Search results for: multiple group analysis

Authors: Prabhakar Venugopal G.

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Complex environments triggered by globalization have necessitated new paradigms of leadership – complexity leadership that encompasses multiple roles that leaders need to take upon. The success of higher education institutions depends on how well leaders can provide adaptive, administrative and enabling leadership. Complexity leadership seems all the more relevant for institutions that are knowledge-driven and thrive on knowledge creation, knowledge storage and retrieval, knowledge sharing and knowledge applications. In this paper are the elements of globalization, the opportunities and challenges that are brought forth by globalization are discussed. The complexity leadership paradigm in a knowledge-based economy and the need for such a paradigm shift for higher education institutions is presented. Further, the paper also discusses the support the leader requires in a knowledge-driven economy through knowledge management initiatives.

Keywords: globalization, complexity leadership, knowledge management

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Authors: Almas Athif Fathin Wiyantoro, Fransiskus Xaverius Ivan Budiman, Fithra Faisal Hastiadi

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The growth of clothing and technology as a marketing tool has a great influence on online business owners to know how much the characteristics and psychology of consumers in influencing purchasing decisions made by Indonesian women consumers. One of the most important issues faced by Indonesian women consumers is the suitability of clothing. The suitability of clothing can affect the body cathexis, identity, and confidence. So the thematic analysis of clothing fitness and body cathexis of women consumers when and after using virtual fitting room technology to purchase decision is important to do. This research using group method of pre-post treatment and considers how the recruitment technique of snowball sampling, which uses interpersonal relations and connections between people, both includes and excludes individuals into 39 participants' social networks to access specific populations. The results obtained from the study that the results of body scans and photos of virtual fitting room results can be made an intervention in women consumers in assessing their body cathexis objectively in the process of making purchasing decisions. The study also obtained a regression equation Y = 0.830 + 0.290X1 + 0.292X2, showing a positive relationship between suitability of clothing and body cathexis which influenced purchasing decisions on women consumers and after (personal and psychological factors) using virtual fitting room, meaning that all independent variables influence Positive towards the purchasing decision of the women consumers.

Keywords: body cathexis, clothing fitness, purchasing decision making and virtual fitting room

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Authors: Narayanakumar Somasundaram, Venkat Nihit Chirivella, Venkata Dilip Kumar Pasupuleti

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Ajakool, India, has a multi-span bridge that is constructed for rail transport with a maximum operating speed of 100 km/hr. It is a standard RDSO design of a PSC box girder carrying a single railway track. The Structural Health Monitoring System (SHM) is designed and installed to compare and analyze the vibrations and displacements on the bridge due to different live loads from moving trains. The study is conducted for three different spans of the same bridge to understand the health of the elastomeric bearings. Also, to validate the same, a three-dimensional finite element model is developed, and modal analysis is carried out. The proposed methodology can help in detecting deteriorated elastomeric bearings using only wireless tri-accelerometer sensors. Detailed analysis and results are presented in terms of mode shapes, accelerations, displacements, and their importance to each other. This can be implemented with a lot of ease and can be more accurate.

Keywords: dynamic effects, vibration analysis, accelerometer sensors, finite element analysis, structural health monitoring, elastomeric bearing

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Authors: Hyun Kyu Cho, Jun Soo Kim, Young Hoon Lee, Sang Hoon Kang, Young Chul Park

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In the study, structure for one of offshore drilling system APV(Air Pressure Vessle) modules was designed by using topology optimum design and performed structural safety evaluation according to DNV rules. 3D model created base on design area and non-design area separated by using topology optimization for the environmental loads. This model separated 17 types for wind loads and dynamic loads and performed structural analysis evaluation for each model. As a result, the maximum stress occurred 181.25MPa.

Keywords: APV, topology optimum design, DNV, structural analysis, stress

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Authors: Sukrat Sinha, Abhay Kumar, Shanthy Sundaram

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The Leishmania homologue of activated C kinase (LACK) is known T cell epitope from soluble Leishmania antigens (SLA) that confers protection against Leishmania challenge. This antigen has been found to be highly conserved among Leishmania strains. LACK has been shown to be protective against L. donovani challenge. A comprehensive analysis of several LACK sequences was completed. The analysis shows a high level of conservation, lower variability and higher antigenicity in specific portions of the LACK protein. This information provides insights for the potential consideration of LACK as a putative candidate in the context of visceral Leishmaniasis vaccine target.

