Search results for: clinical performance assessment

Authors: Onabajo Paul

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The testing and assessment of physical fitness of school-aged adolescents in Nigeria has been going on for several decades. Originally, these tests strictly focused on identifying health and physical fitness status and comparing the results of adolescents with others. There is a considerable interest in health and performance fitness of adolescents in which results attained are compared with criteria representing positive health rather than simply on score comparisons with others. Despite the fact that physical education program is being studied in secondary schools and physical activities are encouraged, it is observed that regular assessment of students’ fitness level and health status seems to be scarce or not being done in these schools. The purpose of the study was to assess the heath and performance fitness of adolescents in middle-income schools in Lagos State. A total number of 150 students were selected using the simple random sampling technique. Participants were measured on hand grip strength, sit-up, pacer 20 meter shuttle run, standing long jump, weight and height. The data collected were analyzed with descriptive statistics of means, standard deviations, and range and compared with fitness norms. It was concluded that majority 111(74.0%) of the adolescents achieved the healthy fitness zone, 33(22.0%) were very lean, and 6(4.0%) needed improvement according to the normative standard of Body Mass Index test. For muscular strength, majority 78(52.0%) were weak, 66(44.0%) were normal, and 6(4.0%) were strong according to the normative standard of hand-grip strength test. For aerobic capacity fitness, majority 93(62.0%) needed improvement and were at health risk, 36(24.0%) achieved healthy fitness zone, and 21(14.0%) needed improvement according to the normative standard of PACER test. Majority 48(32.0%) of the participants had good hip flexibility, 38(25.3%) had fair status, 27(18.0%) needed improvement, 24(16.0%) had very good hip flexibility status, and 13(8.7%) of the participants had excellent status. Majority 61(40.7%) had average muscular endurance status, 30(20.0%) had poor status, 29(18.3%) had good status, 28(18.7%) had fair muscular endurance status, and 2(1.3%) of the participants had excellent status according to the normative standard of sit-up test. Majority 52(34.7%) had low jump ability fitness, 47(31.3%) had marginal fitness, 31(20.7%) had good fitness, and 20(13.3%) had high performance fitness according to the normative standard of standing long jump test. Based on the findings, it was concluded that majority of the adolescents had better Body Mass Index status, and performed well in both hip flexibility and muscular endurance tests. Whereas majority of the adolescents performed poorly in aerobic capacity test, muscular strength and jump ability test. It was recommended that to enhance wellness, adolescents should be involved in physical activities and recreation lasting 30 minutes three times a week. Schools should engage in fitness program for students on regular basis at both senior and junior classes so as to develop good cardio-respiratory, muscular fitness and improve overall health of the students.

Keywords: adolescents, health-related fitness, performance-related fitness, physical fitness

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Authors: Dragos Dragomir-Stanciu, Leon Marsh

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Background As a response to the gaps identified in recent research in the provision of residential care to address co-occurring health needs, including mental health problems and complexities Gamble Aware has facilitated the possibility to provide a new service which would extend the NGTS provision of residential rehabilitation for gambling disorder with complex and co-morbid presentation. Gordon Moody, together with Adferiad have been successful in securing the tender for this service and this presentation aims to introduce FOLD, the resulting model of treatment developed for the delivery of the service. Setting As a partnership, we have come together to coproduce a model which allows us to share our clinical and industry knowledge and build on our reputations as trusted treatment providers. The presentation will outline our expertise share in development of a unified approach to recovery-oriented models of care, clinical governance, risk assessment and management and aftercare and continuous recovery. We will also introduce our innovative specialist referral portal which will offer referring partners the ability to include the service user in planning their own recovery journey. Outcomes Our collaboration has resulted in the development of the FOLD model which includes three agile and flexible treatment packages aimed at offering the most enhanced and comprehensive treatment in UK, to date, for those most affected by gambling harm. The paper will offer insight into each treatment package and all recovery model stages involved, as well as into the partnership work with NGST providers, local mental health and social care providers and lived experience organisation that will enable us to offer support to more 100 people a year who would otherwise get “lost in the system”. Conclusion FOLD offers a great opportunity to develop, implement and evaluate a new, much needed, whole-person and whole-system approach to counter gambling related harms.

Keywords: gambling treatment, partnership working, integrated care pathways, NGTS, complex needs

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Authors: Adam Abdullahi Mohammed

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Performance appraisal is an assessment made to ensure the level of a worker’s productivity in a given period of time. The appraisal system is divided into two categories that are traditional methods and modern methods, with emphasis based on the evaluation of work results. In the traditional approach of staff appraisal, which puts more emphasis on individual traits, supervisors are required to measure employees through interactions based on what they achieved with reference to job descriptions, as well as rating them based on questionnaires without staff interaction. These methods are not effective because staff may give biased information. The study will attempt to assess the effect of performance appraisal on employee productivity at Yobe State University, Damaturu. It is aimed at assessing the process, methods, and objectives of performance appraisal and its feedback to know how they affect the success of the appraisal, its results, and employee productivity. In this study, a quantitative research method is adopted in collecting and analyzing data, and a questionnaire will be used as data collecting instrument. As it is a case study, the target population is the staff of the department of Islamic Studies. The research will employ a census sampling technique where all the subjects in the target populations are given a chance to participate in the study. This sampling method was considered because the entire target population is considered researchable. The expected findings are that staff performance appraisal in the department of Islamic Studies has effects on employee productivity; this is to say if it is given due consideration and the needful being done will improve employee productivity.

