Search results for: computational outcomes assessment
9854 Kinematic Analysis of the Calf Raise Test Using a Mobile iOS Application: Validation of the Calf Raise Application
Authors: Ma. Roxanne Fernandez, Josie Athens, Balsalobre-Fernandez, Masayoshi Kubo, Kim Hébert-Losier
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Objectives: The calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. For testing, individuals stand on one leg and go up on their toes and back down to volitional fatigue. The newly developed Calf Raise application (CRapp) for iOS uses computer-vision algorithms enabling objective measurement of CRT outcomes. We aimed to validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment and establishing its intra- and inter-rater reliability. Methods: CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen healthy individuals (6 males, 7 females) on three occasions and both legs using the CRapp, 3D motion capture, and force plate technologies simultaneously. Data were extracted from two markers: one placed immediately below the lateral malleolus and another on the heel. Concurrent validity and agreement measures were determined using intraclass correlation coefficients (ICC₃,ₖ), typical errors expressed as coefficient of variations (CV), and Bland-Altman methods to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. Results: Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), with precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were, on average better for the lateral malleolus marker. Additionally, inter- and intra-rater reliability were excellent (mean ICC ≥0.949, CV ≤5.6%). Conclusion: These results confirm the CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. The CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.Keywords: calf raise test, mobile application, validity, reliability
Procedia PDF Downloads 1579853 Maternal Perception of Using Epidural Anesthesia and the Childbirth Outcomes
Authors: Jiyoung Kim, Chae Weon Chung
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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.Keywords: epidural anesthesia, delivery outcomes, labor pain, perception
Procedia PDF Downloads 1519852 Uterine Cervical Cancer; Early Treatment Assessment with T2- And Diffusion-Weighted MRI
Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist
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Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma
Procedia PDF Downloads 1359851 Brain-Computer Interface System for Lower Extremity Rehabilitation of Chronic Stroke Patients
Authors: Marc Sebastián-Romagosa, Woosang Cho, Rupert Ortner, Christy Li, Christoph Guger
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Neurorehabilitation based on Brain-Computer Interfaces (BCIs) shows important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. For this publication, seven stroke patients in the chronic phase with hemiparesis in the lower extremity were recruited. All of them participated in 25 BCI sessions about 3 times a week. The BCI system was based on the Motor Imagery (MI) of the paretic ankle dorsiflexion and healthy wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes in motor improvement before, after and during the rehabilitation training. Our primary measures used for the assessment were the 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT fast velocity of 0.18 m/s IQR = [0.12 to 0.2], P = 0.016. The speed in the TUG was also significantly increased by 0.1 m/s IQR = [0.09 to 0.11], P = 0.031. The active ROM assessment increased 4.65º, and IQR = [ 1.67 - 7.4], after rehabilitation training, P = 0.029. These functional improvements persisted at least one month after the end of the therapy. These outcomes show the feasibility of this BCI approach for chronic stroke patients and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tools for stroke patients. However, the results are from only seven chronic stroke patients, so the authors believe that this approach should be further validated in broader randomized controlled studies involving more patients. MI and FES-based non-invasive BCIs are showing improvement in the gait rehabilitation of patients in the chronic stage after stroke. This could have an impact on the rehabilitation techniques used for these patients, especially when they are severely impaired and their mobility is limited.Keywords: neuroscience, brain computer interfaces, rehabilitat, stroke
Procedia PDF Downloads 899850 Nursing Education in the Pandemic Time: Case Study
Authors: Jaana Sepp, Ulvi Kõrgemaa, Kristi Puusepp, Õie Tähtla
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COVID-19 was officially recognized as a pandemic in late 2019 by the WHO, and it has led to changes in the education sector. Educational institutions were closed, and most schools adopted distance learning. Estonia is known as a digitally well-developed country. Based on that, in the pandemic time, nursing education continued, and new technological solutions were implemented. To provide nursing education, special focus was paid on quality and flexibility. The aim of this paper is to present administrative, digital, and technological solutions which support Estonian nursing educators to continue the study process in the pandemic time and to develop a sustainable solution for nursing education for the future. This paper includes the authors’ analysis of the documents and decisions implemented in the institutions through the pandemic time. It is a case study of Estonian nursing educators. Results of the analysis show that the implementation of distance learning principles challenges the development of innovative strategies and technics for the assessment of student performance and educational outcomes and implement new strategies to encourage student engagement in the virtual classroom. Additionally, hospital internships were canceled, and the simulation approach was deeply implemented as a new opportunity to develop and assess students’ practical skills. There are many other technical and administrative changes that have also been carried out, such as students’ support and assessment systems, the designing and conducting of hybrid and blended studies, etc. All services were redesigned and made more available, individual, and flexible. Hence, the feedback system was changed, the information was collected in parallel with educational activities. Experiences of nursing education during the pandemic time are widely presented in scientific literature. However, to conclude our study, authors have found evidence that solutions implemented in Estonian nursing education