Keywords: bioinformatics, genome assembly, leishmania activated protein kinase c (lack), next-generation sequencing

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Authors: Norma Binti Alias, Che Rahim Che The, Norfarizan Mohd Said, Sakinah Abdul Hanan, Akhtar Ali

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This paper discusses on the transportation of magnetic drug targeting through blood within vessels, tissues and cells. There are three integrated mathematical models to be discussed and analyze the concentration of drug and blood flow through magnetic nanoparticles. The cell therapy brought advancement in the field of nanotechnology to fight against the tumors. The systematic therapeutic effect of Single Cells can reduce the growth of cancer tissue. The process of this nanoscale phenomena system is able to measure and to model, by identifying some parameters and applying fundamental principles of mathematical modeling and simulation. The mathematical modeling of single cell growth depends on three types of cell densities such as proliferative, quiescent and necrotic cells. The aim of this paper is to enhance the simulation of three types of models. The first model represents the transport of drugs by coupled partial differential equations (PDEs) with 3D parabolic type in a cylindrical coordinate system. This model is integrated by Non-Newtonian flow equations, leading to blood liquid flow as the medium for transportation system and the magnetic force on the magnetic nanoparticles. The interaction between the magnetic force on drug with magnetic properties produces induced currents and the applied magnetic field yields forces with tend to move slowly the movement of blood and bring the drug to the cancer cells. The devices of nanoscale allow the drug to discharge the blood vessels and even spread out through the tissue and access to the cancer cells. The second model is the transport of drug nanoparticles from the vascular system to a single cell. The treatment of the vascular system encounters some parameter identification such as magnetic nanoparticle targeted delivery, blood flow, momentum transport, density and viscosity for drug and blood medium, intensity of magnetic fields and the radius of the capillary. Based on two discretization techniques, finite difference method (FDM) and finite element method (FEM), the set of integrated models are transformed into a series of grid points to get a large system of equations. The third model is a single cell density model involving the three sets of first order PDEs equations for proliferating, quiescent and necrotic cells change over time and space in Cartesian coordinate which regulates under different rates of nutrients consumptions. The model presents the proliferative and quiescent cell growth depends on some parameter changes and the necrotic cells emerged as the tumor core. Some numerical schemes for solving the system of equations are compared and analyzed. Simulation and computation of the discretized model are supported by Matlab and C programming languages on a single processing unit. Some numerical results and analysis of the algorithms are presented in terms of informative presentation of tables, multiple graph and multidimensional visualization. As a conclusion, the integrated of three types mathematical modeling and the comparison of numerical performance indicates that the superior tool and analysis for solving the complete set of magnetic drug delivery system which give significant effects on the growth of the targeted cancer cell.

Keywords: mathematical modeling, visualization, PDE models, magnetic nanoparticle drug delivery model, drug release model, single cell effects, avascular tumor growth, numerical analysis

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Authors: Leonard Chimaobi Agim, Charles Arinzechukwu Igwe, Emmanuel Uzoma Onweremadu, Gabreil Osuji

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Soil erosion has been linked to stream sedimentation, ecosystem degradation, and loss of soil nutrients. A study was conducted to evaluate the effect of some organic amendment on sediment yield, splash loss, and runoff of soils of selected parent materials in southeastern Nigeria. A total of 20 locations, five from each of four parent materials namely: Asu River Group (ARG), Bende Ameki Group (BAG), Coastal Plain Sand (CPS) and Falsebedded Sandstone (FBS) were used for the study. Collected soil samples were analyzed with standard methods for the initial soil properties. Rainfall simulation at an intensity of 190 mm hr-1was conducted for 30 minutes on the soil samples at both the initial stage and after amendment to obtain erosion parameters. The influence of parent material on sediment yield, splash loss and runoff based on rainfall simulation was tested for using one way analyses of variance, while the influence of organic material and their combinations were a factorially fitted in a randomized complete block design. The organic amendments include; goat dropping (GD), poultry dropping (PD), municipal solid waste (MSW) and their combinations (COA) applied at four rates of 0, 10, 20 and 30 t ha-1 respectively. Data were analyzed using analyses of variance suitable for a factorial experiment. Significant means were separated using LSD at 5 % probability levels. Result showed significant (p ≤ 0.05) lower values of sediment yield, splash loss and runoff following amendment. For instance, organic amendment reduced sediment yield under wet and dry runs by 12.91 % and 26.16% in Ishiagu, 40.76% and 45.67%, in Bende, 16.17% and 50% in Obinze and 22.80% and 42.35% in Umulolo respectively. Goat dropping and combination of amendment gave the best results in reducing sediment yield.