Keywords: performance appraisal, employee productivity, Yobe state University, appraisal feedback

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Authors: Giulia Colonna, Jocelyn Hoye, Bart de Laat, Gelsina Stanley, Jose Key, Alaaddin Ibrahimy, Sule Tinaz, Evan D. Morris

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Parkinson’s disease (PD) is the second most common neurodegenerative disease and affects approximately 1% of the world’s population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and non-motor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap heart rate monitor (Polar Electro Oy, Kempele). The device sometimes proved uncomfortable. Looking forward to larger clinical trials, it would be convenient to employ a more comfortable and user friendly device. The Fitbit Charge 4 (Fitbit Inc) is a potentially comfortable, user-friendly solution since it is a wrist-worn heart rate monitor. Polar H10 has been used in large trials, and for our purposes, we treated it as the gold standard for the beat-to-beat period (R-R interval) assessment. In previous literature, it has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy subjects. It has yet to be determined if the Fitbit is as accurate as the Polar H10 in subjects with PD or in clinical populations, generally. Goal: To compare the Fitbit Charge 4 to the Polar H10 for monitoring HR in PD subjects engaging in an intensive exercise program. Methods: A total of 596 exercise sessions from 11 subjects (6 males) were collected simultaneously by both devices. Subjects with early-stage PD (Hoehn & Yahr <=2) were enrolled in a 6 months exercise training program designed for PD patients. Subjects participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intensive exercise, and cool-down periods. We calculated the bias in the HR via Fitbit under rest (5min) and intensive exercise (20min) by comparing the mean HR during each of the periods to the respective means measured by the Polar (HRFitbit – HRPolar). We also measured the sensitivity and specificity of Fitbit for detecting HRs that exceed the threshold for intensive exercise, defined as 70% of an individual’s theoretical maximum HR. Different types of correlation between the two devices were investigated. Results: The mean bias was 1.68 bpm at rest and 6.29 bpm during high intensity exercise, with an overestimation by Fitbit in both conditions. The mean bias of Fitbit across both rest and intensive exercise periods was 3.98 bpm. The sensitivity of the device in identifying high intensity exercise sessions was 97.14 %. The correlation between the two devices was non-linear, suggesting a saturation tendency of Fitbit to saturate at high values of HR. Conclusion: The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of PD subjects. The device should be considered a reasonable replacement for the more cumbersome chest strap technology in future similar studies of clinical populations.

Keywords: fitbit, heart rate measurements, parkinson’s disease, wrist-wearable devices

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Authors: Xiaoyuan Chen

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Background: This study aimed to characterize the epidemiological and clinical features of five rare subtypes of hepatocellular carcinoma (HCC) and to create a competing risk nomogram for predicting cancer-specific survival. Methods: This study used the Surveillance, Epidemiology, and End Results database to analyze the clinicopathological data of 50,218 patients with classic HCC and five rare subtypes (ICD-O-3 Histology Code=8170/3-8175/3) between 2004 and 2018. The annual percent change (APC) was calculated using Joinpoint regression, and a nomogram was developed based on multivariable competing risk survival analyses. The prognostic performance of the nomogram was evaluated using the Akaike information criterion, Bayesian information criterion, C-index, calibration curve, and area under the receiver operating characteristic curve. Decision curve analysis was used to assess the clinical value of the models. Results: The incidence of scirrhous carcinoma showed a decreasing trend (APC=-6.8%, P=0.025), while the morbidity of other rare subtypes remained stable from 2004 to 2018. The incidence-based mortality plateau in all subtypes during the period. Clear cell carcinoma was the most common subtype (n=551, 1.1%), followed by fibrolamellar (n=241, 0.5%), scirrhous (n=82, 0.2%), spindle cell (n=61, 0.1%), and pleomorphic (n=17, ~0%) carcinomas. Patients with fibrolamellar carcinoma were younger and more likely to have non-cirrhotic liver and better prognoses. Scirrhous carcinoma shared almost the same macro clinical characteristics and outcomes as classic HCC. Clear cell carcinoma tended to occur in the Asia-Pacific elderly male population, and more than half of them were large HCC (Size>5cm). Sarcomatoid (including spindle cell and pleomorphic) carcinoma was associated with larger tumor size, poorer differentiation, and more dismal prognoses. The pathological subtype, T stage, M stage, surgery, alpha-fetoprotein, and cancer history were identified as independent predictors in patients with rare subtypes. The nomogram showed good calibration, discrimination, and net benefits in clinical practice. Conclusion: The rare subtypes of HCC had distinct clinicopathological features and biological behaviors compared with classic HCC. Our findings could provide a valuable reference for clinicians. The constructed nomogram could accurately predict prognoses, which is beneficial for individualized management.

Keywords: hepatocellular carcinoma, pathological subtype, fibrolamellar carcinoma, scirrhous carcinoma, clear cell carcinoma, spindle cell carcinoma, pleomorphic carcinoma

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Authors: Nisa Mohan

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Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.

