Search results for: surgical training

Authors: Susan Diamond

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Machine Learning workloads have traditionally been run in high-performance computing (HPC) environments, where users log in to dedicated machines and utilize the attached GPUs to run training jobs on huge datasets. Training of large neural network models is very resource intensive, and even after exploiting parallelism and accelerators such as GPUs, a single training job can still take days. Consequently, the cost of hardware is a barrier to entry. Even when upfront cost is not a concern, the lead time to set up such an HPC environment takes months from acquiring hardware to set up the hardware with the right set of firmware, software installed and configured. Furthermore, scalability is hard to achieve in a rigid traditional lab environment. Therefore, it is slow to react to the dynamic change in the artificial intelligent industry. Watson Deep Learning as a service, a cloud-based deep learning platform that mitigates the long lead time and high upfront investment in hardware. It enables robust and scalable sharing of resources among the teams in an organization. It is designed for on-demand cloud environments. Providing a similar user experience in a multi-tenant cloud environment comes with its own unique challenges regarding fault tolerance, performance, and security. Watson Deep Learning as a service tackles these challenges and present a deep learning stack for the cloud environments in a secure, scalable and fault-tolerant manner. It supports a wide range of deep-learning frameworks such as Tensorflow, PyTorch, Caffe, Torch, Theano, and MXNet etc. These frameworks reduce the effort and skillset required to design, train, and use deep learning models. Deep Learning as a service is used at IBM by AI researchers in areas including machine translation, computer vision, and healthcare. 

Keywords: deep learning, machine learning, cognitive computing, model training

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Authors: Maria Albuquerque, Miguel Matias, Ângelo Sá, Juliana Sousa, Maria Manuel Mouzinho

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Obesity is a frequent disease in Portugal. The surgical treatment is very effective and has an indication when there is a failure of the medical treatment. Although massive weight loss is associated with considerable health gains, these patients are characterized by a variable degree of dermolipodistrophy. In some cases, there is even the development of physical symptoms such as intertriginous, and some degree of psychological distress is present. In almost all cases, a desire for a better body contour, which inhibits some aspects of social life, is a fact. A prospective study was made to access the impact of body contouring surgery in the quality of life of patients who underwent a massive weight lost correction surgical procedure at Centro Hospitalar de Lisboa Central between January 2020 and December 2021. The patients were submitted to the Body Q subjective questionnaire adapted for the Portuguese language and accessed for the following categories: Anguish with Appearance, Contempt with Body Image, Satisfaction with the Abdomen, and Overall Satisfaction with the Body. The questionnaire was repeated at the 6 months mark. A total of 80 patients were sampled. The sex distribution was 79 female and 1 male. The median BMI index before surgery was inferior to 28%. The pre operatory questionnaire showed high scores for Anguish with Appearance and low scores for the body image self-evaluation. Overall, there was an improvement of at least 50% in all the evaluated scores. Additionally, a correlation was found between abdominoplasty and the contempt with body image and satisfaction with the abdomen (p-value <0.05). Massive weight loss is associated with important body deformities that have a significant impact on the patient’s personal and social life. Body contouring surgery is then vital for these patients as it implicates major aesthetic and functional benefits.

Keywords: abdominoplasty, cruroplasty, obesity, massive weight loss

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Authors: Engy S. El-Kayal, Mohamed M. S. Arafa

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There are various causes of ankle pain including traumatic and non-traumatic causes. Various imaging techniques are available for assessment of AP. MRI is considered to be the imaging modality of choice for ankle joint evaluation with an advantage of its high spatial resolution, multiplanar capability, hence its ability to visualize small complex anatomical structures around the ankle. However, the high costs and the relatively limited availability of MRI systems, as well as the relatively long duration of the examination all are considered disadvantages of MRI examination. Therefore there is a need for a more rapid and less expensive examination modality with good diagnostic accuracy to fulfill this gap. HRU has become increasingly important in the assessment of ankle disorders, with advantages of being fast, reliable, of low cost and readily available. US can visualize detailed anatomical structures and assess tendinous and ligamentous integrity. The aim of this study was to compare the diagnostic accuracy of HRU with MRI in the assessment of patients with AP. We included forty patients complaining of AP. All patients were subjected to real-time HRU and MRI of the affected ankle. Results of both techniques were compared to surgical and arthroscopic findings. All patients were examined according to a defined protocol that includes imaging the tendon tears or tendinitis, muscle tears, masses, or fluid collection, ligament sprain or tears, inflammation or fluid effusion within the joint or bursa, bone and cartilage lesions, erosions and osteophytes. Analysis of the results showed that the mean age of patients was 38 years. The study comprised of 24 women (60%) and 16 men (40%). The accuracy of HRU in detecting causes of AP was 85%, while the accuracy of MRI in the detection of causes of AP was 87.5%. In conclusions: HRU and MRI are two complementary tools of investigation with the former will be used as a primary tool of investigation and the latter will be used to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.