Keywords: organic amendment, parent material, rainfall simulation, soil erosion

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Authors: Nazli W. Hardy

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A critical component in the Internet of Things (IoT) ecosystem is the need for secure and appropriate transmission, processing, and storage of the data. Our current forms of authentication, and identity and access management do not suffice because they are not designed to service cohesive, integrated, interconnected devices, and service applications. The seemingly endless opportunities of IoT are in fact circumscribed on multiple levels by concerns such as trust, privacy, security, loss of control, and related issues. This paper considers multi-factor authentication (MFA) mechanisms and cohesive identity relationship management (IRM) standards. It also surveys messaging protocols that are appropriate for the IoT ecosystem.

Keywords: identity relation management, multifactor authentication, protocols, survey of internet of things ecosystem

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Authors: Saul A. Torres Z., Eduardo Liceaga C., Alfredo Arias M.

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We seek to develop a UAV for agricultural spraying at a maximum altitude of 5000 meters above sea level, with a payload of 100 liters of fumigant. For the developing the aerodynamic design of the aircraft is using computational tools such as the "Vortex Lattice Athena" software, "MATLAB", "ANSYS FLUENT", "XFoil" package among others. Also methods are being used structured programming, exhaustive analysis of optimization methods and search. The results have a very low margin of error, and the multi-objective problems can be helpful for future developments. Also we developed method for Stability Analysis (Lateral-Directional and Longitudinal).

Keywords: aerodynamics design, optimization, algorithm genetic, multi-objective problem, longitudinal stability, lateral-directional stability

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Authors: Piyas Palit, Urbi Pal, Jitendra Mathur, Santanu Das

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Bearing is an important machinery part in the industry. When bearings fail to meet their expected life the consequences are increased downtime, loss of revenue and missed the delivery. This article describes the failure of a gearbox bearing in rolling contact fatigue. The investigation consists of visual observation, chemical analysis, characterization of microstructures using optical microscopes and hardness test. The present study also considers bearing life as well as the operational condition of bearings. Surface-initiated rolling contact fatigue, leading to a surface failure known as pitting, is a life-limiting failure mode in many modern machine elements, particularly rolling element bearings. Metallography analysis of crack propagation, crack morphology was also described. Indication of fatigue spalling in the ferrography test was also discussed. The analysis suggested the probable reasons for such kind of failure in operation. This type of spalling occurred due to (1) heavier external loading condition or (2) exceeds its service life.

Keywords: bearing, rolling contact fatigue, bearing life

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Authors: Farah Al Zaabi, Sarah Amrani

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Complex regional pain syndrome (CRPS) is a chronic pain condition that develops in an extremity following a fracture, soft tissue injury, or surgery. It is a neuropathic pain disorder that is accompanied by the characteristic skin manifestations that are needed for the diagnosis. We report the case of a 30 year old male, who has findings consistent with CRPS and has been followed for over two years by multiple specialties within the healthcare system without obtaining a diagnosis. The symptoms he presented with were treated based on the specialty he was seeing, rather than unified and recognized as a single disease process. Our case highlights the complexity of chronic pain, which can sometimes present with skin manifestations, and the importance of involving a pain specialist early for both the medical and physical recovery of CRPS patients.