Keywords: adverse drug events, clinical coders, decision making, hospital admissions

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Authors: Margit Kastner

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To overcome the negative consequences associated with large class sizes and to support students in developing the necessary competences (e.g., critical thinking, problem-solving, or team-work skills) a marketing course has been redesigned by implementing project-based learning with peer assessment (PBL&PA). This means that students can voluntarily take advantage of this supplementary offer and explore -in addition to attending the lecture where clicker questions are asked- a real-world problem, find a solution, and assess the results of peers while working in small collaborative groups. In order to handle this with little further effort, the process is technically supported by the university’s e-learning system in such a way that students upload their solution in form of an assignment which is then automatically distributed to peer groups who have to assess the work of three other groups. Finally, students’ work is graded automatically considering both, students’ contribution to the project and the conformity of the peer assessment. The purpose of this study is to evaluate students’ perception of PBL&PA using an online-questionnaire to collect the data. More specifically, it aims to discover students’ motivations for (not) working on a project and the benefits and problems students encounter. In addition to the survey, students’ performance was analyzed by comparing the final grades of those who participated in PBL&PA with those who did not participate. Among the 260 students who filled out the questionnaire, 47% participated in PBL&PA. Besides extrinsic motivations (bonus credits), students’ participation was often motivated by learning and social benefits. Reasons for not working on a project were connected to students’ organization and management of their studies (e.g., time constraints, no/wrong information) and teamwork concerns (e.g., missing engagement of peers, prior negative experiences). In addition, high workload and insufficient extrinsic motivation (bonus credits) were mentioned. With regards to benefits and problems students encountered during the project, students provided more positive than negative comments. Positive aspects most often stated were learning and social benefits while negative ones were mainly attached to the technical implementation. Interestingly, bonus credits were hardly named as a positive aspect meaning that intrinsic motivations have become more important when working on the project. Team aspects generated mixed feelings. In addition, students who voluntarily participated in PBL&PA were, in general, more active and utilized further course offers such as clicker questions. Examining students’ performance at the final exam revealed that students without participating in any of the offered active learning tasks performed poorest in the exam while students who used all activities were best. In conclusion, the goals of the implementation were met in terms of students’ perceived benefits and the positive impact on students’ exam performance. Since the comparison of the automatic grading with faculty grading showed valid results, it is possible to rely only on automatic grading in the future. That way, the additional workload for faculty will be within limits. Thus, the implementation of project-based learning with peer assessment can be recommended for large classes.

Keywords: automated grading, large classes, peer assessment, project-based learning

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Authors: Rims Janeliukstis, Deniss Mironovs, Andrejs Kovalovs

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Operational Modal Analysis (OMA) is widely applied as a method for Structural Health Monitoring for structural damage identification and assessment by tracking the changes of the identified modal parameters over time. Unfortunately, modal parameters also depend on such external factors as temperature and loads. Any structural condition assessment using modal parameters should be done taking into consideration those external factors, otherwise there is a high chance of false positives. A method of structural reliability assessment based on anomaly detection technique called Machalanobis Squared Distance (MSD) is proposed. It requires a set of reference conditions to learn healthy state of a structure, which all future parameters are compared to. In this study, structural modal parameters (natural frequency and mode shape), as well as ambient temperature and loads acting on the structure are used as features. Numerical tests were performed on a finite element model of a carbon fibre reinforced polymer composite beam with delamination damage at various locations and of various severities. The advantages of the demonstrated approach include relatively few computational steps, ability to distinguish between healthy and damaged conditions and discriminate between different damage severities. It is anticipated to be promising in reliability assessment of massively produced structural parts.

Keywords: operational modal analysis, reliability assessment, anomaly detection, damage, mahalanobis squared distance

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Authors: Kyu Rae Lee

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The aim of the study is to investigate the clinical efficacy of combination therapeutic modalities using liraglutide (1.2mg/d) add on low-dose phentermine (7.5 mg/d)/topiramate (50mg/d) medication on the obese patient in the bariatric clinic. We assessed the retrospective cohort clinical analyses to the clinical efficacy of medication and combination in the patients who visited the bariatric clinic. We measured all participants’ body fat (bioelectric impedance analysis), weight, height, and the cross-sectional areas of adipose tissues (umbilicus level) after keep fasting for 8 hours at 0, 4, 12 weeks. The design of the study was opened, paired t-test and Wilcoxon test were performed using SPSS for windows (ver.18, IL, USA) for comparison of weight, body fat, and adipose tissues. The participants were one hundred twenty-eight subjects aged 44.67 (1.18) years, 28.95 (0.39) kg/m², and female (82.7%). Their body fat was 40.57 (2.23%), and waist to hip ratio was 0.96 (0.01). The mean cross-sectional area of visceral adipose tissue was 142.59 (7.06) mm², and that of subcutaneous adipose was 274.37 (9.18) mm². 73 of them (57.5%) took medication only, 54 of them took medication with liraglutide for 12 weeks. The subjects in the medication group lost 5.4165 kg, 6.8069%, and those of the combination group did 6.2481 kg, 3.564%. The mean cross-sectional areas of visceral, subcutaneous adipose tissue in the medication group significantly decreased (p=.043), even more in the combination group. (p=.028). Further controlled clinical trials should be considered in the future. We conclude that the low dose of phentermine/topiramate with liraglutide therapeutic modalities would be more effective than phentermine/topiramate medication only in obesity treatment for 12 weeks.

Keywords: low dose phentermine, topiramate, liraglutide, obesity, efficacy

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Authors: Amal Hentati, Mbarka Selmi, Tarek Kormi, Julien Baroth, Barthelemy Harthong

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The impact of uncertainties on the performance assessment of shallow foundations is often significant. The need of the geotechnical engineers to a more objective and rigorous description of soil variations permitting to quantify these uncertainties and to incorporate them into calculation methods led to the development of reliability approaches. In this context, a mechanical-reliability coupling was developed in this paper, using a program coded in Matlab and the finite element software Abaqus, for the bearing capacity assessment of shallow foundations. The reliability analysis, based on the finite element method, assumed both soil cohesion and friction angle as uncertain parameters characterized by normal or lognormal probability distributions. The inherent spatial variability of both soil properties was, then, taken into account using 1D stationary random fields. The application of the proposed methodology to a shallow foundation subjected to a centered vertical loading permitted to highlight the proposed process interest. Findings proved the insufficiency of the conventional approach to predict the foundation failure and a high sensitivity of the ultimate loads to the soil properties uncertainties, mainly those related to the friction angle, was noted. Moreover, an asymmetry of both displacement and velocity fields was obtained.

