Search results for: status of test automation

Authors: Sadeq Al Yaari, Fayza Al Hammadi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari, Salah Al Yami

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Background: When we further take Arabic grammatical issues into account in accordance with applied linguistic investigations on Arabic as Second Language (ASL) learners, a fundamental issue arises at this point as to the production of speech in Arabic: Oral grammatical errors committed by ASL learners. Aims: Using manual rating as well as computational analytic methodology to test a corpus of recorded speech by Second Language (ASL) learners of Arabic, this study aims to find the areas of difficulties in learning Arabic grammar. More specifically, it examines how and why ASL learners make grammatical errors in their oral speech. Methods: Tape recordings of four (4) Arabic as Second Language (ASL) learners who ranged in age from 23 to 30 were naturally collected. All participants have completed an intensive Arabic program (two years) and 20 minute-speech was recorded for each participant. Having the collected corpus, the next procedure was to rate them against Arabic standard grammar. The rating includes four processes: Description, analysis and assessment. Conclusions: Outcomes made from the issues addressed in this paper can be summarized in the fact that ASL learners face many grammatical difficulties when studying Arabic word order, tenses and aspects, function words, subject-verb agreement, verb form, active-passive voice, global and local errors, processes-based errors including addition, omission, substitution or a combination of any of them.

Keywords: grammar, error, oral, Arabic, second language, learner, applied linguistics.

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Authors: Manal Al Bahri, Saif Al Mubahisi, Shamsa Al Shahaimi, Asma Al Qasabi, Jamal Al Aghbari

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Introduction: ILD is a common disease worldwide and in Oman. No previous Omani study was published regarding ILD prognosis based on baseline PFT results and other factors. This study aims to determine the severity of ILD by the baseline PFT, correlate between baseline PFT and outcome, and study other factors that influence disease mortality. Method: It is a retrospective cohort study; data was collected from January 2011 to December 2021 from electronic patient records (EPR). Means, Standard Deviations, frequencies, and Chi-square tests were used to examine the different variables in the study. Results: The total population of the study was 146 patients; 87 (59.6%) were females, and 59 (40.4%) were males. The median age was 59 years. Age at diagnosis, CVA, rheumatological disease, and baseline FVC were found to be statistically significant predictors of mortality .59.6% of the patients are diagnosed with IPF. Most of our study patients had mild disease based on baseline FVC. Death was higher with the more severe disease based on FVC. In mild disease (FVC >70%), 26.9% of the patients died. In moderate disease (FVC 50-69%),55.7% of the patients died, and in the severe group (FVC <50 %), 55.1% died. This was statistically significant with a P value of 0. 001. There is no statistically significant difference in the overall survival distribution between the different groups of DLCO. Conclusion: In our study, we found that ILD is more common among females, but death is more common among males. Based on baseline PFT, we can predict mortality by FVC level, as moderate to severe limitation is associated with a lower survival rate. DLCO was not a statistically significant parameter associated with mortality.

Keywords: PFT, ILD, FVC, DLCO, mortality

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Authors: Bassma A. Abdelhaleem, Mamdouh A. Abdulrhman, Nagwa I. Mohamed

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Malnutrition in children is an increasing problem worldwide which may result in both short and long-term irreversible negative health outcomes. Severe Acute Malnutrition (SAM) affects more than 18 million children each year, mostly living in low-income settings. SAM contributes to 45% of all deaths in children less than five years of age. Honey is a natural sweetener, containing mainly monosaccharides (up to 80%), disaccharides (3–5%), water (17–20%), and a wide range of minor constituents such as vitamins, minerals, proteins, amino acids, enzymes, and phytochemicals, mainly phenolic acids, and flavonoids. Honey has been used in many cultures around the world due to its known nutritional and medicinal benefits including the treatment of hypercholesterolemia. Despite its use since ancient times yet little is known about its potential benefits for malnourished children. Honey has the potential to be an affordable solution for malnourished low-income children as it is nutrient-dense and calorie dense food, easily absorbed, highly palatable, enhances appetite, and boosts immunity. This study assessed the effect of clover honey supplementation on the anthropometric measurements and lipid profile of malnourished infants and children. A prospective interventional clinical trial was conducted between November 2019 to November 2020, on 40 malnourished infants and children divided into two groups: Group A (20 children; 11 males and 9 females) received honey in a dose of 1.75ml/kg/dose, twice weekly for 12 weeks and Group B (20 children; 6 males and 14 females) received placebo. Written informed consent was obtained for parents/guardians. Patients were recruited from the Pediatric Nutrition Clinic at Ain Shams University. Anthropometric measurements (weight, height, body mass index, head circumference, and mid-arm circumference) and fasting serum cholesterol levels were measured at baseline and after 3 months. The 3-month honey consumption had a statistically highly significant effect on increasing weight, height, and body mass index and lowering fasting serum cholesterol levels in primary malnourished infants and children. Weight, height, body mass index, and fasting serum cholesterol level before honey consumption were (9.49 ± 2.03, 81.45 ± 8.31, 14.24 ± 2.15, 178.00 ± 20.91) and after 3 months of honey consumption were (10.91 ± 2.11, 84.80 ± 8.23, 15.07 ± 2.05, 162.45 ± 19.73) respectively with P-value < 0.01. Our results showed a significant desirable effect of honey consumption on changes in nutritional status based on weight, height, and body mass index, and has a favourable effect on lowering fasting serum cholesterol levels. These results propose the use of honey as an affordable solution to improve malnutrition, particularly in low-income countries. However, further research needs to weigh benefits against potential harms including the risk of botulinum toxin that is historically associated with honey consumption in early childhood.

