations were done until one year of age. Among live neonates, 57% who had cystic PVL (Grades2 and 3) manifested as cerebral palsy. In conclusion cystic PVL has permanent neurological disabilities like cerebral palsy. Good protocol of real time cranial ultrasonography to detect PVL is to perform scans at least once a week until one month and at term (40 weeks of gestation).

Keywords: cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia, preterm neonates

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Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz

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Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.

Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)

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Authors: Mohamed Gomaa Mohamed

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Background and purpose: Ideal posture involves a minimal amount of stress or strain on various body segments which are aligned and worked in harmony to protect the body from injury or progressive deformity. One of most common faulty posture encountered in clinical setting is forward head posture (FHP) that was considered one of the main predictors for neck pain. Furthermore, FHP may predispose to thoracic outlet syndrome, temporomandibular joint dysfunction, shoulder pain and headache. The large financial burden related to neck disorders management raises the need to improve the quality of assessment and rehabilitation of FHP. So, the purpose of the study is to compare between measurements of FHP as indicated with craniovertebral (CVA) and gaze angles assessed from dominant and non-dominant sides in football players who extensively use their dominant side and non-athletic subjects. Participants: Twenty-four subjects were divided into 12 football players and 12 non-athletic subjects. Methods: CVA and gaze angles were assessed through photogrammetric method. Photos were taken from dominant and non-dominant sides of the subjects while assuming standing position. Paired t-test was used to assess angles differences between dominant and non-dominant sides of the subjects. Since there were no statistical differences between CVA and gaze angles measured from dominant and non-dominant sides in each group, we pooled data together to become 24 measurements for each group (12 from dominant and 12 from non-dominant). Independent t-test was used to assess angles differences between football players and non-athletic subjects. Results: No significant differences were found between CVA and gaze angles measured from dominant and non-dominant sides of both groups (P>0.05). Also, there were no significant differences between CVA and gaze angles measured from football players and non-athletic subjects (P>0.05). Conclusion: FHP can be assessed from dominant or non-dominant sides interchangeably either in football players or non-athletic subjects. Furthermore, playing football has no impact on measurements of FHP when compared to non-athletic subjects.

Keywords: dominant side, forward head posture, football players, non-dominant side

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Authors: Ho Sy Nam, Tang Ha Nam Anh

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Background: Rotator cuff tears are a common problem in the aging population. The prevalence of massive rotator cuff tears varies in some studies from 10% to 40%. Of irreparable rotator cuff tears (IRCTs), which are mostly associated with massive tear size, 79% are estimated to have recurrent tears after surgical repair. Recent studies have shown that superior capsule reconstruction (SCR) in massive rotator cuff tears can be an efficient technique with optimistic clinical scores and preservation of stable glenohumeral stability. Superior capsule reconstruction techniques most commonly use either fascia lata autograft or dermal allograft, both of which have their own benefits and drawbacks (such as the potential for donor site issues, allergic reactions, and high cost). We propose a simple technique for superior capsule reconstruction that involves using the long head of the biceps tendon as a local autograft; therefore, the comorbidities related to graft harvesting are eliminated. The long head of the biceps tendon proximal portion is relocated to the footprint and secured as the SCR, serving to both stabilize the glenohumeral joint and maintain vascular supply to aid healing. Objective: The purpose of this study is to assess the clinical outcomes of patients with large to massive RCTs treated by SCR using LHBT. Materials and methods: A study was performed of consecutive patients with large to massive RCTs who were treated by SCR using LHBT between January 2022 and December 2022. We use one double-loaded suture anchor to secure the long head of the biceps to the middle of the footprint. Two more anchors are used to repair the rotator cuff using a single-row technique, which is placed anteriorly and posteriorly on the lateral side of the previously transposed LHBT. Results: The 3 men and 5 women had an average age of 61.25 years (range 48 to 76 years) at the time of surgery. The average follow-up was 8.2 months (6 to 10 months) after surgery. The average preoperative ASES was 45.8, and the average postoperative ASES was 85.83. The average postoperative UCLA score was 29.12. VAS score was improved from 5.9 to 1.12. The mean preoperative ROM of forward flexion and external rotation of the shoulder was 720 ± 160 and 280 ± 80, respectively. The mean postoperative ROM of forward flexion and external rotation were 1310 ± 220 and 630 ± 60, respectively. There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Conclusion: SCR using LHBT is considered a treatment option for patients with large or massive RC tears. It can restore superior glenohumeral stability and function of the shoulder joint and can be an effective procedure for selected patients, helping to avoid progression to cuff tear arthropathy.