Keywords: ankle pain (AP), high-resolution ultrasound (HRU), magnetic resonance imaging (MRI) ultrasonography (US)

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Authors: Mara Aparecida De Castilho Lopes. Maria Eliza Mattosinho Bernardes

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The education of deaf individuals in Brazil is grounded in the bilingual approach, which presupposes Brazilian Sign Language (Libras) as the first language for these students. In this perspective, Portuguese should be taught as a second language in its written form, ensuring that deaf students also have access to various academic subjects in sign language. Brazilian legislation (Federal Decree No. 5626 of 2005) mandates the teaching of Brazilian Sign Language in university teacher training programs, but there is no pre-established minimum workload. As a result, there is a significant disparity in the teaching and quality of teacher education across the Brazilian territory. Added to this fact is the general lack of awareness within society regarding the linguistic status of Libras, leading to a shortage of competent teachers for its use and instruction, particularly in higher education. Recently, Federal Law No. 14191 of 2021 established bilingual education for the deaf as a mode of instruction, indicating the need for adjustments in teacher training within higher education teacher preparation programs. Given this context, the objective of the present study was to analyze the teaching proposals for Brazilian Sign Language for students in teacher training programs at public universities in Brazil, presenting alternatives to overcome the current models and academic pathways of teaching and learning. In addition to analyzing Brazilian teaching models, an analysis of a continuing education model for teachers in a French institution was also conducted - considering the historical Franco-Brazilian path of deaf education in Brazil. The analysis of the current teacher training model for deaf education in Brazil revealed that initial exposure to sign language and its linguistic structure is not sufficient to provide future teachers with opportunities to reflect on bilingual teaching methods and practices, as seen in other definitions of bilingualism - bilingual education for proficient listeners in two oral languages. As a result, a training proposal was developed for an experimental interdisciplinary course, integrating the curriculum of an initial and continuing teacher training program alongside the Alfredo Bossi Chair at the University of São Paulo. This proposal is structured into three disciplines, which constitute consecutive moments in teacher education: Fundamental Aspects of Brazilian Sign Language, Bilingual Teaching Methodology, and Teaching Investigation Project - interdisciplinary engagement in the field of deafness. The last offered discipline represents an interdisciplinary supervised internship proposal, considering the multi-professional context that constitutes deaf education within a bilingual approach. In interdisciplinary work within the field of deafness, dialogue between teachers and other professionals who work with deaf students from different perspectives - teachers, speech therapists, and sign language interpreters - is frequently necessary. Through alternative avenues, these actions aim to direct the linguistic development of deaf students within their learning processes. Based on the innovative curriculum proposal described here, the intention is to contribute to the enhancement of teacher education in Brazil, with the goal of ensuring bilingual education for deaf students.

Keywords: bilingual education, teacher training, historical-cultural approach, interdisciplinary education, inclusive education

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Authors: Radwa R. El-Saadany , Medhat Abu Zeid, Tarek Omar, Marwa S. Maqsoud

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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by attention deficit, hyperactivity, and impulsivity. Neurofeedback (NF) is one of the neurotherapy treatments that cause brain wave changes. Method: The current pseudo-experimental study with a pre–post-test design was conducted on a population of children with attention deficit hyperactivity disorder (ADHD).The sample size comprised of (30) children selected by random sampling method and assigned to two therapeutic groups: First therapeutic group received a neurofeedback program. Based on QEEG, it reached (10) children. The second therapeutic group received an organization skills training program, it reached (10) and the control group that did not receive programs, it reached (10) children. Results: There are significant differences between pre- and post-assessments among therapeutic groups in reducing the three core symptoms of ADHD in favor of post measurement. There are no significant differences between post-assessment and follow up measurement of the therapeutic groups.