Keywords: clinical trial, dyslipidemia, honey, malnutrition

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Authors: Teklebrhan Kidane

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The aim of this study is to investigate the species diversity and relative abundance of migratory waterbirds in Abijata Lake, an Important Bird Area and potential Ramsar site located in the Central Rift Valley of Ethiopia. The study was carried out, using line transect method along the shoreline and open area of the Lake. The data was analyzed with different diversity indices; t-Test and descriptive statistics. Thirty-two migratory waterbird species grouped into twelve families consisting of globally threatened birds were identified and recorded. Family Scolopacidae (12 species) had the highest number of species. The lowest number of species was observed under the families Ciconidae, Accipitridae, Laridae and Falconidae with one species each. The recorded bird species comprised 19 Palearctic, 5 Intra-African, 2 local migrants as well as 6 resident Palearctic migratory waterbird species. The dry season had higher species diversity (H'=1.01) compared to the wet season (H'=0.76). The highest and lowest diversity of migratory waterbirds were recorded during January (H'= 1.28) and June (H'= 0.52), respectively. However, the highest evenness (E) of bird species was recorded during wet season (E=0.21) and lower during the dry season (E=0.09). The computed seasonal effect reveals that there is significant effect of seasons on species diversity (t=2.80, P < 0.05), but the effect of seasons on individuals of migratory bird species was not significant (t=1.42, P > 0.05). Even though Lake Abijata is the sanctuary of several migratory waterbirds, anthropogenic activities are rigorously threatening their survival. Therefore, it needs an urgent conservation concern.

Keywords: migration, important bird area, species diversity, wetland birds

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Authors: Virginia Vettori, Chiara Lorini, Vieri Lastrucci, Giulia Di Pisa, Alessia De Blasi, Sara Giuggioli, Guglielmo Bonaccorsi

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The design of the Nutrition Literacy Assessment Instrument (NLit) responds to the need to provide a tool to adequately assess the construct of nutrition literacy (NL), which is strictly connected to the quality of the diet and nutritional health status. The NLit was originally developed and validated in the US context, and it was recently validated for Italian people too (NLit-IT), involving a sample of N = 74 adults. The results of the cross-cultural adaptation of the tool confirmed its validity since it was established that the level of NL contributed to predicting the level of adherence to the Mediterranean Diet (convergent validity). Additionally, results obtained proved that Internal Consistency and reliability of the NLit-IT were good (Cronbach’s alpha (ρT) = 0.78; 95% CI, 0.69–0.84; Intraclass Correlation Coefficient (ICC) = 0.68, 95% CI, 0.46–0.85). However, the Subscale 3 of the NLit-IT “Household Food Measurement” showed lower values of ρT and ICC (ρT = 0.27; 95% CI, 0.1–0.55; ICC = 0.19, 95% CI, 0.01–0.63) than the entire instrument. Subscale 3 includes nine items which are constituted by written questions and the corresponding pictures of the meals. In particular, items 2, 3, and 8 of Subscale 3 had the lowest level of correct answers. The purpose of the present study was to identify the factors that influenced the Internal Consistency and reliability of Subscale 3 of NLit-IT using the methodology of a focus group. A panel of seven experts was formed, involving professionals in the field of public health nutrition, dietetics, and health promotion and all of them were trained on the concepts of nutrition literacy and food appearance. A member of the group drove the discussion, which was oriented in the identification of the reasons for the low levels of reliability and Internal Consistency. The members of the group discussed the level of comprehension of the items and how they could be readapted. From the discussion, it emerges that the written questions were clear and easy to understand, but it was observed that the representations of the meal needed to be improved. Firstly, it has been decided to introduce a fork or a spoon as a reference dimension to better understand the dimension of the food portion (items 1, 4 and 8). Additionally, the flat plate of items 3 and 5 should be substituted with a soup plate because, in the Italian national context, it is common to eat pasta or rice on this kind of plate. Secondly, specific measures should be considered for some kind of foods such as the brick of yogurt instead of a cup of yogurt (items 1 and 4). Lastly, it has been decided to redo the photos of the meals basing on professional photographic techniques. In conclusion, we noted that the graphical representation of the items strictly influenced the level of participants’ comprehension of the questions; moreover, the research group agreed that the level of knowledge about nutrition and food portion size is low in the general population.

Keywords: nutritional literacy, cross cultural adaptation, misinformation, food design

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Authors: Vemula Amalakrishna, S. Pushpavanam

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Change and motion characterize and persistently reshape the world around us, on scales from molecular to global. The subtle interplay between change (Reaction) and motion (Diffusion) gives rise to an astonishing intricate spatial or temporal pattern. These pattern formation in nature has been intellectually appealing for many scientists since antiquity. Periodic precipitation patterns, also known as Liesegang patterns (LP), are one of the stimulating examples of such self-assembling reaction-diffusion (RD) systems. LP formation has a great potential in micro and nanotechnology. So far, the research on LPs has been concentrated mostly on how these patterns are forming, retrieving information to build a universal mathematical model for them. Researchers have developed various theoretical models to comprehensively construct the geometrical diversity of LPs. To the best of our knowledge, simulation studies of LPs assume an arbitrary value of RD parameters to explain experimental observation qualitatively. In this work, existing models were studied to understand the mechanism behind this phenomenon and challenges pertaining to models were understood and explained. These models are not computationally effective due to the presence of discontinuous precipitation rate in RD equations. To overcome the computational challenges, smoothened Heaviside functions have been introduced, which downsizes the computational time as well. Experiments were performed using a conventional LP system (AgNO₃-K₂Cr₂O₇) to understand the effects of different gels and temperatures on formed LPs. The model is extended for real parameter values to compare the simulated results with experimental data for both 1-D (Cartesian test tubes) and 2-D(cylindrical and Petri dish).

Keywords: reaction-diffusion, spatio-temporal patterns, nucleation and growth, supersaturation

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Authors: Ya-Ju Ju, Li-Chen Yang, Yi-Chun Du, Rong-Ju Cherng

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Introduction: It is estimated that 5-6% of school-aged children may be diagnosed to have developmental coordination disorder (DCD). Children with DCD are characterized with motor skill difficulty which cannot be explained by any medical or intellectual reasons. Such motor difficulties limit children’s participation to sports activity, further affect their physical fitness, cardiopulmonary function and balance, and may lead to obesity. The purpose of the project was to develop an exergaming system for children with DCD aiming to improve their physical fitness, cardiopulmonary function and balance ability. Methods: This study took five steps to build up the system: system planning, tasks selection, tasks programming, system integration and usability test. The system basically adopted virtual reality technique to integrate self-developed training programs. The training programs were developed to brainstorm among team members and after literature review. The selected tasks for training in the system were a combination of fundamental movement tor skill. Results and Discussion: Based on the theory of motor development, we design the training task from easy ones to hard ones, from single tasks to dual tasks. The tasks included walking, sit to stand, jumping, kicking, weight shifting, side jumping and their combination. Preliminary study showed that the tasks presented an order of development. Further study is needed to examine its effect on motor skill and cardiovascular fitness in children with DCD.