Keywords: mechanical-reliability coupling, finite element method, shallow foundation, random fields, spatial variability

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Authors: Kuei-Yu Chien, Hsiu-Yu Chiu, Chia-Nan Chen, Shu-Chen Chen

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Background: Frailty is associated with decreased physical performances that affect mobility of the elderly. Time up and go test (TUG) was the common method to evaluate mobility in the community. The purpose of this study was to compare the parameters in different stages of Time up and go test (TUG) and physical performance between pre-frail elderly (PFE) and non-frail elderly (NFE). We also investigated the relationship between TUG parameters and physical performance. Methods: Ninety-two community-dwelling older adults were as participants in this study. Based on Canadian Study of Health and Aging Clinical Frailty Scale, 22 older adults were classified as PFE (71.77 ± 6.05 yrs.) and 70 were classified as NFE (71.2 ± 5.02 yrs.). We performed body composition and physical performance, including balance, muscular strength/endurance, mobility, cardiorespiratory endurance, and flexibility. Results: Pre-frail elderly took significantly longer time than NFE in TUG test (p=.004). Pre-frail elderly had lower turning average angular velocity (p = .017), turning peak angular velocity (p = .041) and turning-stand to sit peak angular velocity (p = .037) than NFE. The turning related parameters related to open-eye stand on right foot, 30-second chair stand test, back scratch, and 2-min step tests. Conclusions: Turning average angular velocity, turning peak angular velocity and turning-stand to sit peak angular velocity mainly affected the TUG performance. We suggested that static/dynamic balance, agility, flexibility, and muscle strengthening of lower limbs exercise were important to PFE.

Keywords: mobility, aglity, active ageing, functional fitness

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Authors: N. N. Pilau, M. S. Abubakar, A. Danmaigoro, P. C. Mshelia, Y. Sani

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A severely debilitated 4months old Caucasian male dog presented dehydration, emaciation, vomiting, icteric ocular and oral mucous membranes, generalized lymphadenopathy, hematuria, anorexia and prolonged recumbency. Clinical workup was done in established protocols for diagnosis based on history, clinical signs and selected laboratory tests. Treatment course were administered over 48hours during which the patient died of overwhelming hepatopathy, nephropathy and pneumonia. Postmortem findings supported by ante mortem laboratory test results tentatively diagnosed leptospirosis, a disease endemic and presenting potentially fatal epidemics and zoonoses in some countries amongst the developing regions of the world. This disease is reviewed and a call for attention on the public health significance of the disease is hereby presented through this case report.

Keywords: canine, endemic, leptospirosis, prevalence

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Authors: Nalini Kaul, Barrie Drewitt, Elsie Kohoot

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Hyperpigmentation is the third most common pigmentary disorder where dermatologic treatment is sought. It affects all ages resulting in skin darkening because of melanin accumulation. An uneven skin tone because of either exposure to the sun (solar lentigos/age spots/sun spots or skin disruption following acne, or rashes (post-inflammatory hyperpigmentation -PIH) or hormonal changes (melasma) can lead to significant psychosocial impairment. Dyschromia is a result of various alterations in biochemical processes regulating melanogenesis. Treatments include the daily use of sunscreen with lightening, brightening, and exfoliating products. Depigmentation is achieved by various depigmenting agents: common examples are hydroquinone, arbutin, azelaic acid, aloesin, mulberry, licorice extracts, kojic acid, niacinamide, ellagic acid, arbutin, green tea, turmeric, soy, ascorbic acid, and tranexamic acid. These agents affect pigmentation by interfering with mechanisms before, during, and after melanin synthesis. While immediate correction is much sought after, patience and diligence are key. Our objective was to assess the effects of a facial product with pigmentation treatment and UV protection in 35 healthy F (35-65y), meeting the study criteria. Subjects with mild to moderate hyperpigmentation and fine lines with no use of skin-lightening products in the last six months or any dermatological procedures in the last twelve months before the study started were included. Efficacy parameters included expert clinical grading for hyperpigmentation, radiance, skin tone & smoothness, fine lines, and wrinkles bioinstrumentation (Corneometer®, Colorimeter®), digital photography and imaging (Visia-CR®), and self-assessment questionnaires. Safety included grading for erythema, edema, dryness & peeling and self-assessments for itching, stinging, tingling, and burning. Our results showed statistically significant improvement in clinical grading scores, bioinstrumentation, and digital photos for hyperpigmentation-brown spots, fine lines/wrinkles, skin tone, radiance, pores, skin smoothness, and overall appearance compared to baseline. The product was also well-tolerated and liked by subjects. Conclusion: Facial hyperpigmentation is of great concern, and treatment strategies are increasingly sought. Clinical trials with both subjective and objective assessments, imaging analyses, and self-perception are essential to distinguish evidence-based products. The multifunctional cosmetic product tested in this clinical study showed efficacy, tolerability, and subject satisfaction in reducing hyperpigmentation and global photoaging.