Keywords: QEEG-based neurofeedback therapy program, organizational skills training program, attention deficit hyperactivity disorder

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Authors: Rimel Mwamba, Mohan Gundeti

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Introduction: The use of robot-assisted laparoscopic surgeries (RALS) has largely increased in recent years, offering faster and safer treatment options for pediatric patients. In the field of urology, RALS has shown a significant advantage over laparoscopic and open surgeries but continues to be controversial in pediatric cases due to limited comprehensive data on its use. Methods: In this review, we aim to summarize the factors associated with RALS use in pediatric cases involving pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction. We used PubMed, EMBASE, and the Cochrane Database of Systematic Reviews to systematically search for literature on the topic. We then critically assessed and compiled data on RALS outcomes, complications, and associated factors. Results: To date, numerous comparative studies have been conducted on pediatric RALS, with only one randomized control trial investigating the nuances of robotic use against standard of care treatments. These robotic approaches have shown promise in post-surgical outcomes for pediatric patients undergoing upper and lower urinary tract reconstruction. Barriers to use still persist, however, showcasing a need to increase access to the technology, refine instruments for pediatric use, address cost barriers, and provide proper training for surgeons. Conclusion: RALS providesan opportunity to improve pediatric patient outcomes for numerous urologic complications. Additional studies are required to better compare the use of RALS with current standard practices. Due to the difficult nature of conducting randomized control trials, additional prospective observational studies are needed.

Keywords: pediatric urology, robot-assisted laparoscopic surgeries (RALS), pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction

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Authors: Naim Izet Kajtazi

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Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

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Authors: María-Dolores Olvera-Lobo, Bryan John Robinson, Juncal Gutierrez-Artacho

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Graduates are equipped with a wide range of generic competencies which complement solid curricular competencies and facilitate their access to the labour market in diverse fields and careers. However, some generic competencies such as instrumental, personal and systemic competencies related to teamwork and interpersonal communication skills, decision-making and organization skills are seldom taught explicitly and even less often assessed. In this context, translator training has embraced a broad range of competencies specified in the undergraduate program currently taught at universities and opens up the learning experience to cover areas often ignored due to the difficulties inherent in both teaching and assessment. In practice, translator training combines two well-established approaches to teaching/learning: project-based learning and genuinely cooperative – or merely collaborative – learning. Our professional approach to translator training is a model focused on and adapted to the teleworking context of professional translation and presented through the medium of blended e-learning. Teamwork-related competencies are extremely relevant, and they require explicit and implicit teaching so that graduates can be confident about their capacity to make their way in professional contexts. In order to highlight the importance of teamwork and intra-team relationships beyond the classroom, we aim to raise awareness of teamwork processes so as to empower translation students in managing their interaction and ensure that they gain valuable pre-professional experience. With these objectives, at the University of Granada (Spain) we have developed a range of classroom activities and assessment tools. The results of their application are summarized in this study.

Keywords: blended learning, collaborative teamwork, cross-curricular competencies, higher education, intra-team relationships, students’ perceptions, translator training

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Authors: Winai Rungrittidetch

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This paper investigated the operational system, procedures, outcomes, and obstacles during the application of the Corporate Social Responsibility by the small enterprises and other involved groups in the anchor production business of the core firm, Jatura Charoen Chai Company Limited. The paper also aimed to discover ways to improve the stakeholders who participated in the CSR training and advisory programme. The paper utilized the qualitative methodology which included documentary review and semi- structured interview. The interviews were made with 8 respondents as the representative of different groups of the company’s stakeholder. The findings drew out the lessons learned from the participation of the selected small manufacturing enterprises in the CSR training and advisory programme. Some suggestions were also made, addressing the significance of the Philosophy of Sufficiency Economy.