allowed the students to graduate within the nominal study period without any decline in education quality. Operative information system and flexibility provided the minimum distance between the students, support, and academic staff, and likewise, the changes were implemented quickly and efficiently. Institution memberships were updated with the appropriate information, and it positively affected their satisfaction, motivation, and commitment. We recommend that the feedback process and the system should be permanently changed in the future to place all members in the same information area, redefine the hospital internship process, implement hybrid learning, as well as to improve the communication system between stakeholders inside and outside the organization. The main limitation of this study relates to the size of Estonia. Nursing education is provided by two institutions only, and similarly, the number of students is low. The result could be generated to the institutions with a similar size and administrative system. In the future, the relationship between nurses’ performance and organizational outcomes should be deeply investigated and influences of the pandemic time education analyzed at workplaces.Keywords: hybrid learning, nursing education, nursing, COVID-19
Procedia PDF Downloads 1179849 Positive Outcomes of Internship for Students Majoring in Mathematics
Authors: Irina Peterburgsky
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We have been working on finding internship positions for our math and computer science majors. Among many other positive outcomes of internship for students majoring in mathematics, there are: students see new applications of mathematics to real life and see new scientific problems; they learn new methods, tools, etc. that they have not seen in their classes; they appreciate the power of mathematics that increases their interest in learning mathematics; they make decisions to take more advanced math courses; students understand better what their potentials, strong points, and limitations are; learn what work ethic is; learn how to work as a member of a team at a workplace; understand better how to offer their help and how to ask for help; start building their professional relationship; build self-confidence as young professionals, and what is the most important - they get a better understanding of their goals in their future professional careers.Keywords: internship, mathematics, positive outcoms for students, workplace
Procedia PDF Downloads 1749848 Experimental and Computational Investigations of Baffle Position Effects on the Performance of Oil and Water Separator Tanks
Authors: Haitham A. Hussein, Rozi Abdullah, Md Azlin Md Said
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Gravity separator tanks are used to separate oil from water in treatment units. Achieving the best flow uniformity in a separator tank will improve the maximum removal efficiency of oil globules from water. In this study, the effect on hydraulic performance of different baffle structure positions inside a tank was investigated. Experimental data and 2D computation fluid dynamics were used for analysis. In the numerical model, two-phase flow (drift flux model) was used to validate one-phase flow. For laboratory measurements, the velocity fields were measured using an acoustic Doppler velocimeter. The measurements were compared with the result of the computational model. The results of the experimental and computational simulations indicate that the best location of a baffle structure is achieved when the standard deviation of the velocity profile and the volume of the circulation zone inside the tank are minimized.Keywords: gravity separator tanks, CFD, baffle position, two phase flow, ADV, oil droplet
Procedia PDF Downloads 3179847 Assessment of Time-variant Work Stress for Human Error Prevention
Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee
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For an operator in a nuclear power plant, human error is one of the most dreaded factors that may result in unexpected accidents. The possibility of human errors may be low, but the risk of them would be unimaginably enormous. Thus, for accident prevention, it is quite indispensable to analyze the influence of any factors which may raise the possibility of human errors. During the past decades, not a few research results showed that performance of human operators may vary over time due to lots of factors. Among them, stress is known to be an indirect factor that may cause human errors and result in mental illness. Until now, not a few assessment tools have been developed to assess stress level of human workers. However, it still is questionable to utilize them for human performance anticipation which is related with human error possibility, because they were mainly developed from the viewpoint of mental health rather than industrial safety. Stress level of a person may go up or down with work time. In that sense, if they would be applicable in the safety aspect, they should be able to assess the variation resulted from work time at least. Therefore, this study aimed to compare their applicability for safety purpose. More than 10 kinds of work stress tools were analyzed with reference to assessment items, assessment and analysis methods, and follow-up measures which are known to close related factors with work stress. The results showed that most tools mainly focused their weights on some common organizational factors such as demands, supports, and relationships, in sequence. Their weights were broadly similar. However, they failed to recommend practical solutions. Instead, they merely advised to set up overall counterplans in PDCA cycle or risk management activities which would be far from practical human error prevention. Thus, it was concluded that application of stress assessment tools mainly developed for mental health seemed to be impractical for safety purpose with respect to human performance anticipation, and that development of a new assessment tools would be inevitable if anyone wants to assess stress level in the aspect of human performance variation and accident prevention. As a consequence, as practical counterplans, this study proposed a new scheme for assessment of work stress level of a human operator that may vary over work time which is closely related with the possibility of human errors.Keywords: human error, human performance, work stress, assessment tool, time-variant, accident prevention
Procedia PDF Downloads 6679846 The Bespoke ‘Hybrid Virtual Fracture Clinic’ during the COVID-19 Pandemic: A Paradigm Shift?