Keywords: complex regional pain syndrome, chronic pain, skin changes of CRPS, dermatological manifestions of CRPS

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Authors: Abdulsallam A. Bakdash, Aiyshah M. Alshehri, Hind M. Alenzi

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Benzatropine (benztropine) is used to treat symptoms of Parkinson's disease or involuntary movements due to the side effects of certain psychiatric drugs. We report in this study, results of a procedure for the determination of benzatropine in hair using LLE, once with methanol and second with phosphate buffer (pH 6.0), followed by filtration and then re-extraction with dichloromethane. A GC/MS method was developed and validated for this determination using selected ion monitoring (SIM) detection without derivatization. Linearity established over the concentration range 0.1-20.0 ng/mg hair, and the correlation coefficients were greater than 0.99. Recoveries were 52.2% and 21.1% using methanol and phosphate buffer extraction, respectively. Detection limits of benzatropine in hair were between 0.65 and 3.0 ng/mg hair, while the accuracy were 10.4% and 18.5% (RSD), respectively. We also applied this method to the analysis of soaked hair samples and demonstrated that the LLE using methanol meets the requirement for the analysis of benzatropine in hair.

Keywords: hair analysis, benzatropine, liquid-liquid extraction, GC/MS

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Authors: Debolina Chatterjee, Suhita Chopra Chatterjee

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Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.

Keywords: imprisonment, Indian prisons, prison healthcare, punishment

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Authors: Vipin Kumar Singhal, Rohit Kumar Mittal, Pavitra Ranjan Maiti

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Damage analysis is one of the preliminary activities to be done after an earthquake so as to enhance the seismic building design technologies and prevent similar type of failure in future during earthquakes. This research article investigates the damage pattern and most probable reason of failure by observing photographs of seven major buildings collapsed/damaged which were evenly spread over the region during Mw7.8, Nepal earthquake 2015 followed by more than 400 aftershocks of Mw4 with one aftershock reaching a magnitude of Mw7.3. Over 250,000 buildings got damaged, and more than 9000 people got injured in this earthquake. Photographs of these buildings were collected after the earthquake and the cause of failure was estimated along with the severity of damage and comment on the reparability of structure has been made. Based on observations, it was concluded that the damage in reinforced concrete buildings was less compared to masonry structures. The number of buildings damaged was high near Kathmandu region due to high building density in that region. This type of damage analysis can be used as a cost effective and quick method for damage assessment during earthquakes.

Keywords: Nepal earthquake, damage analysis, damage assessment, damage scales

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Authors: Ting Shen

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Whether resource matters to school has been a topic of intense debate since 1960s. Educational researchers and policy makers have been particularly interested in knowing the return or payoff of Per-Pupil Expenditure (PPE) on improving students’ achievement. However, the evidence on the effect of PPE has been mixed and the size of the effect is also unknown. With regard to the methods, it is well-known that meta-analysis study is superior to individual study and it is also preferred to vote counting method in terms of scientifically weighting the evidence by the sample size. This meta-analysis study aims to provide a synthesized evidence on the correlation between PPE and student academic achievement using recent study data from 1990s to 2010s. Meta-analytical approach of fixed- and random-effects models will be utilized in addition to a meta regression with predictors of year, location, region and school type. A preliminary result indicates that by and large there is no statistically significant relationship between per pupil expenditure and student achievement, but location seems to have a mediating effect.

Keywords: per pupil expenditure, student academic achievement, multilevel model, meta-analysis

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Authors: Anand Malik

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The Himalayas with high tectonic activities poses a great threat to human life and property. Climate change is another reason which triggering extreme events multiple fold effect on high mountain glacial environment, rock falls, landslides, debris flows, flash flood and snow avalanches. One such extreme event of cloud burst along with breach of moraine dammed Chorabri Lake occurred from June 14 to June 17, 2013, triggered flooding of Saraswati and Mandakini rivers in the Kedarnath Valley of Rudraprayag district of Uttrakhand state of India. As a result, huge volume of water with its high velocity created a catastrophe of the century, which resulted into loss of large number of human/animals, pilgrimage, tourism, agriculture and property. Thus a comprehensive assessment of debris flow hazards requires GIS-based modeling using numerical methods. The aim of present study is to focus on analysis and mapping of debris flow movements using geospatial data with flow-r (developed by team at IGAR, University of Lausanne). The model is based on combined probabilistic and energetic algorithms for the assessment of spreading of flow with maximum run out distances. Aster Digital Elevation Model (DEM) with 30m x 30m cell size (resolution) is used as main geospatial data for preparing the run out assessment, while Landsat data is used to analyze land use land cover change in the study area. The results of the study area show that model can be applied with great accuracy as the model is very useful in determining debris flow areas. The results are compared with existing available landslides/debris flow maps. ArcGIS software is used in preparing run out susceptibility maps which can be used in debris flow mitigation and future land use planning.