Keywords: corporate, social, responsibility, enterprises

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Authors: F. Nur Baran Aksakal, Özge Dinç, H. Tanju Besler, Begüm Mutuş, Özlem Üliç Çatar, Orhan Aydoğdu, Serhat Ünal

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Healthy eating habits are associated not only with the newborn, child, and maternal health but also with longer life expectancy by acting as a protective factor against non-communicable diseases such as obesity, diabetes, cardiovascular diseases, and cancer. The role of nutrition in medical education is to provide information about the relationship between healthy nutrition and malnutrition as well as diet-related non-communicable diseases. Considering the information pollution experienced in the field of nutrition and health in the society, it is seen that more than half of the population receives information from family physicians as the closest counseling unit. However, postgraduate nutrition education programs for physicians and other health professionals who wish to improve their current knowledge of the role of nutrition communication in the prevention and management of chronic diseases are limited worldwide. However, nutrition courses are either not included in the undergraduate medical education curriculum of physicians or they are insufficient. Based on this need, the main aim of the study group was to develop a "Nutrition and Nutrition Communication Training for Physicians" program that would be conducted in cooperation with the Sabri Ülker Foundation and the Federation of Family Physicians Associations (AHEF). This program is the first online nutrition and nutrition communication information platform for physicians in Turkey. This program aims to present the concept of adequate and balanced nutrition to physicians, the importance of nutrition in diseases with scientific data, and to gain communication skills that may be necessary while transferring scientific information to the public. A needs assessment questionnaire was applied to identify pre-program training needs. A study plan was made to allow the participation of all family physicians in the population, and a complete inventory was targeted. In other words, we aimed to reach the whole source without taking a section of the population. Participation in the training is based on volunteerism. The needs assessment study is conducted using 25,102 family physicians for whom email addresses are available. The online questionnaire was sent to all the family physicians with a reminder email one week after the first one, and 1308 responded. Considering the topics determined, a training program was prepared for family physicians under eight online training titles, starting in March 2022, and conducted once every two weeks. The number of audience members present at each session was between 1217 and 1673, and a minimum of 17 and a maximum of 53 questions were received in each session. We strongly believe that to prevent individuals' health problems and to have better control over chronic diseases, the information level of physicians should be increased via these kinds of interventions, and better collaboration between family physicians and dieticians should be established.

Keywords: nutrition communication, nutrition training, communication, nutrition

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Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

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Authors: Guanghua Zhang, Fubao Wang, Weijun Duan

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Convolution neural network (CNN) has attracted more and more attention on recent years. Especially in the field of computer vision and image classification. However, unsupervised learning with CNN has received less attention than supervised learning. In this work, we use a new powerful tool which is deep convolutional generative adversarial networks (DCGANs) to generate images from Sloan Digital Sky Survey. Training by various star and galaxy images, it shows that both the generator and the discriminator are good for unsupervised learning. In this paper, we also took several experiments to choose the best value for hyper-parameters and which could help to stabilize the training process and promise a good quality of the output.

Keywords: convolution neural network, discriminator, generator, unsupervised learning

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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Authors: Jan Stodt, Christoph Reich

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The usage of machine learning models for prediction is growing rapidly and proof that the intended requirements are met is essential. Audits are a proven method to determine whether requirements or guidelines are met. However, machine learning models have intrinsic characteristics, such as the quality of training data, that make it difficult to demonstrate the required behavior and make audits more challenging. This paper describes an ML audit framework that evaluates and reviews the risks of machine learning applications, the quality of the training data, and the machine learning model. We evaluate and demonstrate the functionality of the proposed framework by auditing an steel plate fault prediction model.

Keywords: audit, machine learning, assessment, metrics

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Authors: Jawaher F. Alsharef, Abdullah A. Ghaddaf, Mohammed S. Alomari, Abdullah A. Al Qurashi, Ahmed S. Abdulhamid, Mohammed S. Alshehri, Majed Alosaimi