Authors: Anirudh Sharma
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Introduction: The Covid-19 pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospital. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient – either a face-to-face or telephone consultation depending on patient need – a ‘hybrid virtual clinic (HVC).’ We report patient satisfaction and outcomes with this novel service. Methods: Patients booked onto our fracture clinics during the first 2 weeks of national lockdown were retrospectively contacted to assess the mode of consultations (virtual, face-to-face, or hybrid), patient experience, and outcome. Patient experience was assessed using the net promoter (NPS), customer effort (CES) and customer satisfaction scores (CSS), and their likelihood of using the HVC in the absence of a pandemic. Patient outcomes were assessed using the components of the EQ5D score. Results: Of 269 possible patients, 140 patients responded to the questionnaire. Of these, 66.4% had ‘hybrid’ consultations, 27.1% had only virtual consultations, and 6.4% had only face-to-face consultations. The mean overall NPS, CES, and CSS (on a scale of 1-10) were 7.27, 7.25, and 7.37, respectively. The mean likelihood of patients using the HVC in the absence of a pandemic was 6.5/10. Patients who had ‘hybrid’ consultations showed better effort scores and greater overall satisfaction than those with virtual consultations only and also reported superior EQ5D outcomes (mean 79.27 vs. 72.7). Patients who did not require surgery reported increased satisfaction (mean 7.51 vs. 7.08) and were more likely to use the HVC in the absence of a pandemic. Conclusion: Our study indicates that a bespoke HVC has good overall patient satisfaction and outcomes and is a better format of fracture clinic service than virtual consultations alone. It may be the preferred mode for fracture clinics in similar situations in the future. Further analysis needs to be conducted in order to explore the impact on resources and clinician experience of HVC in order to appreciate this new paradigm shift.Keywords: hybrid virtual clinic, coronavirus, COVID-19, fracture clinic, remote consultation
Procedia PDF Downloads 1299845 Changing Trends and Attitudes towards Online Assessment
Authors: Renáta Nagy, Alexandra Csongor, Jon Marquette, Vilmos Warta
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The presentation aims at eliciting insight into the results of ongoing research regarding evolving trends and attitudes towards online assessment of English for Medical Purposes. The focus pinpointsonline as one of the most trending formsavailable during the global pandemic. The study was first initiated in 2019 in which its main target was to reveal the intriguing question of students’ and assessors’ attitudes towards online assessment. The research questions the attitudes towards the latest trends, possible online task types, their advantagesand disadvantages through an in-depth experimental process currently undergoing implementation. Material and methods include surveys, needs and wants analysis, and thorough investigations regarding candidates’ and assessors’ attitudes towards online tests in the field of Medicine. The examined test tasks include various online tests drafted in both English and Hungarian by student volunteers at the Medical School of the University of Pécs, Hungary. Over 400 respondents from more than 28 countries participated in the survey, which gives us an international and intercultural insight into how students with different cultural and educational background deal with the evolving online world. The results show the pandemic’s impact, which brought the slumbering online world of assessing roaring alive, fully operational andnowbearsphenomenalrelevancein today’s global education. Undeniably, the results can be used as a perspective in a vast array of contents. The survey hypothesized the generation of the 21st century expect everything readily available online, however, questions whether they are ready for this challenge are lurking in the background.Keywords: assessment, changes, english, ESP, online assessment, online, trends
Procedia PDF Downloads 1949844 Translation and Adaptation of the Assessment Instrument “Kiddycat” for European Portuguese
Authors: Elsa Marta Soares, Ana Rita Valente, Cristiana Rodrigues, Filipa Gonçalves
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Background: The assessment of feelings and attitudes of preschool children in relation to stuttering is crucial. Negative experiences can lead to anxiety, worry or frustration. To avoid the worsening of attitudes and feelings related to stuttering, it is important the early detection in order to intervene as soon as possible through an individualized intervention plan. Then it is important to have Portuguese instruments that allow this assessment. Aims: The aim of the present study is to realize the translation and adaptation of the Communication Attitude Test for Children in Preschool Age and Kindergarten (KiddyCat) for EP. Methodology: For the translation and adaptation process, a methodological study was carried out with the following steps: translation, back translation, assessment by a committee of experts and pre-test. This abstract describes the results of the first two phases of this process. The translation was accomplished by two bilingual individuals without experience in health and any knowledge