Keywords: hyperpigmentation; photoaging, clinical testing, expert visual evaluations, bio-instruments

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Authors: Isabel Cristina Ortiz Trujillo, Lina Maria Martinez Sanchez, Felipe Hernández Restrepo, Daniel Gallego Gonzalez, Natalia Vargas Grisales, Camilo Andrés Agudelo Vélez

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Chorioamnionitis, is a pregnancy infection, causes different fetal and maternal symptoms. Streptococcus agalactiae present in the normal vaginal microflora of some women, favouring its abnormal multiplication during pregnancy, causing perinatal morbidity and mortality. Objective. Describe the clinical and epidemiological profile of the patients with diagnosis of clinical chorioanmionitis. Methodology. Descriptive, cross-sectional study. The population was patients with diagnosis of clinical chorioanmionitis. The information was taken from the medical records. The research was approved by the Ethics Committee. We used the program SPSS ® version 17.0 (SPSS Inc; Chicago, Illinois, USA) for the information analysis, descriptive statistics were used. Results. 78 patients in total with clinical chorioamnionitis, with a mean age of 26.3 ±5, 8 years old, the 69.2% primigravid women. 2.6% of women had positive culture for Streptococcus agalactiae in urine sample during current pregnancy and 30.7% had received some kind of antibiotics during current pregnancy. The 57.7% had 37 to 40 weeks of gestation in the current pregnancy it was calculated more frequently by ultrasound (66.7% in first quarter, 11.5% in the second and 1.9% in the third). In a 60.3% way of termination of pregnancy was vaginal and a 35.9 percent were caesarean section. Among the women in the study, a 30.8% had premature rupture of membranes. Conclusion. The chorioamnionitis continues to be an important cause of antibiotic use during pregnancy or labour and the decision to do a caesarean, with highest percentage in pregnancies-preterm and preterm premature rupture of membranes.

Keywords: chorioamnionitis, Streptococcus agalactiae, pregnancy complications, infectious

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Authors: Khalid Kaddoura, Tarek Zayed

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Sewer networks are constructed to protect the communities and the environment from any contact with the sewer mediums. Pipelines, being laterals or sewer mains, and manholes form the huge underground infrastructure in every urban city. Due to the sewer networks importance, the infrastructure asset management field has extensive advancement in condition assessment and rehabilitation decision models. However, most of the focus was devoted to pipelines giving little attention toward manholes condition assessment. In fact, recent studies started to emerge in this area to preserve manholes from any malfunction. Therefore, the main objective of this study is to propose a condition assessment model for sewer manholes. The model divides the manhole into several components and determines the relative importance weight of each component using the Analytic Network Process (ANP) decision-making method. Later, the condition of the manhole is computed by aggregating the condition of each component with its corresponding weight. Accordingly, the proposed assessment model will enable decision-makers to have a final index suggesting the overall condition of the manhole and a backward analysis to check the condition of each component. Consequently, better decisions are made pertinent to maintenance, rehabilitation, and replacement actions.

Keywords: Analytic Network Process (ANP), condition assessment, decision-making, manholes

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Authors: Fatemeh Keshavarz

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Background: Rheumatoid arthritis (RA) is one of the most common autoimmune diseases, often leading to joint damage and physical disability. This study aimed to investigate the relationship of serum levels of interleukin 17 and anti-CCP factor with disease severity in RA patients. Materials and Methods: Fifty-four patients with RA confirmed by clinical and laboratory criteria were recruited. A 5 ml venous blood sample was taken from every patient, its serum was separated. Based on clinical data and severity of symptoms, patients were classified into three groups of those with mild, moderate, and severe symptoms. Serum levels of IL-17 and anti-CCP in all samples were measured using ELISA. Results: Analysis of IL-17 serum levels in different groups showed that its amount was higher in the group with mild clinical symptoms than in other groups. Comparison of IL-17 serum levels between mild and moderate disease severity groups showed a statistically significant relationship. There was also a positive linear relationship between anti-CCP and serum IL-17 levels in different groups of the disease, and serum IL-17 levels were inversely related to the duration of exposure to the disease. Conclusion: Higher IL-17 serum levels in patients with mild symptom severity confirm that this highly specific marker is involved in the pathogenesis of RA and may be effective in initiating patients’ clinical symptoms.

Keywords: IL-17, anti-CCP, rheumatoid arthritis, autoimmune

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Authors: Hyeon-Kyo Lim, Sang-Hun Byun

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Risk assessment is carried out in most industrial plants for accident prevention, but there exists insufficient data for statistical decision making. It is commonly said that risk can be expressed as a product of consequence and likelihood of a corresponding hazard factor. Eventually, therefore, risk assessment involves human decision making which cannot be objective per se. This study was carried out to comprehend perceptive characteristics of human beings in industrial plants. Subjects were shown a set of illustrations describing scenes of industrial plants, and were asked to assess the risk of each scene with not only linguistic variables but also numeric scores in the aspect of consequence and likelihood. After that, their responses were formulated as fuzzy membership functions, and compared with those of university students who had no experience of industrial works. The results showed that risk level of industrial workers were lower than those of any other groups, which implied that the workers might generally have a tendency to neglect more hazard factors in their work fields.

Keywords: fuzzy, hazard, linguistic variable, risk assessment

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Authors: Martina Holenko Dlab, Natasa Hoic-Bozic

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This paper presents an original approach to student and group activity level assessment that relies on certainty factors theory. Activity level is used to represent quantity and continuity of student’s contributions in individual and collaborative e‑learning activities (e‑tivities) and is calculated to assist teachers in assessing quantitative aspects of student's achievements. Calculated activity levels are also used to raise awareness and provide recommendations during the learning process. The proposed approach was implemented within the educational recommender system ELARS and validated using data obtained from e‑tivity realized during a blended learning course. The results showed that the proposed approach can be used to estimate activity level in the context of e-tivities realized using Web 2.0 tools as well as to facilitate the assessment of quantitative aspect of students’ participation in e‑tivities.