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Botulinum toxin type A (BTX-A) is the most popular therapeutic agent for muscle relaxation and pain control. Lately, BTX-A injection received great interest as a part of multimodal pain management for lower limb lengthening and deformity correction. This systematic review aimed to determine the role of BTX-A injection in pain management for during lower limb lengthening and/or deformity correction. We searched Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared the BTX-A injection to placebo for individuals undergoing lower limb lengthening and/or deformity correction. We sought to evaluate the following outcomes: pain on visual analogue scale (VAS), range of motion parameters, average opioid consumption, and adverse events. The standardized mean difference (SMD) was used to represent continuous outcomes while risk ratio (RR) was used to represent dichotomous outcomes. A total of 4 RCTs that enrolled 257 participants (337 limbs) deemed eligible. Adjuvant BTX-A injection showed a significant reduction in post-operative pain compared to placebo (SMD=–0.28, 95% CI –0.53 to –0.04). No difference was found between BTX-A injection and placebo in terms of range of motion parameters, average opioid consumption, or adverse events after surgical limb lengthening and/or deformity correction (RR= 0.77, 95% CI –0.58 to 1.03). Conclusions: Adjuvant BTX-A injection conferred a discernible reduction in post-operative pain during surgical limb lengthening and/or deformity without increasing the risk of adverse events.

Keywords: botulinum toxin type A, limb lengthening, distraction osteogenesis, deformity correction, pain management

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Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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Authors: Weizhi Zhong, Xiaoyi Lu, Lei Xu

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In order to solve the problem of inaccurate synchronization for distributed multiple-input multiple-output (MIMO) system in multipath environment, a golay pair aided timing synchronization method is proposed in this paper. A new synchronous training sequence based on golay pair is designed. By utilizing the aperiodic auto-correlation complementary property of the new training sequence, the fine timing point is obtained at the receiver. Simulation results show that, compared with the tradition timing synchronization approaches, the proposed algorithm can provide high accuracy in synchronization, especially under multipath condition.

Keywords: distributed MIMO system, golay pair, multipath, synchronization

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Authors: Silvia Franco, Marcos Sarasola

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The Faculty of Business Administration at the Catholic University of Uruguay is performing an important educational innovation, unique in the country. In preparing future professionals in companies, teamwork competence is very important. However, there is no often a systematic and specific training in the acquisition of this competence in undergraduate students. For this reason, we have designed and implemented an educational innovation through an intervention method to improve teamwork competence for undergraduate students of business studies. Students’ teams are integrated according to the complementary roles of Belbin; changes in teamwork competence during training period are measured with CCSAC tool; classroom methodology in the prio-border teamwork by Team-Based Learning. Methodology also integrates coaching and support team performance during the first two semesters.

Keywords: business students, teamwork, learning, competences

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Authors: Abdullah A. AlShaher

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In this paper, we demonstrate how regression curves can be used to recognize 2D non-rigid handwritten shapes. Each shape is represented by a set of non-overlapping uniformly distributed landmarks. The underlying models utilize 2^nd order of polynomials to model shapes within a training set. To estimate the regression models, we need to extract the required coefficients which describe the variations for a set of shape class. Hence, a least square method is used to estimate such modes. We then proceed by training these coefficients using the apparatus Expectation Maximization algorithm. Recognition is carried out by finding the least error landmarks displacement with respect to the model curves. Handwritten isolated Arabic characters are used to evaluate our approach.

Keywords: character recognition, regression curves, handwritten Arabic letters, expectation maximization algorithm

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Authors: Ali Baker, Russel Krawitz