Keywords: debris flow, geospatial data, GIS based modeling, flow-R

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Authors: Jeries J. Abou-Hanna, Bradley Storm

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This paper looks to reduce the complexity of determining stress intensity factors while maintaining high levels of accuracy by the use of a linearized layering approach. Many techniques for stress intensity factor determination exist, but they can be limited by conservative results, requiring too many user parameters, or by being too computationally intensive. Multiple notch geometries with various crack lengths were investigated in this study to better understand the effectiveness of the proposed method. By linearizing the average stresses in radial layers around the crack tip, stress intensity factors were found to have error ranging from -10.03% to 8.94% when compared to analytically exact solutions. This approach proved to be a robust and efficient method of accurately determining stress intensity factors.

Keywords: fracture mechanics, finite element method, stress intensity factor, stress linearization

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Authors: Sarah Mohammed, Huda Allagany, Ayah Barakat, Muna Elyas

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This paper delves into the history and development of ChatGPT, tracing its evolution from its inception by OpenAI to its current state, and emphasizing its design improvements and strategic partnerships. It also explores the performance and applicability of ChatGPT versions 3.5 and 4 in various contexts, examining its capabilities and limitations in producing accurate and relevant responses. Utilizing a quantitative approach, user satisfaction, speed of response, learning capabilities, and overall utility in academic performance were assessed through surveys and analysis tools. Findings indicate that while ChatGPT generally delivers high accuracy and speed in responses, the need for clarification and more specific user instructions persists. The study highlights the tool's increasing integration across different sectors, showcasing its potential in educational and professional settings.

Keywords: artificial intelligence, chat GPT, analysis, education

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Authors: Çiğdem Avcı Karataş

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Mitigation of structural damage caused by earthquake and reduction of fatality is one of the main concerns of engineers in seismic prone zones of the world. To achieve this aim many technologies have been developed in the last decades and applied in construction and retrofit of structures. On the one hand Turkey is well-known a country of high level of seismicity; on the other hand steel-composite structures appear competitive today in this country by comparison with other types of structures, for example only-steel or concrete structures. Composite construction is the dominant form of construction for the multi-storey building sector. The reason why composite construction is often so good can be expressed in one simple way - concrete is good in compression and steel is good in tension. By joining the two materials together structurally these strengths can be exploited to result in a highly efficient design. The reduced self-weight of composite elements has a knock-on effect by reducing the forces in those elements supporting them, including the foundations. The floor depth reductions that can be achieved using composite construction can also provide significant benefits in terms of the costs of services and the building envelope. The scope of this paper covers analysis, materials take-off, cost analysis and economic comparisons of a multi-storey building with composite and steel frames. The aim of this work is to show that designing load carrying systems as composite is more economical than designing as steel. Design of the nine stories building which is under consideration is done according to the regulation of the 2007, Turkish Earthquake Code and by using static and dynamic analysis methods. For the analyses of the steel and composite systems, plastic analysis methods have been used and whereas steel system analyses have been checked in compliance with EC3 and composite system analyses have been checked in compliance with EC4. At the end of the comparisons, it is revealed that composite load carrying systems analysis is more economical than the steel load carrying systems analysis considering the materials to be used in the load carrying system and the workmanship to be spent for this job.

Keywords: composite analysis, earthquake, steel, multi-storey building

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Authors: Hamed Zolfaghari, Mojtaba Kord

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After feasibility study the design phase is started and the rest of other phases are highly dependent on this phase. forecasting the duration of design phase could do a miracle and would save a lot of time. This study provides a fast and accurate Machine learning (ML) and optimization framework, which allows a quick duration estimation of project design phase, hence improving operational efficiency and competitiveness of a design construction company. 3 data sets of three years composed of daily time spent for different design projects are used to train and validate the ML models to perform multiple projects. Our study concluded that Artificial Neural Network (ANN) performed an accuracy of 0.94.