Keywords: assessment, ELARS, e-learning, recommender systems, student model

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Authors: Per Blomqvist

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This study is part of a larger research project on creativity and writing cultures in upper secondary schools in Sweden, with the purpose of exploring how formative assessment practices can be developed to better support students' writing of subject-specific texts. The purpose of the study is to shed light on how writing has changed over time in the subjects of Social Studies and Swedish, especially regarding changes in the formative assessment practice in relation to students opportunities to take part in creative writing processes that can develop their subject specific-writing. Theoretically, the study is based on concepts and models concerning creativity, writing instructions and formative assessment, especially regarding scaffolding in relation to the development of students' subject-specific writing. The empirical data consists of video recordings of teacher groups' conversations from five upper secondary schools in Sweden, compromising a total of twenty teachers. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how writing assessment has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers in each group. The result highlights two different assessment practices that are described as giving students different opportunities to take part in creative writing processes to develop their writing of subject-specific texts. One of the assessment practices is characterized by teachers focusing on explaining to the students what the grading criteria mean and showing sample texts that correspond to a certain grade. The teachers describe that this assessment practice has led to a formalized, instrumental and product-oriented writing culture that has negative consequences for the student's development of their subject-specific writing, which often lacks independent reasoning, own conclusions and understanding of concepts. The other assessment practice is characterized by students examining text qualities and discussing a variety of sample texts to understand what different texts require. These teachers describe the assessment practice as an exploratory work that leads to more creative writing processes where the students gradually deepen their understanding of subject-specific texts and develop their writing.

Keywords: teaching for creativity, writing processes, formative assessment, subject-specific writing

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Authors: Hamna Hamid, Kashmala Zaman

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The aim of this study was to evaluate the relationship between self-efficacy, resilience, and social support among clinical psychologists, counselors, and teachers of special schools. The study also assesses the gender differences in self-efficacy, resilience, social support, and vicarious trauma and also vicarious trauma differences among three professions, i.e., clinical psychologists, counselors, and teachers of special schools. A sample of 150 women and 97 men were handed out a set questionnaire to complete: a General Self-Efficacy Scale, Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, and Vicarious Trauma Scale. Results showed that there is a significant negative correlation between self-efficacy, resilience, and vicarious trauma. Women experience higher levels of vicarious trauma as compared to men. At the same time, clinical psychologists and counselors experience higher levels of vicarious trauma as compared to teachers of special schools. The moderation effect of social support is not significant towards resilience and vicarious trauma.

Keywords: self-efficacy, resilience, vicarious-trauma social-support, social support

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Authors: Alfred Hasanaj , Ardit Gjeta, Miranda Kullolli

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The approach in analyzing defects on different pipe lines is conducted through Failure Assessment Diagram (FAD). These methods of analyses have further extended in recent years. This approach is used to identify and stress out a solution for the defects which randomly occur with gas pipes such are corrosion defects, gauge defects, and combination of defects where gauge and dents are included. Few of the defects are to be analyzed in this paper where our main focus will be the fracture of cast Iron pipes, elastic-plastic failure and plastic collapse of X52 steel pipes for gas transport. We need to conduct a calculation of probability of the defects in order to predict and avoid such costly defects.

Keywords: defects, failure assessment diagrams, steel pipes, safety factor

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Authors: Jennifer M. Glennon, Hana D'Souza, Luke Mason, Annette Karmiloff-Smith, Michael S. C. Thomas

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Genetic syndrome groups that feature high rates of autism comorbidity, like Down syndrome (DS) and fragile X syndrome (FXS), have been presented as useful models for understanding risk and protective factors involved in the emergence of autistic traits. Yet despite reaching clinical thresholds, these ‘syndromic’ forms of autism appear to differ in important ways from the idiopathic or ‘non-syndromic’ autism phenotype. To uncover the true nature of these comorbidities, it is necessary to extend definitions of autism to include the cognitive characteristics of the disorder and to then apply this broadened conceptualisation to the study of syndromic autism profiles. The current study employs a variety of well-established eye-tracking paradigms to assess visual attentional performance in children with DS and FXS who reach thresholds for autism on the Social Communication Questionnaire. It investigates whether autism profiles in these children are accompanied by visual orienting difficulties (‘sticky attention’), decreased social attention, and enhanced visual search performance, all of which are characteristic of the idiopathic autism phenotype. Data is collected from children with DS and FXS aged between 6 and 10 years, in addition to two control groups matched on age and intellectual ability (i.e., children with idiopathic autism and neurotypical controls). Cross-sectional developmental trajectory analyses are conducted to enable visuo-attentional profile comparisons. Significant differences in the visuo-attentional processes underpinning autism presentations in children with FXS and DS are hypothesised, supporting notions of syndrome specificity. The study provides insight into the complex heterogeneity associated with syndromic autism presentations and autism per se, with clinical implications for the utility of autism intervention programmes in DS and FXS populations.