Keywords: virtual reality, virtual reality system, developmental coordination disorder, children

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Authors: Rozh Abdulrahman Kareem

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The displacement of individuals has become a common interest for international players. Mostly occurs in Islamic states, as religion is considered the most common cause of this form of displacement. Therefore, this thesis aims to depict the reality of the situations of the refugees, particularly in KRI, illustrating how they are treated and protected and if the treatment merits the protection clause as envisaged in the 1951 Refugee Convention. Overall, the aim is to touch on the issue of protection by non-governmental organizations and government towards the refugees here. In light of this, it focused on the adequate protection of refugees in relation to the refugee law. In the Middle East, including Iraq, there have been multiple reports on violations of these refugee laws and human rights. Protection involves providing physical security to the concerned parties, functional administration with legal structures, and infrastructural setup that could help citizens exercise rights. The KRI has provided the refugees with various benefits, including education, access to residency, and employment. It also provided transitionary in various social dimensions like gender-based violence. The Convention on Status of Refugees 1951 tried to resolve this problem, whereby the principle of ‘nonrefoulement’ under Article 33 was passed. The ‘nonrefoulement’, an exceptional reference, was enacted to protect refugees from forcible return to their countries of the original. However, the convention never addressed an unusual scenario regarding the application of this principle, ‘Extradition Treaties.’ Even though some scholarly article exists regarding the problems of refugees, the topic of interplay between Nonrefoulement and Extradition Treaties has never been explained in detail in the available books on refugee laws and practices. Each year, millions of refugees seek protection from foreign countries for fear of being tortured, victimized, or executed. People seeking international protection are susceptible and insecure. The main objective of the prevention is to provide security to citizens susceptible to inhuman treatment, distress, oppression, or other human rights defilements when they arrive back in their own countries. The refugee situation may get worse in the near future. Just like several nations within the Middle East, Iraq is not a signatory to the globally acknowledged legal structure for the protection of refugees. The first law of 1971 in Iraq was issued only for military or political causes. This law also establishes benefits such as the right to education and health services and the right to acquire employment just as the Iraqi nationals. The other legislative instrument is the 21st law from the ministry of migration of Iraq widened the description of an immigrant to incorporate the definition from the refugee resolution. Nonetheless, there is a lack of overall consistency in the protection provided under these legislations regarding rights and entitlement. A Memorandum of Understanding was signed in October 2016 by the UNHCR and the Iraq government to develop the protection of refugees. Under the term of this MoU, the Iraqi Government is obligated to provide identity documents to asylum seekers beside that UNHCR provides more guidance.

Keywords: law, refugee, protection, Kurdistan

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Authors: Anjum-Zubair, Muhammad, Muhammad Shoaib Alam, Muhammad Samee Mubarik, Iftikhar Ahmad

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The aim of present research was to evaluate the effect of dietary protein (soybean) formulated feed on the growth performance of carp fish seed (Rohu, Mori, Grass, and Gulfam) in ponds under polyculture system. Keeping in view the protein requirements of these four carps, they were fed with formulated feed contains 30% of crude protein. The fingerlings were fed once on daily basis at 5% of their wet body weight. A 90 days experiment was conducted in two cemented ponds situated at Fish Seed Hatchery and Research Centre, Rawal Town, Islamabad, Pakistan. Pond1 contain major carps i.e. Rohu and Mori while pond 2 was stocked with Chinese carps i.e. Grass carp and Gulfam. Random sampling of five individuals of each species was done fortnightly to measure the body weight and total body length. Maximum growth was observed in fingerling of Grass carp followed by Mori, Rohu and Gulfam. Total fish production was recorded as Grass 623.45 gm followed by Mori 260.3 gm, Rohu 243.08 gm and Gulfam 181.165 gm respectively. Significantly results were obtained among these four fish species when the corresponding data was subjected to statistical analysis by using two sample t-test. The survival rate was 100%. Study shows that soybean as plant based protein can be easily used as substitute to fish meal without any adverse effect on fish health and fish production.

Keywords: carps, fry growth, poly culture, soybean meal

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Authors: L. Freeborn

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Recent years have seen an increasing number of neuroimaging studies related to language learning as imaging techniques such as fMRI and EEG have become more widely accessible to researchers. By using a variety of structural and functional neuroimaging techniques, these studies have already made considerable progress in terms of our understanding of neural networks and processing related to first and second language acquisition. However, the methodological designs employed in neuroimaging studies to test language learning have been questioned by applied linguists working within the field of second language acquisition (SLA). One of the major criticisms is that tasks designed to measure language learning gains rarely have a communicative function, and seldom assess learners’ ability to use the language in authentic situations. This brings the validity of many neuroimaging tasks into question. The fundamental reason why people learn a language is to communicate, and it is well-known that both first and second language proficiency are developed through meaningful social interaction. With this in mind, the SLA field is in agreement that second language acquisition and proficiency should be measured through learners’ ability to communicate in authentic real-life situations. Whilst authenticity is not always possible to achieve in a classroom environment, the importance of task authenticity should be reflected in the design of language assessments, teaching materials, and curricula. Tasks that bear little relation to how language is used in real-life situations can be considered to lack construct validity. This paper first describes the typical tasks used in neuroimaging studies to measure language gains and proficiency, then analyses to what extent these tasks can validly assess these constructs.