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This paper describes a rare occurrence where a potentially fatal complication of COVID-19 infection (MIS-A) was misdiagnosed as an acute abdomen. As most patients with this syndrome present with fever and gastrointestinal symptoms, they may inadvertently fall under the care of the surgical unit. However, unusual imaging findings and a poor response to anti-microbial therapy should prompt clinicians to suspect a non-surgical etiology. More than half of MIS-A patients require ICU admission and vasopressor support. Prompt referral to a physician is key, as the cornerstone of treatment is IVIG and corticosteroid therapy. A 32 year old woman presented with right sided abdominal pain and fevers. She had also contracted COVID-19 two months earlier. Abdominal examination revealed generalised right sided tenderness. The patient had raised inflammatory markers, but other blood tests were unremarkable. CT scan revealed extensive lymphadenopathy along the ileocolic chain. The patient proved to be a diagnostic dilemma. She was reviewed by several surgical consultants and discussed with several inpatient teams. Although IV antibiotics were commenced, the right sided abdominal pain, and fevers persisted. Pan-culture returned negative. A mild cholestatic derangement developed. On day 5, the patient underwent preparation for colonoscopy to assess for a potential intraluminal etiology. The following day, the patient developed sinus tachycardia and hypotension that was refractory to fluid resuscitation. That patient was transferred to ICU and required vasopressor support. Repeat CT showed peri-portal edema and a thickened gallbladder wall. On re-examination, the patient was Murphy’s sign positive. Biliary ultrasound was equivocal for cholecystitis. The patient was planned for diagnostic laparoscopy. The following morning, a marked rise in cardiac troponin was discovered, and a follow-up echocardiogram revealed moderate to severe global systolic dysfunction. The impression was post-COVID MIS with myocardial involvement. IVIG and Methylprednisolone infusions were commenced. The patient had a great response. Vasopressor support was weaned, and the patient was discharged from ICU. The patient continued to improve clinically with oral prednisolone, and was discharged on day 17. Although MIS following COVID-19 infection is well-described syndrome in children, only recently has it come to light that it can occur in adults. The exact incidence is unknown, but it is thought to be rare. A recent systematic review found only 221 cases of MIS-A, which could be included for analysis. Symptoms vary, but the most frequent include fever, gastrointestinal, and mucocutaneous. Many patients progress to multi-organ failure and require vasopressor support. 7% succumb to the illness. The pathophysiology of MIS is only partly understood. It shares similarities with Kawasaki disease, macrophage activation syndrome, and cytokine release syndrome. Importantly, by definition, the patient must have an absence of severe respiratory symptoms. It is thought to be due to a dysregulated immune response to the virus. Potential mechanisms include reduced levels of neutralising antibodies and autoreactive antibodies that promote inflammation. Further research into MIS-A is needed. Although rare, this potentially fatal syndrome should be considered in the unwell surgical patient who has recently contracted COVID-19 and poses a diagnostic dilemma.

Keywords: acute-abdomen, MIS, COVID-19, ICU

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Authors: J. Fenianos, C. Khater, D. Brouillet

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Ecological projects are often faced with reluctance from local communities hosting the project, especially when this project involves variation from preset ideas or classical practices. This paper aims at appreciating the contribution of environmental psychology through cognitive flexibility exercises to improve the acceptability of local communities in adopting more ecological rehabilitation scenarios. The study is based on a quarry site located in Bekaa- Lebanon. Four groups were considered with different levels of involvement, as follows: Group 1 is Training (T) – 50 hours of on-site training over 8 months, Group 2 is Awareness (A) – 2 hours of awareness raising session, Group 3 is Flexibility (F) – 2 hours of flexibility exercises and Group 4 is the Control (C). The results show that individuals in Group 3 (F) who followed flexibility sessions accept comparably the ecological rehabilitation option over the more classical one. This is also the case for the people in Group 1 (T) who followed a more time-demanding “on-site training”. Another experience was conducted on a second quarry site combining flexibility with awareness-raising. This research confirms that it is possible to reduce resistance to change thanks to a limited in-time intervention using cognitive flexibility. This methodological approach could be transferable to other environmental problems involving local communities and changes in preset perceptions.

Keywords: acceptability, ecological restoration, environmental psychology, Lebanon, local communities, resistance to change

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Authors: Renga Rao Krishnamoorthy, Raihan Tahir

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The quality of classroom learning and teaching delivery has been and will continue to be debated at various levels worldwide. The regional cooperation programme to improve the quality and labour market orientation of the Technical and Vocational Education and Training (RECOTVET), ‘Deutsche Gesellschaft für Internationale Zusammenarbeit’ (GIZ), in line with the sustainable development goals (SDG), has taken the initiative in the development of quality TVET in the ASEAN region by developing the Quality Toolbox for Better TVET Delivery (Quality Toolbox). This initiative aims to provide quick and practical materials to trainers, instructors, and personnel involved in education and training at an institute to shape the quality of classroom learning and teaching. The Quality Toolbox for Better TVET Delivery was developed in three stages: literature review and development, validation, and finalization. Thematic areas in the Quality Toolbox were derived from collective input of concerns and challenges raised from experts’ workshops through moderated sessions involving representatives of TVET institutes from 9 ASEAN Member States (AMS). The sessions were facilitated by professional moderators and international experts. TVET practitioners representing AMS further analysed and discussed the structure of the Quality Toolbox and content of thematic areas and outlined a set of specific requirements and recommendations. The application exercise of the Quality Toolbox was carried out by TVET institutes among ASM. Experience sharing sessions from participating ASEAN countries were conducted virtually. The findings revealed that TVET institutes use two types of approaches in shaping the quality of learning and teaching, which is ascribed to inductive or deductive, shaping of quality in learning and teaching is a non-linear process and finally, Q-tools can be adopted and adapted to shape the quality of learning and teaching at TVET institutes in the following: improvement of the institutional quality, improvement of teaching quality and improvement on the organisation of learning and teaching for students and trainers. The Quality Toolbox has good potential to be used at education and training institutes to shape quality in learning and teaching.