about the instrument. One of them was an English teacher and the other one a Translator. The back-translation was conducted by two Senior Class Teachers that live in United Kingdom without any knowledge in health and about the instrument. Results and Discussion: In translation there were differences in semantic equivalences of various expressions and concepts. A discussion between the two translators, mediated by the researchers, allowed to achieve the consensus version of the translated instrument. Taking into account the original version of KiddyCAT the results demonstrated that back-translation versions were similar to the original version of this assessment instrument. Although the back-translators used different words, they were synonymous, maintaining semantic and idiomatic equivalences of the instrument’s items. Conclusion: This project contributes with an important resource that can be used in the assessment of feelings and attitudes of preschool children who stutter. This was the first phase of the research; expert panel and pretest are being developed. Therefore, it is expected that this instrument contributes to an holistic therapeutic intervention, taking into account the individual characteristics of each child.Keywords: assessment, feelings and attitudes, preschool children, stuttering
Procedia PDF Downloads 1459843 Computational Aerodynamics and Aeroacoustics of a Nose Landing Gear
Authors: Kamal Haider
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Numerical simulations over landing gear of simplified and partially-dressed configurations with closed cavity have been performed to compute aerodynamically and aeroacoustics parameters using commercial engineering software. The objective of numerical computations is two folds. Firstly, to validate experimental data of newly built nose landing gear and secondly perform high-fidelity calculations using CFD/FW-H hybrid approach, as future engineering challenges need more advanced aircraft configurations such as performance noise and efficiency. Both geometries are used for multi-block structured, and unstructured/hybrid meshed to develop some understanding of physics in terms of aerodynamics and aeroacoustics. Detached Eddy Simulation (DES) approach is employed to compute surface pressure. Also far-field noise calculations have been generated by Ffowcs-William and Hawking solver. Both results of aerodynamics and aeroacoustics are compared with experimental data.Keywords: landing gear, computational aeroacoustics, computational aerodynamics, detached eddy simulation
Procedia PDF Downloads 2779842 Model of MSD Risk Assessment at Workplace
Authors: K. Sekulová, M. Šimon
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This article focuses on upper-extremity musculoskeletal disorders risk assessment model at workplace. In this model are used risk factors that are responsible for musculoskeletal system damage. Based on statistic calculations the model is able to define what risk of MSD threatens workers who are under risk factors. The model is also able to say how MSD risk would decrease if these risk factors are eliminated.Keywords: ergonomics, musculoskeletal disorders, occupational diseases, risk factors
Procedia PDF Downloads 5439841 Psychometric Examination of the QUEST-25: An Online Assessment of Intellectual Curiosity and Scientific Epistemology
Authors: Matthew J. Zagumny
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The current study reports an examination of the QUEST-25 (Q-Assessment of Undergraduate Epistemology and Scientific Thinking) online version for assessing the dispositional attitudes toward scientific thinking and intellectual curiosity among undergraduate students. The QUEST-25 consists of scientific thinking (SIQ-25) and intellectual curiosity (ICIQ-25), which were correlated in hypothesized directions with the Religious Commitment Inventory, Curiosity and Exploration Inventory, Belief in Science scale, and measures of academic self-efficacy. Additionally, concurrent validity was established by the resulting significant differences between those identifying the centrality of religious belief in their lives and those who do not self-identify as being guided daily by religious beliefs. This study demonstrates the utility of the QUEST-25 for research, evaluation, and theory development.Keywords: guided-inquiry learning, intellectual curiosity, psychometric assessment, scientific thinking
Procedia PDF Downloads 2589840 Prediction of the Transmittance of Various Bended Angles Lightpipe by Using Neural Network under Different Sky Clearness Condition
Authors: Li Zhang, Yuehong Su
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Lightpipe as a mature solar light tube technique has been employed worldwide. Accurately assessing the performance of lightpipe and evaluate daylighting available has been a challenging topic. Previous research had used regression model and computational simulation methods to estimate the performance of lightpipe. However, due to the nonlinear nature of solar light transferring in lightpipe, the methods mentioned above express inaccurate and time-costing issues. In the present study, a neural network model as an alternative method is investigated to predict the transmittance of lightpipe. Four types of commercial lightpipe with bended angle 0°, 30°, 45° and 60° are discussed under clear, intermediate and overcast sky conditions respectively. The neural network is generated in MATLAB by using the outcomes of an optical software Photopia simulations as targets for networks training and testing. The coefficient of determination (R²) for each model is higher than 0.98, and the mean square error (MSE) is less than 0.0019, which indicate the neural network strong predictive ability and the use of the neural network method could be an efficient technique for determining the performance of lightpipe.Keywords: neural network, bended lightpipe, transmittance, Photopia