Keywords: time estimation, machine learning, Artificial neural network, project design phase

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Authors: Joon-Ho Lee, Jeong-Hwan Yoon, Jung-Hwan Yoon, Sangmo Kang, Su-Yeon Hong, Hyun-Woo Jeong, Jaeick Chae

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There are several dedicated individual chambers for sports that are supplied and used, but none of them are multi-pressured all-in-one chambers that can provide a sports multi-environment simultaneously. In this study, we design a multi-pressure (positive/atmospheric/negative pressure) integrated vessel that can be used for the sport-multi-artificial environment system. We presented additional vessel designs with enlarged space for the tall users; with reinforcement pads added to reduce the maximum stress in the joints of its shells, and then carried out numerical analysis for the structural analysis with maximum stress and structural safety. Under the targeted allowable pressure conditions, maximum stresses occurred at the joint of the shell, and the entrance, the safety of the structure was checked with the allowable stress of its material.

Keywords: structural analysis, multi-pressure, integrated vessel, sport-multi-artificial environment

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Authors: Ammar Aljabri, Alhussain Halawani, Alaa Ashqar, Omar Alageely

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Objective: mild Traumatic Brain Injury (mTBI) or concussion is a common yet undermanaged and underreported condition. This systematic review and meta-analysis aim to determine the efficacy of VRT as a treatment option for mTBI. Method: This review and meta-analysis was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included RCTs and pre-VRT/post-VRT retrospective chart reviews. Records meeting the inclusion criteria were extracted from the following databases: Medline, Embase, and Cochrane Register of Controlled Trials (CENTRAL). Results: Eight articles met the inclusion criteria, and six RCTs were included in the meta-analysis. VRT demonstrated significant improvement in decreasing perceived dizziness at the end of the intervention program, as shown by DHI scores (SMD= -0.33, 95% CI -0.62 to -0.03, p=0.03, I2= 0%). However, no significant reduction in DHI was evident after two months of follow-up (SMD= 0.15, 95% CI -0.23 to 0.52, p=0.44, I2=0%). Quantitative analysis also depicts significant reduction in both VOMS (SMD=-0.40, 95% CI -0.60 to -0.20, p<0.0001, I2=0%) and PCSS (SMD= -0.39, 95% CI -0.71 to -0.07, p=0.02, I2=0%) following the intervention. Lastly, there was no significant difference between intervention groups on BESS scores (SMD= -31, 95% CI -0.71 to 0.10, p=0.14, I2=0%) and return to sport/function (95% CI 0.32 to 30.80, p=0.32, I2=82%). Conclusions: Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provide evidence that supports the role of VRT in improving perceived symptoms following concussion. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.

Keywords: concussion, traumatic brain injury, vestibular rehabilitation, neurorehabilitation

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Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: Milan N. A. Van Der Kuil, Anne M. A. Visser-Meily, Andrea W. M. Evers, Ineke J. M. Van Der Ham

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Navigation ability is essential for autonomy and mobility in daily life. In patients with acquired brain injury, navigation impairment is frequently impaired; however, in this study, we tested the effectiveness of a serious gaming training protocol as a tool for cognitive rehabilitation to reduce navigation impairment. In total, 38 patients with acquired brain injury and subjective navigation complaints completed the experiment, with a partially blind, randomized control trial design. An objective navigation test was used to construct a strengths and weaknesses profile for each patient. Subsequently, patients received personalized compensation training that matched their strengths and weaknesses by addressing an egocentric or allocentric strategy or a strategy aimed at minimizing the use of landmarks. Participants in the experimental condition received psychoeducation and a home-based rehabilitation game with a series of exercises (e.g., map reading, place finding, and turn memorization). The exercises were developed to stimulate the adoption of more beneficial strategies, according to the compensatory approach. Self-reported navigation ability (wayfinding questionnaire), participation level, and objective navigation performance were measured before and after 1 and 4 weeks after completing the six-week training program. Results indicate that the experimental group significantly improved in subjective navigation ability both 1 and 4 weeks after completion of the training, in comparison to the score before training and the scores of the control group. Similarly, goal attainment showed a significant increase after the first and fourth week after training. Objective navigation performance was not affected by the training. This navigation training protocol provides an effective solution to address navigation impairment after acquired brain injury, with clear improvements in subjective performance and goal attainment of the participants. The outcomes of the training should be re-examined after implementation in a clinical setting.