Keywords: neuroimaging studies, research design, second language acquisition, task validity

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Authors: Olubajo Olumide Olu

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This paper studies the effect of Metakaolin (MK) and Rice husk ash (RHA) on the compressive strength of ternary cement mortar at replacement level up to 30%. The compressive strength test of the blended cement mortars were conducted using Tonic Technic compression and machine. Nineteen ternary cement mortars were prepared comprising of ordinary Portland cement (OPC), Rice husk ash (RHA) and Metakaolin (MK) at different proportion. Ternary mortar prisms in which Portland cement was replaced by up to 30% were tested at various age; 2, 7, 28 and 60 days. Result showed that the compressive strength of the cement mortars increased as the curing days were lengthened for both OPC and the blended cement samples. The ternary cement’s compressive strengths showed significant improvement compared with the control especially beyond 28 days. This can be attributed to the slow pozzolanic reaction resulting from the formation of additional CSH from the interaction of the residual CH content and the silica available in the Metakaolin and Rice husk ash, thus providing significant strength gain at later age. Results indicated that the addition of metakaolin with rice husk ash kept constant was found to lead to an increment in the compressive strength. This can either be attributed to the high silica/alumina contribution to the matrix or the C/S ratio in the cement matrix. Whereas, increment in the rice husk ash content while metakaolin was held constant led to an increment in the compressive strength, which could be attributed to the reactivity of the rice husk ash followed by decrement owing to the presence of unburnt carbon in the RHA matrix. The best compressive strength results were obtained at 10% cement replacement (5% RHA, 5% MK); 15% cement replacement (10% MK and 5% RHA); 20% cement replacement (15% MK and 5% RHA); 25% cement replacement (20% MK and 5% RHA); 30% cement replacement (10%/20% MK and 20%/10% RHA). With the optimal combination of either 15% and 20% MK with 5% RHA giving the best compressive strength of 40.5MPa.

Keywords: metakaolin, rice husk ash, compressive strength, ternary mortar, curing days

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Authors: Suraj Sharma

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Green infrastructure (GI) offers a contemporary approach for reducing the risk of flooding, improve water quality, and harvesting stormwater for sustainable use. GI promotes landscape planning to enhance sustainable development and urban resilience. However, the existing literature is lacking in ensuring the comprehensive assessment of GI performance in terms of ecosystem function and services for social, ecological, and economical system resilience. We propose a robust indicator set and fuzzy comprehensive evaluation (FCE) for quantitative and qualitative analysis for sustainable water management to assess the capacity of urban resilience. Green infrastructure in urban resilience water management system (GIUR-WMS) supports decision-making for GI planning through scenario comparisons with urban resilience capacity index. To demonstrate the GIUR-WMS, we develop five scenarios for five sectors of Chandigarh (12, 26, 14, 17, and 34) to test common type of GI (rain barrel, rain gardens, detention basins, porous pavements, and open spaces). The result shows the open spaces achieve the highest green infrastructure urban resilience index of 4.22/5. To implement the open space scenario in urban sites, suitable vacant can be converted to green spaces (example: forest, low impact recreation areas, and detention basins) GIUR-WMS is easy to replicate, customize and apply to cities of different sizes to assess environmental, social and ecological dimensions.

Keywords: green infrastructure, assessment, urban resilience, water management system, fuzzy comprehensive evaluation

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Authors: Kolawole F. Farinloye, Samson O. Ojo

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Two Columbiformes species were recently introduced to the newly established Awba Dam Tourism Centre [ADTC], hence there is need to investigate the effect of seasonal variation on these species with respect to hematological composition. Blood samples were obtained from superficial ulna vein of the 128 apparently healthy C. livia and C. guinea into tubes containing EDTA as anticoagulant. Thin blood smears (TBS) were prepared, stained and viewed under microscope. Values of Red Blood Cell (RBC) count, White Blood Cell (WBC) count, cholesterol (CH), Uric Acid (UA), Protein (PR), Mean Corpuscular Volume (MCV), Haemoglobin Content (HB), Blood Volume (BV), Plasma Glucose (PG) and Length/Width (L/W) ratio of red blood cells were assessed. The procedure was carried out on a seasonal basis (wet and dry seasons of 2013-2014). Data was analyzed using descriptive and inferential statistics. Lymphocyte count for C. livia was F3, 161 = 13.15, while for C. guinea was F3, 178 = 13.15. Heterophil, H/L ratio and Muscle score values for both species were (rs = -0.38, rs = -0.44), (rs = 0.51, rs = 0.31) (4, 3) respectively. Analyses also demonstrated a low WBC to RBC ratio (0.004: 25.3) in both species during the wet season compared to dry season, respectively. L/W varied significantly among sampling seasons i.e. wet (19.1% of BV, 12.6% of BV, 0.1% of BV) and dry (18.9% of BV, 12.7% of BV, 0.08% of BV). The level of HB in wet season (19.20±8.46108) is lower compared to dry season (19.70±8.48762). T-test also showed (wet=15.625, 0.111), (dry=12.125, 0.146) respectively, hence there is no association between species and haematological parameters. Species introduced were found to be haematologically stable. Although there were slight differences in seasonal composition, however this can be attributed to seasonal variation; suggesting little or no effect of seasons on their blood composition.

Keywords: seasonal variation, Columbiformes, Awba Dam tourism centre, University of Ibadan, Ibadan

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Authors: Maria Amodeo, Pasquale Arpaia, Marco Buzio, Vincenzo Di Capua, Francesco Donnarumma

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Different deep neural network architectures have been compared and tested to predict magnetic hysteresis in the context of pulsed electromagnets for experimental physics applications. Modelling quasi-static or dynamic major and especially minor hysteresis loops is one of the most challenging topics for computational magnetism. Recent attempts at mathematical prediction in this context using Preisach models could not attain better than percent-level accuracy. Hence, this work explores neural network approaches and shows that the architecture that best fits the measured magnetic field behaviour, including the effects of hysteresis and eddy currents, is the nonlinear autoregressive exogenous neural network (NARX) model. This architecture aims to achieve a relative RMSE of the order of a few 100 ppm for complex magnetic field cycling, including arbitrary sequences of pseudo-random high field and low field cycles. The NARX-based architecture is compared with the state-of-the-art, showing better performance than the classical operator-based and differential models, and is tested on a reference quadrupole magnetic lens used for CERN particle beams, chosen as a case study. The training and test datasets are a representative example of real-world magnet operation; this makes the good result obtained very promising for future applications in this context.