Keywords: autism, down syndrome, fragile X syndrome, eye tracking

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Authors: Sadeq Al Yaari, Nassr Almaflehi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background: Assessment of language-related functional activities (ALFA) is of vital importance in assessing aphasics’ performance of both sexes. However, the validity and reliability of this language therapeutic test has never been validated in the Arabic medical literature. Purpose: The aim of this study was to validate the test by assessing the language-related functional activities of 100 gender aphasics based in a medical faculty. Design: ALFA Pre-and-posttest was administered twice in three weeks to test the language-related functional activities of 100 gender aphasics. Settings: Al Khars hospital in Al Ahsa’a, Kingdom of Saudi Arabia (KSA). Participants: Sixteen to eight-year-old participants (N = 100 men and women) were enrolled in this experiment. Again, the purpose was to assess their language-related functional activities using ALFA. Procedures: The first step was to translate the English version of ALFA test into the mother tongue of the patients (Arabic). Secondly, the translated text is reviewed and edited by three specialists of Arabic language. Having the test standardized, the third step was to assess language-related functional activities of the participants in natural environment. Assessment took place in three weeks. In the first week, a pre-test was administered to the participants at hand and after two weeks, a post-test was administered to identify whether or not significant differences between the two tests (pre-and-posttest) could be observed. Interventions: Outcomes of the results obtained from the analyses were broadly discussed. Linguistic and statistical comparisons were held to illustrate the findings of this study. Main outcomes and Results: The analysis of the obtained results indicated that the performance of the aphasic participants in the post-test did not differ from that of the pre-test (, respectively). Conclusions & Implications: ALFA was proved to be a valid and reliable test. Moreover, outlined results pointed out the importance of assessing not only gender aphasics’ language, but also their language-related functional activities. Further research is needed to explore how gender aphasics’ verbal and non-verbal performances interact.

Keywords: ALFA, language test, Arab aphasics, validity, reliability, psychoneurolinguistics.

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

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Authors: Nima Pirhadi, Shao Yong Bo, Xusheng Wan, Jianguo Lu, Jilei Hu

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Although gravels and gravelly soils are assumed to be non-liquefiable because of high conductivity and small modulus; however, the occurrence of this phenomenon in some historical earthquakes, especially recently earthquakes during 2008 Wenchuan, Mw= 7.9, 2014 Cephalonia, Greece, Mw= 6.1 and 2016, Kaikoura, New Zealand, Mw = 7.8, has been promoted the essential consideration to evaluate risk assessment and hazard analysis of seismic gravelly soil liquefaction. Due to the limitation in sampling and laboratory testing of this type of soil, in situ tests and site exploration of case histories are the most accepted procedures. Of all in situ tests, dynamic penetration test (DPT), Which is well known as the Chinese dynamic penetration test, and shear wave velocity (Vs) test, have been demonstrated high performance to evaluate seismic gravelly soil liquefaction. However, the lack of a sufficient number of case histories provides an essential limitation for developing new models. This study at first investigates recent earthquakes that caused liquefaction in gravelly soils to collect new data. Then, it adds these data to the available literature’s dataset to extend them and finally develops new models to assess seismic gravelly soil liquefaction. To validate the presented models, their results are compared to extra available models. The results show the reasonable performance of the proposed models and the critical effect of gravel content (GC)% on the assessment.

Keywords: liquefaction, gravel, dynamic penetration test, shear wave velocity

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Authors: Nur Syahidatul Idany Abdul Ghani, Rahizar Ramli, Jamilah Mohamad, Ahmad Saifizul, Mohamed Rehan Karim

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Increasing fatalities in road accidents in Malaysia over the last 10 years are quite alarming. Based on Malaysian Institute of Road Safety Research (Miros) latest research ‘Predicting Malaysian Road Fatalities for year 2020; it is predicted that road fatalities in Malaysia for 2015 is 8,780 and 10,716 for the year 2020 which 30 percent of fatalities were caused by accidents involving commercial vehicles. Government, related agencies and NGOs have continuously and persistently work to reduce the statistics through enforcement, educating the public, training to drivers, road safety campaigns, advertisements etc. However, the trend of casualties does not show encouraging pattern but instead, steadily growing. Thus, this comparative study reviews the literature pertaining on method of measurement used to evaluate commercial drivers competency. In several studies driving competency has been assessed with different assessment based on the license procedures and requirements according to the country regulation. The assessment criteria that has been establish for commercial drivers generally focus on driving tasks and assessment e.g. theory test, medical test and road assessment rather than driving competency test or physical test. Realizing the importance of specific assessment test for drivers competency this comparative study reviews the most discussed literature related to competency assessment method to identify competency of the drivers include (1. judgement and reaction, 2. skill of drivers, 3. experiences and fatigue). The concluding analysis of this paper is a comparative table for assessment methodology to access driver’s competency. A comparative study is a further discussion reviewing past literature to provide an overview on existing assessment test and potential subject matters that can be identified for further studies to increase awareness of the drivers, passengers as well as the authorities about the importance of competent drivers in order to improve safety in commercial vehicles.

Keywords: commercial vehicles, driver’s competency, specific assessment

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Authors: Skyler Kim

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An early diagnosis of leukemia has always been a challenge to doctors and hematologists. On a worldwide basis, it was reported that there were approximately 350,000 new cases in 2012, and diagnosing leukemia was time-consuming and inefficient because of an endemic shortage of flow cytometry equipment in current clinical practice. As the number of medical diagnosis tools increased and a large volume of high-quality data was produced, there was an urgent need for more advanced data analysis methods. One of these methods was the AI approach. This approach has become a major trend in recent years, and several research groups have been working on developing these diagnostic models. However, designing and implementing a leukemia diagnostic system in real clinical environments based on a deep learning approach with larger sets remains complex. Leukemia is a major hematological malignancy that results in mortality and morbidity throughout different ages. We decided to select acute lymphocytic leukemia to develop our diagnostic system since acute lymphocytic leukemia is the most common type of leukemia, accounting for 74% of all children diagnosed with leukemia. The results from this development work can be applied to all other types of leukemia. To develop our model, the Kaggle dataset was used, which consists of 15135 total images, 8491 of these are images of abnormal cells, and 5398 images are normal. In this paper, we design and implement a leukemia diagnostic system in a real clinical environment based on deep learning approaches with larger sets. The proposed diagnostic system has the function of detecting and classifying leukemia. Different from other AI approaches, we explore hybrid architectures to improve the current performance. First, we developed two independent convolutional neural network models: VGG19 and ResNet50. Then, using both VGG19 and ResNet50, we developed a hybrid deep learning architecture employing transfer learning techniques to extract features from each input image. In our approach, fusing the features from specific abstraction layers can be deemed as auxiliary features and lead to further improvement of the classification accuracy. In this approach, features extracted from the lower levels are combined into higher dimension feature maps to help improve the discriminative capability of intermediate features and also overcome the problem of network gradient vanishing or exploding. By comparing VGG19 and ResNet50 and the proposed hybrid model, we concluded that the hybrid model had a significant advantage in accuracy. The detailed results of each model’s performance and their pros and cons will be presented in the conference.