Procedia PDF Downloads 1479839 Mammotome Vacuum-Assisted Breast Biopsy versus Conventional Open Surgery: A Meta-Analysis
Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li
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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis
Procedia PDF Downloads 2099838 Ingratiation as a Moderator of the Impact of the Perception of Organizational Politics on Job Satisfaction
Authors: Triana Fitriastuti, Pipiet Larasatie, Alex Vanderstraten
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Many scholars have demonstrated the negative impacts of the perception of organizational politics on organizational outcomes. The model proposed in this study analyzes the impact of the perception of organizational politics on job satisfaction. In the same way, ingratiation as a moderator variable is tested. We applied regression analysis to test the hypothesis. The findings of the current research, which was conducted with 240 employees in the public sector in Indonesia, show that the perception of organizational politics has a negative effect on job satisfaction. In contrast, ingratiation plays a role that fully moderates the relationship between organizational politics and organizational outcomes and changes the correlation between the perception of organizational politics on job satisfaction. Employees who use ingratiation as a coping mechanism tend to do so when they perceive a high degree of organizational politics.Keywords: ingratiation, impression management, job satisfaction, perception of organizational politics
Procedia PDF Downloads 1449837 Enhancing the Interpretation of Group-Level Diagnostic Results from Cognitive Diagnostic Assessment: Application of Quantile Regression and Cluster Analysis
Authors: Wenbo Du, Xiaomei Ma
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With the empowerment of Cognitive Diagnostic Assessment (CDA), various domains of language testing and assessment have been investigated to dig out more diagnostic information. What is noticeable is that most of the extant empirical CDA-based research puts much emphasis on individual-level diagnostic purpose with very few concerned about learners’ group-level performance. Even though the personalized diagnostic feedback is the unique feature that differentiates CDA from other assessment tools, group-level diagnostic information cannot be overlooked in that it might be more practical in classroom setting. Additionally, the group-level diagnostic information obtained via current CDA always results in a “flat pattern”, that is, the mastery/non-mastery of all tested skills accounts for the two highest proportion. In that case, the outcome does not bring too much benefits than the original total score. To address these issues, the present study attempts to apply cluster analysis for group classification and quantile regression analysis to pinpoint learners’ performance at different proficiency levels (beginner, intermediate and advanced) thus to enhance the interpretation of the CDA results extracted from a group of EFL learners’ reading performance on a diagnostic reading test designed by PELDiaG research team from a key university in China. The results show that EM method in cluster analysis yield more appropriate classification results than that of CDA, and quantile regression analysis does picture more insightful characteristics of learners with different reading proficiencies. The findings are helpful and practical for instructors to refine EFL reading curriculum and instructional plan tailored based on the group classification results and quantile regression analysis. Meanwhile, these innovative statistical methods could also make up the deficiencies of CDA and push forward the development of language testing and assessment in the future.Keywords: cognitive diagnostic assessment, diagnostic feedback, EFL reading, quantile regression
Procedia PDF Downloads 1459836 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London
Authors: Michael Adebayo, Saheed Lawal
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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality
Procedia PDF Downloads 799835 Numerical Simulation of the Coal Spontaneous Combustion Dangerous Area in Composite Long-Wall Gobs
Authors: Changshan Zhang, Zhijin Yu, Shixing Fan
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A comprehensive hazard evaluation for coal self-heating in composite long-wall gobs is heavily dependent on computational simulation. In this study, the spatial distributions of cracks which caused significant air leakage were simulated by universal distinct element code (UDEC) simulation. Based on the main routes of air leakage and characteristics of coal self-heating, a computational fluid dynamics (CFD) modeling was conducted to model the coal spontaneous combustion dangerous area in composite long-wall gobs. The results included the oxygen concentration distributions and temperature profiles showed that the numerical approach is validated by comparison with the test data. Furthermore, under the conditions of specific engineering, the major locations where some techniques for extinguishing and preventing long-wall gob fires need to be put into practice were also examined.Keywords: computational simulation, UDEC simulation, coal self-heating, CFD modeling, long-wall gobs