Keywords: deep neural network, magnetic modelling, measurement and empirical software engineering, NARX

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Authors: Mohd Tahseen Islam Talukder, Sheikh Adnan Enam, Latifa Akter Lithi, Soebur Rahman

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Composite structures have made significant advances in construction applications during the last few decades. Composite structures are composed of structural steel shapes and reinforced concrete combined with shear connectors, which benefit each material's unique properties. Significant research has been conducted on different types of connectors’ behavior and shear capacity. Moreover, the AISC 360-16 “Specification for Steel Structural Buildings” consists of a formula for channel shear connectors' shear capacity. This research compares the behavior of C type and L type shear connectors using Finite Element Analysis. Experimental results from published literature are used to validate the finite element models. The 3-D Finite Element Model (FEM) was built using ABAQUS 2017 to investigate non-linear capabilities and the ultimate load-carrying potential of the connectors using push-out tests. The changes in connector dimensions were analyzed using this non-linear model in parametric investigations. The parametric study shows that by increasing the length of the shear connector by 10 mm, its shear strength increases by 21%. Shear capacity increased by 13% as the height was increased by 10 mm. The thickness of the specimen was raised by 1 mm, resulting in a 2% increase in shear capacity. However, the shear capacity of channel connectors was reduced by 21% due to an increase of thickness by 2 mm.

Keywords: finite element method, channel shear connector, angle shear connector, ABAQUS, composite structure, shear connector, parametric study, ultimate shear capacity, push-out test

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Authors: Sami Houry

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Complex systems exhibit universal characteristics as they near a tipping point. Among them are common generic early warning signals which precede critical transitions. These signals include: critical slowing down in which the rate of recovery from perturbations decreases over time; an increase in the variance of the state variable; an increase in the skewness of the state variable; an increase in the autocorrelations of the state variable; flickering between different states; and an increase in spatial correlations over time. The presence of the signals has management implications, as the identification of the signals near the tipping point could allow management to identify intervention points. Despite the applications of the generic early warning signals in various scientific fields, such as fisheries, ecology and finance, a review of literature did not identify any applications that address the program student withdrawal problem at the undergraduate distance universities. This area could benefit from the application of generic early warning signals as the program withdrawal rate amongst distance students is higher than the program withdrawal rate at face-to-face conventional universities. This research specifically assessed the generic early warning signals through an intensive case study of undergraduate program student withdrawal at a Canadian distance university. The university is non-cohort based due to its system of continuous course enrollment where students can enroll in a course at the beginning of every month. The assessment of the signals was achieved through the comparison of the incidences of generic early warning signals among students who withdrew or simply became inactive in their undergraduate program of study, the true positives, to the incidences of the generic early warning signals among graduates, the false positives. This was achieved through significance testing. Research findings showed support for the signal pertaining to the rise in flickering which is represented in the increase in the student’s non-pass rates prior to withdrawing from a program; moderate support for the signals of critical slowing down as reflected in the increase in the time a student spends in a course; and moderate support for the signals on increase in autocorrelation and increase in variance in the grade variable. The findings did not support the signal on the increase in skewness of the grade variable. The research also proposes a new signal based on the fractal-like characteristic of student behavior. The research also sought to extend knowledge by investigating whether the emergence of a program withdrawal status is self-similar or fractal-like at multiple levels of observation, specifically the program level and the course level. In other words, whether the act of withdrawal at the program level is also present at the course level. The findings moderately supported self-similarity as a potential signal. Overall, the assessment of the signals suggests that the signals, with the exception with the increase of skewness, could be utilized as a predictive management tool and potentially add one more tool, the fractal-like characteristic of withdrawal, as an additional signal in addressing the student program withdrawal problem.

Keywords: critical transitions, fractals, generic early warning signals, program student withdrawal

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Authors: Ru-Yin Yang, Chi Wu, Cheng-Yu Tsai, Yin-Tzu Lin, Wen-Te Liu

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Background: Sleep breathing disorder (SDB) is a condition demonstrated by recurrent episodes of the airway obstruction leading to intermittent hypoxia and quality fragmentation during sleep time. However, the procedures for SDB severity examination remain complicated and costly. Objective: The objective of this study is to establish a simplified examination method for SDB by the respiratory impendence pattern sensor combining the signal processing and machine learning model. Methodologies: We records heart rate variability by the electrocardiogram and respiratory pattern by impendence. After the polysomnography (PSG) been done with the diagnosis of SDB by the apnea and hypopnea index (AHI), we calculate the episodes with the absence of flow and arousal index (AI) from device record. Subjects were divided into training and testing groups. Neuron network was used to establish a prediction model to classify the severity of the SDB by the AI, episodes, and body profiles. The performance was evaluated by classification in the testing group compared with PSG. Results: In this study, we enrolled 66 subjects (Male/Female: 37/29; Age:49.9±13.2) with the diagnosis of SDB in a sleep center in Taipei city, Taiwan, from 2015 to 2016. The accuracy from the confusion matrix on the test group by NN is 71.94 %. Conclusion: Based on the models, we established a prediction model for SDB by means of the wearable sensor. With more cases incoming and training, this system may be used to rapidly and automatically screen the risk of SDB in the future.