Keywords: acute lymphoblastic leukemia, hybrid model, leukemia diagnostic system, machine learning

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Authors: Prataksitorn Chonlakan, Tiparat Wongsilarat

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The traditional clinical practice guideline used at the emergency room at Songkhla Hospital in caring for patients who come in contact with jellyfish venom took a long time for the pain to reduce to the level that patients can cope with. To investigate the effectiveness of clinical practice guidelines by comparing the effectiveness of a newly developed clinical practice guideline with the traditional clinical practice guideline in the following aspects: 1) pain reduction, 2) length of pain, 3) the rate of patient’s re-visit, 4) the rate of severe complications such as anaphylactic shock, and cardiac arrest, and death, and 5) patient satisfaction. This study employed a quasi-experimental research design. Thirty subjects were selected with purposive sampling from jellyfish-sting patients who came for treatment at the Emergency Room of Songkhla Hospital. The subjects were divided using random assignment into two groups of 15 each: an experimental group, and the control group. The control group was treated using the traditional clinical practice guideline consisting of rinsing the affected area with 0.9% normal saline, using a cloth soaked with vinegar to press against the affected area, and controlling pain using tramadol or diclofenac intramuscular injection. The data were analyzed using descriptive statistics and paired t-test at the significance level p < 0.05. The results of the study revealed the following. The pain level in the experimental group was significantly lower than that of the control group (the average pain score of the experimental group was 3.46 while that of the control group was 6.33) (p < 0.05).The length of pain in the experimental group was significantly lower than that of the control group (the average length of pain in the experimental group was 48.67 minutes while that of the control group was 105.35 minutes) (p < 0.05). The rate of re-visit within 12 hours in the experimental group was significantly lower than that of the control group (the rate of re-visit within 12 hours of the experimental group was 0.07 while that of the control group was 0.00) (p < 0.05).No severe complications such as anaphylactic shock, and cardiac arrest were found in the two groups of subjects.The rate of satisfaction among the subjects in the experimental group was significantly higher than that of the control group (the rate of satisfaction among the subjects of the experimental group was 90.00 percent while that among the control group was 66.33 percent) (p < 0.05). The newly develop clinical practice guideline could reduce pain and increase satisfaction among jellyfish-sting patients better than the traditional clinical practice guideline.

Keywords: effectiveness, clinical practice guideline, jellyfish-sting patients, cardiac arrest

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Authors: Milan Paudel, Fook Fah Yap, Anil K. Bastola

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The difficulties in riding small wheel bicycles and their lesser stability have been perceived for a long time. Although small wheel bicycles are designed using the similar approach and guidelines that have worked well for big wheel bicycles, the performance of the big wheelers and the smaller wheelers are markedly different. Since both the big wheelers and small wheelers have same fundamental geometry, most blame the small wheel for this discrepancy in the performance. This paper reviews existing guidelines for bicycle design, especially the front steering geometry for the bicycle, and provides a systematic and quantitative analysis of different wheel sized bicycles. A validated mathematical model has been used as a tool to assess the dynamic performance of the bicycles in term of their self-stability. The results obtained were found to corroborate the subjective perception of cyclists for small wheel bicycles. The current approach for small wheel bicycle design requires higher speed to be self-stable. However, it was found that increasing the headtube angle and selecting a proper trail could improve the dynamic performance of small wheel bicycles. A range of parameters for front steering geometry has been identified for small wheel bicycles that have comparable stability as big wheel bicycles. Interestingly, most of the identified geometries are found to be beyond the ISO recommended range and seem to counter the current approach of small wheel bicycle design. Therefore, it was successfully shown that the guidelines for big wheelers do not translate directly to small wheelers, but careful selection of the front geometry could make small wheel bicycles as stable as big wheel bicycles.

Keywords: big wheel bicycle, design approach, ISO requirements, small wheel bicycle, stability and performance

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Authors: G. Khasaev, S. Ashmarina , A. Zotova

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The priority of Russian enterprises development has been given to the optimization process of industrial enterprise activity for their sustainable development in a long-term period. The assessment of sustainable development level as one of the most efficient instruments of sustainable development management at the industrial enterprise gives a complex view of its state. In order to perform accurate analysis of the current state of the industrial enterprise, it is necessary to perform the assessment of its sustainable development and using its results to elaborate the further tactic of enterprise functioning. The assessment of sustainable development level of the enterprise may help the effective management of strategy development only if the corresponding indicators system is created. The elaboration and usage the sustainable development indicators allows the enterprise to implement analysis of its activity results and monitoring of sustainable enterprise functioning. The authors’ methods are based on general aspects of the industrial enterprise functioning such as finance, customers, inner economic process, and staff system.

Keywords: assessment methods, indicators system, industrial enterprise, sustainable development

Procedia PDF Downloads 364