Procedia PDF Downloads 3059834 Consideration of Failed Fuel Detector Location through Computational Flow Dynamics Analysis on Primary Cooling System Flow with Two Outlets
Authors: Sanghoon Bae, Hanju Cha
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Failed fuel detector (FFD) in research reactor is a very crucial instrument to detect the anomaly from failed fuels in the early stage around primary cooling system (PCS) outlet prior to the decay tank. FFD is considered as a mandatory sensor to ensure the integrity of fuel assemblies and mitigate the consequence from a failed fuel accident. For the effective function of FFD, the location of them should be determined by contemplating the effect from coolant flow around two outlets. For this, the analysis on computational flow dynamics (CFD) should be first performed how the coolant outlet flow including radioactive materials from failed fuels are mixed and discharged through the outlet plenum within certain seconds. The analysis result shows that the outlet flow is well mixed regardless of the position of failed fuel and ultimately illustrates the effect of detector location.Keywords: computational flow dynamics (CFD), failed fuel detector (FFD), fresh fuel assembly (FFA), spent fuel assembly (SFA)
Procedia PDF Downloads 2389833 Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Tunisia: Risk and Protective Factor
Authors: Ahmed Sami Hammami, Mohamed Jellazi
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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors
Procedia PDF Downloads 1929832 Integration of an Evidence-Based Medicine Curriculum into Physician Assistant Education: Teaching for Today and the Future
Authors: Martina I. Reinhold, Theresa Bacon-Baguley
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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students.Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant
Procedia PDF Downloads 1249831 A Phenomenological Approach to Computational Modeling of Analogy
Authors: José Eduardo García-Mendiola
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In this work, a phenomenological approach to computational modeling of analogy processing is carried out. The paper goes through the consideration of the structure of the analogy, based on the possibility of sustaining the genesis of its elements regarding Husserl's genetic theory of association. Among particular processes which take place in order to get analogical inferences, there is one which arises crucial for enabling efficient base cases retrieval through long-term memory, namely analogical transference grounded on familiarity. In general, it has been argued that analogical reasoning is a way by which a conscious agent tries to determine or define a certain scope of objects and relationships between them using previous knowledge of other familiar domain of objects and relations. However, looking for a complete description of analogy process, a deeper consideration of phenomenological nature is required in so far, its simulation by computational programs is aimed. Also, one would get an idea of how complex it would be to have a fully computational account of the analogy elements. In fact, familiarity is not a result of a mere chain of repetitions of objects or events but generated insofar as the object/attribute or event in question is integrable inside a certain context that is taking shape as functionalities and functional approaches or perspectives of the object are being defined. Its familiarity is generated not by the identification of its parts or objective determinations as if they were isolated from those functionalities and approaches. Rather, at the core of such a familiarity between entities of different kinds lays the way they are functionally encoded. So, and hoping to make deeper inroads towards these topics, this essay allows us to consider that cognitive-computational perspectives can visualize, from the phenomenological projection of the analogy process reviewing achievements already obtained as well as exploration of new theoretical-experimental configurations towards implementation of analogy models in specific as well as in general purpose machines.Keywords: analogy, association, encoding, retrieval
Procedia PDF Downloads 1149830 Computational Thinking Based Coding Environment for Coding and Free Semester Mathematics Education in Korea
Authors: Han Hyuk Cho, Hanik Jo
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In recent years, coding education has been globally emphasized, and the Free Semester System and coding education were introduced to the public schools from the beginning of 2016 and 2018 respectively in Korea. With the introduction of the Free Semester System and the rising demand of Computational Thinking (CT) capacity, this paper aims to design ‘Coding Environment’ and Minecraft-like Turtlecraft in which learners can design and construct mathematical objects through mathematical symbolic expressions. Students can transfer the constructed mathematical objects to the Turtlecraft environment (open-source codingmath website), and also can print them out through 3D printers. Furthermore, we design learnable mathematics and coding curriculum by representing the figurate numbers and patterns in terms of executable expression in the coding context and connecting them to algebraic symbols, which will allow students to experience mathematical patterns and symbolic coding expressions.Keywords: coding education, computational thinking, mathematics education, TurtleMAL and Turtlecraft