Keywords: sleep breathing disorder, apnea and hypopnea index, body parameters, neuron network

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Authors: Muhammad Naveed Tahir, Wang Yingkuan, Huang Wenjiang, Raheel Osman

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Numerous models used in prediction and decision-making process but most of them are linear in natural environment, and linear models reach their limitations with non-linearity in data. Therefore accurate estimation is difficult. Artificial Neural Networks (ANN) found extensive acceptance to address the modeling of the complex real world for the non-linear environment. ANN’s have more general and flexible functional forms than traditional statistical methods can effectively deal with. The link between information technology and agriculture will become more firm in the near future. Monitoring crop biophysical properties non-destructively can provide a rapid and accurate understanding of its response to various environmental influences. Crop chlorophyll content is an important indicator of crop health and therefore the estimation of crop yield. In recent years, remote sensing has been accepted as a robust tool for site-specific management by detecting crop parameters at both local and large scales. The present research combined the ANN model with satellite-derived chlorophyll indices from LANDSAT 8 imagery for predicting real-time wheat chlorophyll estimation. The cloud-free scenes of LANDSAT 8 were acquired (Feb-March 2016-17) at the same time when ground-truthing campaign was performed for chlorophyll estimation by using SPAD-502. Different vegetation indices were derived from LANDSAT 8 imagery using ERADAS Imagine (v.2014) software for chlorophyll determination. The vegetation indices were including Normalized Difference Vegetation Index (NDVI), Green Normalized Difference Vegetation Index (GNDVI), Chlorophyll Absorbed Ratio Index (CARI), Modified Chlorophyll Absorbed Ratio Index (MCARI) and Transformed Chlorophyll Absorbed Ratio index (TCARI). For ANN modeling, MATLAB and SPSS (ANN) tools were used. Multilayer Perceptron (MLP) in MATLAB provided very satisfactory results. For training purpose of MLP 61.7% of the data, for validation purpose 28.3% of data and rest 10% of data were used to evaluate and validate the ANN model results. For error evaluation, sum of squares error and relative error were used. ANN model summery showed that sum of squares error of 10.786, the average overall relative error was .099. The MCARI and NDVI were revealed to be more sensitive indices for assessing wheat chlorophyll content with the highest coefficient of determination R²=0.93 and 0.90 respectively. The results suggested that use of high spatial resolution satellite imagery for the retrieval of crop chlorophyll content by using ANN model provides accurate, reliable assessment of crop health status at a larger scale which can help in managing crop nutrition requirement in real time.

Keywords: ANN, chlorophyll content, chlorophyll indices, satellite images, wheat

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Authors: Mohamed Mohamed, Philip Bonello, Peter Russhard

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Blade Tip Timing (BTT) is a technology concerned with the estimation of both frequency and amplitude of rotating blades. A BTT system comprises two main parts: (a) the arrival time measurement system, and (b) the analysis algorithms. Simulators play an important role in the development of the analysis algorithms since they generate blade tip displacement data from the simulated blade vibration under controlled conditions. This enables an assessment of the performance of the different algorithms with respect to their ability to accurately reproduce the original simulated vibration. Such an assessment is usually not possible with real engine data since there is no practical alternative to BTT for blade vibration measurement. Most simulators used in the literature are based on a simple spring-mass-damper model to determine the vibration. In this work, a more realistic experimentally validated simulator based on the Finite Element (FE) model of a bladed disc (blisk) is first presented. It is then used to generate the necessary data for the assessment of different BTT algorithms. The FE modelling is validated using both a hammer test and two firewire cameras for the mode shapes. A number of autoregressive methods, fitting methods and state-of-the-art inverse methods (i.e. Russhard) are compared. All methods are compared with respect to both synchronous and asynchronous excitations with both single and simultaneous frequencies. The study assesses the applicability of each method for different conditions of vibration, amount of sampling data, and testing facilities, according to its performance and efficiency under these conditions.

Keywords: blade tip timing, blisk, finite element, vibration measurement

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Tigist Girma Kidane, Yalew Dessalegn Asfaw

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Abstract: The current investigation aims to measure the longitudinal and transversal three-point bending tests of bamboo fibres polypropylene composites (BFPPCs) for the application of the automobile industry. Research has not been done on the properties of Ethiopian bamboo fibres for the utilization of composite development. The samples of bamboo plants have been harvested in 3–groups of age, 2–harvesting seasons, and 3–regions of bamboo species. Roll milling machine used for the extraction of bamboo fibres which has been developed by the authors. Chemical constituents measured using gravimetric methods. Unidirectional bamboo fibres prepreg has been produced using PP and hot press machine, then BFPPCs were produced using 6 layers of prepregs at automatic hot press machine. Age, harvesting month, and bamboo species have a statistically significant effect on the longitudinal and transverse flexural strength (FS), modulus of elasticity (MOE), and failure strain at α = 0.05 as evaluated by one-way ANOVA. 2–yrs old of BFPPCs have the highest FS and MOE, whereas November has the highest value of flexural properties. The highest to the lowest FS and MOE of BFPPCs has measured in Injibara, Mekaneselam, and Kombolcha, respectively. The transverse 3-point bending test has a lower FS and MOE compared to the longitudinal direction. The chemical constituents of Injibara, Mekaneselam, and Kombolcha have the highest to the lowest, respectively. 2-years old of bamboo fibres has the highest chemical constituent. The chemical constituents improved the flexural properties. Bamboo fibres in Ethiopia can be relevant for composite development, which has been applied in the area of requiring higher flexural properties.

Keywords: age, bamboo species, flexural properties, harvesting season, polypropylene

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Authors: Miesam Golzadeh Gangraj, Younes Parvasi, Mohammad Ghasemi, Ahmad Abdi, Saeid Fazelifar

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The purpose of the study was to determine the effect of glucose feeding on energy and hormonal indexes in plasma and lymphocyte immediately after wrestling – base techniques circuit exercise (WBTCE) in young male freestyle wrestlers. Sixteen wrestlers (weight = 75/45 ± 12/92 kg, age = 22/29 ± 0/90 years, BMI = 26/23 ± 2/64 kg/m²) were randomly divided into two groups: control (water), glucose (2 gr per kg body weight). Blood samples were obtained before, immediately, and 90 minutes of the post-exercise recovery period. Glucose (2 g/kg of body weight, 1W/5V) and water (equal volumes) solutions were given immediately after the second blood sampling. Data were analyzed by using an ANOVA (a repeated measure) and a suitable post hoc test (LSD). A significant decrease was observed in lymphocytes glycogen immediately after exercise (P < 0.001). In the experimental group, increase Lymphocyte glycogen concentration (P < 0.028) than in the control group in 90 min post-exercise. Plasma glucose concentrations increased in all groups immediately after exercise (P < 0.05). Plasma insulin concentrations in both groups decreased immediately after exercise, but at 90 min after exercise, its level was significantly increased only in glucose group (P < 0.001). Our results suggested that WBTCE protocol could be affected cellular energy sources and hormonal response. Furthermore, Glucose consumption can increase the lymphocyte glycogen and better energy within the cell.