Keywords: spatial navigation, cognitive rehabilitation, serious gaming, acquired brain injury

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Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

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Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: average run length (ARL), bernoulli cusum (BC) chart, beta binomial posterior predictive (BBPP) distribution, clinical indicator (CI), healthcare organization (HCO), highest posterior density (HPD) interval

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Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

Abstract:

Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

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Authors: Hadas Hirsch

Abstract:

Clothing is aimed at concealing and revealing the body, protecting it, and manifesting religious, political, and social declarations. The material and symbolic meanings of clothing and its raw materials are evaluated through the context of their social, cultural, and religious systems. The raw materials for clothing that were frequent and familiar in the 7th century Arab Peninsula were wool, leather, cotton, and some kinds of silk. The spread of the Muslim empire and the intersections with other religions and cultures enable the trickling of new raw materials that were unknown to Muslims or unaccepted. The sources for this research are hadith collections that discuss in details various kinds of textiles and their origin, together with a legal explanation that permits or prohibits its use. The paper will describe and analyze this discussion by contextualizing it in social, religious, and cultural reality that creates a structure of socio-religious dependency. The aim is not to identify, catalogue, and technically analyze fabrics but to reveal their role in Muslims’ life as a means of creating dependency for the community and setting borders inside and outside. The analysis is built upon a scale that starts with the most recommended raw materials, then comes the permitted ones and, in the end, the prohibited raw materials. This mapping will provide an insight into the ways textiles, as a cultural medium, help to shape and redefine identities and, at the same time, enable a sphere for creative expression within socio-cultural and religious limits and context. To sum up, hadith literature has the main role is characterizing Muslim clothing, from garments to textiles and colors, including multiple variations and contradicting aspects. The Muslim style of clothing and, in particular, textiles is a manifestation of the socio-religious structure of dependency that creates differentiated Muslim identity together with subdivision of gendered groups. Some other aspects are the tension between authenticity and imitation and the jurists’ pragmatic and practice attitude that enables an individual sphere of expression within the limits of jurisprudence.

Keywords: Hadith, jurisprudence, medieval Islam, material culture

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Authors: Winnie Wing Mui So, Yu Chen

Abstract:

This study investigated primary school teachers’ and students’ perceptions of science learning in an e-learning environment. This study used a multiple case study design and involved eight science teachers and their students from four Hong Kong primary schools. The science topics taught included ‘season and weather’ ‘force and movement’, ‘solar and lunar eclipse’ and ‘living things and habitats’. Data were collected through lesson observations, interviews with teachers, and interviews with students. Results revealed some differences between the teachers’ and the students’ perceptions regarding the usefulness of e-learning resources, the organization of student-centred activities, and the impact on engagement and interactions in lessons. The findings have implications for the more effective creation of e-learning environments for science teaching and learning in primary schools.

Keywords: e-learning, science education, teacher' and students' perceptions, primary schools

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Authors: William Feng, Qingyu Gao

Abstract:

Despite the extensive discussions about Hong Kong’s sentiments towards the Chinese Mainland since the sovereignty transfer in 1997, there has been no large-scale empirical analysis of the changing attitudes in the mainstream media, which both reflect and shape sentiments in the society. To address this gap, the present study uses an optimised semantic-based automatic sentiment analysis method to examine a corpus of news about China from 1997 to 2020 in three main Chinese-language newspapers in Hong Kong, namely Apple Daily, Ming Pao, and Oriental Daily News. The analysis shows that although the Hong Kong press had a positive emotional tone toward China in general, the overall trend of sentiment was becoming increasingly negative. Meanwhile, the alignment and antagonism toward China have both increased, providing empirical evidence of attitudinal polarisation in the Hong Kong society. Specifically, Apple Daily’s depictions of China have become increasingly negative, though with some positive turns before 2008, whilst Oriental Daily News has consistently expressed more favourable sentiments. Ming Pao maintained an impartial stance toward China through an increased but balanced representation of positive and negative sentiments, with its subjectivity and sentiment intensity growing to an industry-standard level. The results provide new insights into the complexity of sentiments towards China in the Hong Kong press and media attitudes in general in terms of the “us” and “them” positioning by explicating the cross-newspaper and cross-period variations using an enhanced sentiment analysis method which incorporates sentiment-oriented and semantic role analysis techniques.

Keywords: media attitude, sentiment analysis, Hong Kong press, one country two systems

Procedia PDF Downloads 88