Procedia PDF Downloads 2009829 Assessment of Potential Chemical Exposure to Betamethasone Valerate and Clobetasol Propionate in Pharmaceutical Manufacturing Laboratories
Authors: Nadeen Felemban, Hamsa Banjer, Rabaah Jaafari
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One of the most common hazards in the pharmaceutical industry is the chemical hazard, which can cause harm or develop occupational health diseases/illnesses due to chronic exposures to hazardous substances. Therefore, a chemical agent management system is required, including hazard identification, risk assessment, controls for specific hazards and inspections, to keep your workplace healthy and safe. However, routine management monitoring is also required to verify the effectiveness of the control measures. Moreover, Betamethasone Valerate and Clobetasol Propionate are some of the APIs (Active Pharmaceutical Ingredients) with highly hazardous classification-Occupational Hazard Category (OHC 4), which requires a full containment (ECA-D) during handling to avoid chemical exposure. According to Safety Data Sheet, those chemicals are reproductive toxicants (reprotoxicant H360D), which may affect female workers’ health and cause fatal damage to an unborn child, or impair fertility. In this study, qualitative (chemical Risk assessment-qCRA) was conducted to assess the chemical exposure during handling of Betamethasone Valerate and Clobetasol Propionate in pharmaceutical laboratories. The outcomes of qCRA identified that there is a risk of potential chemical exposure (risk rating 8 Amber risk). Therefore, immediate actions were taken to ensure interim controls (according to the Hierarchy of controls) are in place and in use to minimize the risk of chemical exposure. No open handlings should be done out of the Steroid Glove Box Isolator (SGB) with the required Personal Protective Equipment (PPEs). The PPEs include coverall, nitrile hand gloves, safety shoes and powered air-purifying respirators (PAPR). Furthermore, a quantitative assessment (personal air sampling) was conducted to verify the effectiveness of the engineering controls (SGB Isolator) and to confirm if there is chemical exposure, as indicated earlier by qCRA. Three personal air samples were collected using an air sampling pump and filter (IOM2 filters, 25mm glass fiber media). The collected samples were analyzed by HPLC in the BV lab, and the measured concentrations were reported in (ug/m3) with reference to Occupation Exposure Limits, 8hr OELs (8hr TWA) for each analytic. The analytical results are needed in 8hr TWA (8hr Time-weighted Average) to be analyzed using Bayesian statistics (IHDataAnalyst). The results of the Bayesian Likelihood Graph indicate (category 0), which means Exposures are de "minimus," trivial, or non-existent Employees have little to no exposure. Also, these results indicate that the 3 samplings are representative samplings with very low variations (SD=0.0014). In conclusion, the engineering controls were effective in protecting the operators from such exposure. However, routine chemical monitoring is required every 3 years unless there is a change in the processor type of chemicals. Also, frequent management monitoring (daily, weekly, and monthly) is required to ensure the control measures are in place and in use. Furthermore, a Similar Exposure Group (SEG) was identified in this activity and included in the annual health surveillance for health monitoring.Keywords: occupational health and safety, risk assessment, chemical exposure, hierarchy of control, reproductive
Procedia PDF Downloads 1659828 Analysis of the Engineering Judgement Influence on the Selection of Geotechnical Parameters Characteristic Values
Authors: K. Ivandic, F. Dodigovic, D. Stuhec, S. Strelec
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A characteristic value of certain geotechnical parameter results from an engineering assessment. Its selection has to be based on technical principles and standards of engineering practice. It has been shown that the results of engineering assessment of different authors for the same problem and input data are significantly dispersed. A survey was conducted in which participants had to estimate the force that causes a 10 cm displacement at the top of a axially in-situ compressed pile. Fifty experts from all over the world took part in it. The lowest estimated force value was 42% and the highest was 133% of measured force resulting from a mentioned static pile load test. These extreme values result in significantly different technical solutions to the same engineering task. In case of selecting a characteristic value of a geotechnical parameter the importance of the influence of an engineering assessment can be reduced by using statistical methods. An informative annex of Eurocode 1 prescribes the method of selecting the characteristic values of