Keywords: glucose feeding, lymphocyte, Wrestling – base techniques circuit , exercise

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Authors: R. W. Chan, Kan Kan Chan

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Augmented Reality (AR), with the affordance of bridging between real world and virtual world, brings users immersive experience. It has been applied in education gradually and even come into practice in student daily learning. However, a systematic review shows that there are limited researches in the area of vocabulary acquisition in early childhood education. Since kindergarten is a key stage where children acquire language and AR as an emerging and potential technology to support the vocabulary acquisition, this study aims to explore its value in in real classroom with teacher’s view. Participants were a class of 5 to 6 years old kids studying in a Macau school that follows Cambridge curriculum and emphasizes multicultural ethos. There were 11 boys, 13 girls, and in a total of 24 kids. They learnt animal vocabulary using mobile device and AR flashcards, IPad to scan AR flashcards and interact with pop-up virtual objects. In order to estimate the effectiveness of using Augmented Reality, children attended vocabulary pre-posttest. In addition, teacher interview was administrated after this learning activity to seek practitioner’s opinion towards this technology. For data analysis, paired samples t-test was utilized to measure the instructional effect based on the pre-posttest data. Result shows that Augmented Reality could significantly enhance children vocabulary learning with large effect size. Teachers indicated that children enjoyed the AR learning activity but clear instruction is needed. Suggestions for the future implementation of vocabulary acquisition using AR are suggested.

Keywords: augmented reality, kindergarten children, vocabulary learning, Macau

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Authors: P. Amarnath, Albert Thomas

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Buildings qualify to be the major consumer of energy and resources thereby urging the designers, architects and policy makers to place a great deal of effort in achieving and implementing sustainable building strategies in construction. Green building rating systems help a great deal in this by measuring the effectiveness of these strategies along with the escalation of building performance in social, environmental and economic perspective, and construct new sustainable buildings. However, for a country like India, enormous population and its rapid rate of growth impose an increasing burden on the country's limited and continuously degrading natural resource base, which also includes the land available for construction. In general, the number of sustainable rated buildings in India is very minimal primarily due to the complexity and obstinate nature of the assessment systems/regulations that restrict the stakeholders and designers in proper implementation and utilization of these rating systems. This paper aims to introduce a data driven and user-friendly framework which cross compares the present prominent green building rating systems such as LEED, BREEAM, and GRIHA and subsequently help the users to rate their proposed building design as per the regulations of these assessment frameworks. This framework is validated using the input data collected from green buildings constructed globally. The proposed system has prospects to encourage the users to test the efficiency of various sustainable construction practices and thereby promote more sustainable buildings in the country.

Keywords: BREEAM, GRIHA, green building rating systems, LEED, sustainable buildings

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Authors: Mahjabeen Akbar

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Dental aesthetics and its associated psychosocial influence have a significant impact on individuals. Correcting malocclusions is a key motivating factor for majority patients; however, psychosocial factors have been rarely incorporated in evaluating malocclusions. Therefore, it is necessary to study the psychosocial influence of malocclusion in patients. The study aimed to determine the psychosocial influence of dental aesthetics in dental students by the ‘Psychosocial Impact of Dental Aesthetics Questionnaire’ and self-rated Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN). This was a quantitative study using a cross-sectional study design. One hundred twenty dental students (71 females and 49 males; mean age 24.5) were selected via purposive sampling from July to August 2019. Dental students with no former orthodontic treatment were requested to fill out the ‘Psychosocial Impact of Dental Aesthetics Questionnaire.’ Variables including; self-confidence/insecurity, social influence, psychological influence and self-perception of the need of an orthodontic treatment were evaluated by a sequence of statements, while dental aesthetics were evaluated by using the IOTN Aesthetic Component. To determine the significance, the Kruskal-Wallis test was utilized. The results show that all four variables measuring psychosocial impact indicated significant correlations with the perceived malocclusions with a p-value of less than 0.01. The results conclude there is a strong psychological and social influence of altered dental aesthetics on an individual. Moreover, the relationship between the IOTN-AC grading with the psychosocial wellbeing of an individual stands proven, indicating that the perception of altered dental aesthetics is as important as a factor in treatment need as the amount of malocclusion.

Keywords: dental aesthetics, malocclusion, psychosocial influence, dental students

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Authors: Emin Z. Mahmud

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Shaking table tests are planned in order to deepen the understanding of the behavior of confined masonry structures with or without openings. The tests are realized in the laboratory of the Institute of Earthquake Engineering and Engineering Seismology (IZIIS) – Skopje. The specimens were examined separately on the shaking table, with uniaxial, in-plane excitation. After testing, samples were strengthened with GFRP (Glass Fiber Reinforced Plastic) and re-tested. This paper presents the observations from a series of shaking-table tests done on a 1:1 scaled confined masonry wall model, with opening for a window – specimens CMWuS (before strengthening) and CMWS (after strengthening). Frequency and stiffness changes before and after GFRP wall strengthening are analyzed. Definition of dynamic properties of the models was the first step of the experimental testing, which enabled acquiring important information about the achieved stiffness (natural frequencies) of the model. The natural frequency was defined in the Y direction of the model by applying resonant frequency search tests. It is important to mention that both specimens CMWuS and CMWS are subjected to the same effects. The initial frequency of the undamaged model CMWuS is 18.79 Hz, while at the end of the testing, the frequency decreased to 12.96 Hz. This emphasizes the reduction of the initial stiffness of the model due to damage, especially in the masonry and tie-beam to tie-column connection. After strengthening the damaged wall, the natural frequency increases to 14.67 Hz. This highlights the beneficial effect of strengthening. After completion of dynamic testing at CMWS, the natural frequency is reduced to 10.75 Hz.