Keywords: superior capsule reconstruction, large or massive rotator cuff tears, the long head of the biceps, stabilize the glenohumeral joint

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Authors: V. Saccà, A. Sarica, F. Novellino, S. Barone, T. Tallarico, E. Filippelli, A. Granata, P. Valentino, A. Quattrone

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The work aim was to evaluate how well Random Forest (RF) and Support Vector Machine (SVM) algorithms could support the early diagnosis of Multiple Sclerosis (MS) from resting-state functional connectivity data. In particular, we wanted to explore the ability in distinguishing between controls and patients of mean signals extracted from ICA components corresponding to 15 well-known networks. Eighteen patients with early-MS (mean-age 37.42±8.11, 9 females) were recruited according to McDonald and Polman, and matched for demographic variables with 19 healthy controls (mean-age 37.55±14.76, 10 females). MRI was acquired by a 3T scanner with 8-channel head coil: (a)whole-brain T1-weighted; (b)conventional T2-weighted; (c)resting-state functional MRI (rsFMRI), 200 volumes. Estimated total lesion load (ml) and number of lesions were calculated using LST-toolbox from the corrected T1 and FLAIR. All rsFMRIs were pre-processed using tools from the FMRIB's Software Library as follows: (1) discarding of the first 5 volumes to remove T1 equilibrium effects, (2) skull-stripping of images, (3) motion and slice-time correction, (4) denoising with high-pass temporal filter (128s), (5) spatial smoothing with a Gaussian kernel of FWHM 8mm. No statistical significant differences (t-test, p < 0.05) were found between the two groups in the mean Euclidian distance and the mean Euler angle. WM and CSF signal together with 6 motion parameters were regressed out from the time series. We applied an independent component analysis (ICA) with the GIFT-toolbox using the Infomax approach with number of components=21. Fifteen mean components were visually identified by two experts. The resulting z-score maps were thresholded and binarized to extract the mean signal of the 15 networks for each subject. Statistical and machine learning analysis were then conducted on this dataset composed of 37 rows (subjects) and 15 features (mean signal in the network) with R language. The dataset was randomly splitted into training (75%) and test sets and two different classifiers were trained: RF and RBF-SVM. We used the intrinsic feature selection of RF, based on the Gini index, and recursive feature elimination (rfe) for the SVM, to obtain a rank of the most predictive variables. Thus, we built two new classifiers only on the most important features and we evaluated the accuracies (with and without feature selection) on test-set. The classifiers, trained on all the features, showed very poor accuracies on training (RF:58.62%, SVM:65.52%) and test sets (RF:62.5%, SVM:50%). Interestingly, when feature selection by RF and rfe-SVM were performed, the most important variable was the sensori-motor network I in both cases. Indeed, with only this network, RF and SVM classifiers reached an accuracy of 87.5% on test-set. More interestingly, the only misclassified patient resulted to have the lowest value of lesion volume. We showed that, with two different classification algorithms and feature selection approaches, the best discriminant network between controls and early MS, was the sensori-motor I. Similar importance values were obtained for the sensori-motor II, cerebellum and working memory networks. These findings, in according to the early manifestation of motor/sensorial deficits in MS, could represent an encouraging step toward the translation to the clinical diagnosis and prognosis.

Keywords: feature selection, machine learning, multiple sclerosis, random forest, support vector machine

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