material properties. This is followed by Eurocode 7 with certain specificities linked to selecting characteristic values of geotechnical parameters. The paper shows the procedure of selecting characteristic values of a geotechnical parameter by using a statistical method with different initial conditions. The aim of the paper is to quantify an engineering assessment in the example of determining a characteristic value of a specific geotechnical parameter. It is assumed that this assessment is a random variable and that its statistical features will be determined. For this purpose, a survey research was conducted among relevant experts from the field of geotechnical engineering. Conclusively, the results of the survey and the application of statistical method were compared.Keywords: characteristic values, engineering judgement, Eurocode 7, statistical methods
Procedia PDF Downloads 2909827 Measuring Investigation and Computational Simulation of Cavitation Phenomenon Effects on the Industrial Centrifugal Pump Vibration
Authors: Mahdi Hamzehei, Homan Alimoradzadeh, Mahdi Shahriyari
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In this paper, vibration of the industrial centrifugal pumps studied by measuring analysis and computational simulation. Effects of different parameters on pump vibration were investigated. Also, simulation of cavitation in the centrifugal pump was down. First, via CF-TURBO software, the pump impeller and the fluid passing through the pump is modelled and finally, the phenomenon of cavitation in the impeller has been modelled by Ansys software. Also, the effects of changes in the amount of NPSH and bubbles generation in the pump impeller were investigated. By simulation of piping with pipe flow software, effect of fluid velocity and pressure on hydraulics and vibration were studied computationally by applying Computational Fluid Dynamic (CFD) techniques, fluent software and experimentally. Furthermore, this comparison showed that the model can predict hydraulics and vibration behaviour.Keywords: cavitation, vibration, centrifugal pumps, performance curves, NPSH
Procedia PDF Downloads 5419826 Collocation Assessment between GEO and GSO Satellites
Authors: A. E. Emam, M. Abd Elghany
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The change in orbit evolution between collocated satellites (X, Y) inside +/-0.09 ° E/W and +/- 0.07 ° N/S cluster, after one of these satellites is placed in an inclined orbit (satellite X) and the effect of this change in the collocation safety inside the cluster window has been studied and evaluated. Several collocation scenarios had been studied in order to adjust the location of both satellites inside their cluster to maximize the separation between them and safe the mission.Keywords: satellite, GEO, collocation, risk assessment
Procedia PDF Downloads 3899825 Nurturing of Children with Results from Their Nature (DNA) Using DNA-MILE
Authors: Tan Lay Cheng (Cheryl), Low Huiqi
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Background: All children learn at different pace. Individualized learning is an approach that tailors to the individual learning needs of each child. When implementing this approach, educators have to base their lessons on the understanding that all students learn differently and that what works for one student may not work for another. In the current early childhood environment, individualized learning is for children with diverse needs. However, a typical developing child is also able to benefit from individualized learning. This research abstract explores the concept of utilizing DNA-MILE, a patented (in Singapore) DNA-based assessment tool that can be used to measure a variety of factors that can impact learning. The assessment report includes the dominant intelligence of the user or, in this case, the child. From the result, a personalized learning plan that is tailored to each individual student's needs. Methods: A study will be conducted to investigate the effectiveness of DNA-MILE in supporting individualized learning. The study will involve a group of 20 preschoolers who were randomly assigned to either a DNA-MILE-assessed group (experimental group) or a control group. 10 children in each group. The experimental group will receive DNA Mile assessments and personalized learning plans, while the control group will not. The children in the experimental group will be taught using the dominant intelligence (as shown in the DNA-MILE report) to enhance their learning in other domains. The children in the control group will be taught using the curriculum and lesson plan set by their teacher for the whole class. Parents’ and teachers’ interviews will be conducted to provide information about the children before the study and after the study. Results: The results of the study will show the difference in the outcome of the learning, which received DNA Mile assessments and personalized learning plans, significantly outperformed the control group on a variety of measures, including standardized tests, grades, and motivation. Conclusion: The results of this study suggest that DNA Mile can be an effective tool for supporting individualized learning. By providing personalized learning plans, DNA Mile can help to improve learning outcomes for all students.Keywords: individualized, DNA-MILE, learning, preschool, DNA, multiple intelligence
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