Keywords: behaviour of masonry structures, Eurocode, frequency, masonry, shaking table test, strengthening

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Authors: Fajana Sola Isaac

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In the last two decades, we have witnessed an increased interest in exchange rate pass-through (ERPT) in developing economies and emerging markets. This is perhaps due to the acknowledged significance of the pattern of exchange rate pass-through as a key instrument in monetary policy design, principally in retort to a shock in exchange rate in literature. This paper analyzed Exchange Rate Pass-Through by A Model of Oil Prices and Asymmetric Exchange Rate Fluctuations in Selected African Countries. The study adopted A Non-Linear Autoregressive Distributed Lag approach using yearly data on Algeria, Burundi, Nigeria and South Africa from 1986 to 2022. The paper found asymmetry in exchange rate pass-through in net oil-importing and net oil-exporting countries in the short run during the period under review. An ERPT exhibited a complete pass-through in the short run in the case of net oil-importing countries but an incomplete pass-through in the case of the net oil-exporting countries that were examined. An extended result revealed a significant impact of oil price shock on exchange rate pass-through to domestic price in the long run only for net oil importing countries. The Wald restriction test also confirms the evidence of asymmetric with the role of oil price acting as an accelerator to exchange rate pass-through to domestic price in the countries examined. The study found the outcome to be very useful for gaining expansive knowledge on the external shock impact on ERPT and could be of critical value for national monetary policy decisions on inflation targeting, especially for countries examined and other developing net oil importers and exporters.

Keywords: pass through, exchange rate, ARDL, monetary policy

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Authors: Rosa Amalia Safitri, Ine van der Fels-Klerx, Henk Hogeveen

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Halal is a dietary law observed by people following Islamic faith. It is considered as a type of credence food quality which cannot be easily assured by consumers even upon and after consumption. Therefore, Halal certification takes place as a practical tool for the consumers to make an informed choice particularly in a non-Muslim majority country, including the Netherlands. Discrete choice experiment (DCE) was employed in this study for its ability to assess the importance of attributes attached to Halal beef in the Dutch market and to investigate consumer utilities. Furthermore, willingness to pay (WTP) for the desired Halal certification was estimated. Four most relevant attributes were selected, i.e., the slaughter method, traceability information, place of purchase, and Halal certification. Price was incorporated as an attribute to allow estimation of willingness to pay for Halal certification. There were 242 Muslim respondents who regularly consumed Halal beef completed the survey, from Dutch (53%) and non-Dutch consumers living in the Netherlands (47%). The vast majority of the respondents (95%) were within the age of 18-45 years old, with the largest group being student (43%) followed by employee (30%) and housewife (12%). Majority of the respondents (76%) had disposable monthly income less than € 2,500, while the rest earned more than € 2,500. The respondents assessed themselves of having good knowledge of the studied attributes, except for traceability information with 62% of the respondents considered themselves not knowledgeable. The findings indicated that slaughter method was valued as the most important attribute, followed by Halal certificate, place of purchase, price, and traceability information. This order of importance varied across sociodemographic variables, except for the slaughter method. Both Dutch and non-Dutch subgroups valued Halal certification as the third most important attributes. However, non-Dutch respondents valued it with higher importance (0,20) than their Dutch counterparts (0,16). For non-Dutch, the price was more important than Halal certification. The ideal product preferred by the consumers indicated the product serving the highest utilities for consumers, and characterized by beef obtained without pre-slaughtering stunning, with traceability info, available at Halal store, certified by an official certifier, and sold at 2.75 € per 500 gr. In general, an official Halal certifier was mostly preferred. However, consumers were not willing to pay for premium for any type of Halal certifiers, indicated by negative WTP of -0.73 €, -0.93 €, and -1,03€ for small, official, and international certifiers, respectively. This finding indicated that consumers tend to lose their utility when confronted with price. WTP estimates differ across socio-demographic variables with male and non-Dutch respondents had the lowest WTP. The unfamiliarity to traceability information might cause respondents to perceive it as the least important attribute. In the context of Halal certified meat, adding traceability information into meat packaging can serve two functions, first consumers can justify for themselves whether the processes comply with Halal requirements, for example, the use of pre-slaughtering stunning, and secondly to assure its safety. Therefore, integrating traceability info into meat packaging can help to make informed decision for both Halal status and food safety.

Keywords: consumer utilities, discrete choice experiments, Halal certification, willingness to pay

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Authors: Mohammad Zainie Bin Hassan

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Background: Erectile dysfunction (ED) is a complication commonly seen among men with diabetes which can be assessed based upon International Index of Erectile Function (IIEF-5) questionnaire. Creatinine level is a blood test that indicates kidney functionality. Object: To evaluate the association between ED, determined by the IIEF-5scores and Creatinine level in diabetic men attending Temerloh Health Clinic, Pahang, Malaysia.Hence, to identify raising Creatinine level related with ED or not. Methods: All married diabetic patients will be investigated face to face after consented for answering the IIEF-5 questionnaire. Creatinine level will be taken by using standard method.Patients with no sexual partner, refuse to answer the questionnaire, cancer, stroke, heart disease and language barrier will be excluded.Data obtained from IIEF-5 score and Creatinine level will be analyzed by using Pearson correlation. All statistical value determined by p=0.05. ED will be categorized accordingly to IIEF-5 scores: no ED (22-25), mild (17-21), moderate (12-16), severe (8-11) and very severe (1-7). Results: A total of 450 patients were investigated with 385 patients were included (85.6% respondant rate) and 65 patients were excluded in this study with age range from 29 to 85 years old. 7% had no ED, 28% mild ED, 34% moderate ED, 16% severe ED and 15% had very severe ED. There was a significant negative correlation between Creatinine level and IIEF-5 scores (r=-0.218, p <0.001). This result implicated that poor kidney function which indicated by high Creatinine level associated significantly with erectile dysfunction. 93% had ED with a different range of severity which triggers for appropriate aggressive ED management among diabetics. Conclusion: The high level of Creatinine is associated with erectile dysfunction among diabetics in Temerloh Health Clinic.

Keywords: correlation, creatinine level, erectile dysfunction, ED, diabetes

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Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

Procedia PDF Downloads 238