Keywords: AMS, GIZ, RECOTVET, quality tools

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Authors: Oscar E. Cariceo

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In Chile, social workers´ professional training is developed in the undergraduate level, mainly. Despite the fact that several schools have been launched Master of Social Work programs, the Bachelor in Social Work is the minimum qualification to start a professional career. In the current Chilean higher education system, there exist different financial aid options in order to guarantee equal access to higher education. These policies, which are student loans and scholarships, basically, are applied and distributed by Government agencies. They are linked to academic performance and socio-economic needs, in terms of standardized test scores and social vulnerability criteria. In addition, institutions that enroll students with high scores, also receive direct financial support. In other words, social work students must compete for the resources to pay for college tuitions and fees with other students from different programs and knowledge fields and, as a consequence, they can indirectly enhance schools´ money income. This work aims to describe the reality of social work students to access to financial aid in Chile. The analysis presents the results of the University Selection Test of students, who were accepted in social work undergraduate programs during 2014 related to their qualifications to apply to three main financial aid programs, and their contribution to attracting resources to their schools. In general, data show that social work students participate in a low proportion in the distribution of financial aid, both student loans and scholarships. Few of them reach enough scores to guarantee direct financial resources to their institutions. Therefore, this situation has deep implications on equal access to higher education for vulnerable students and affects equal access to training options for young social workers, due to the highly competitive financial aid system.

Keywords: social work, professional training, higher education, financial aid, equity

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Authors: Omaima E. S. Mohammed, Amira A. A. Abdallah, Amal A. M. El Borady

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Background: Core stability training has recently attracted attention for improving muscle performance. Purpose: This study investigated the effect of beginners' core stability exercises on trunk active repositioning error at 30° and 60° trunk flexion. Methods: Forty healthy males participated in the study. They were divided into two equal groups; experimental “group I” and control “group II”. Their mean age, weight and height were 19.35±1.11 vs 20.45±1.64 years, 70.15±6.44 vs 72.45±6.91 kg and 174.7±7.02 vs 176.3±7.24 cm for group I vs group II. Data were collected using the Biodex Isokinetic system at an angular velocity of 60º/s. The participants were tested twice; before and after a 6-week period during which group I performed a core stability training program. Results: The Mixed 3-way ANOVA revealed significant increases (p<0.05) in the absolute error (AE) at 30˚ compared with 60˚ flexion in the pre-test condition of group I and II and the post-test condition of group II. Moreover, there were significant decreases (p<0.05) in the AE in the post-test condition compared with the pre-test in group I at both 30˚ and 60˚ flexion with no significant differences for group II. Finally, there were significant decreases (p<0.05) in the AE in group I compared with group II in the post-test condition at 30˚ and 60˚ flexion with no significant differences for the pre-test condition Interpretation/Conclusion: The improvement in trunk proprioception indicated by the decrease in the active repositioning error in the experimental group recommends including core stability training in the exercise programs that aim to improve trunk proprioception.

Keywords: core stability, isokinetic, trunk proprioception, biomechanics

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Authors: Muneeb Ullah, Daishihan, Xiadong Young

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Deep learning plays a crucial role in identifying COVID-19 and preventing its spread. To improve the accuracy of COVID-19 diagnoses, it is important to have access to a sufficient number of training images of CXRs (chest X-rays) depicting the disease. However, there is currently a shortage of such images. To address this issue, this paper introduces COVID-19 GAN, a model that uses generative adversarial networks (GANs) to generate realistic CXR images of COVID-19, which can be used to train identification models. Initially, a generator model is created that uses digressive channels to generate images of CXR scans for COVID-19. To differentiate between real and fake disease images, an efficient discriminator is developed by combining the dense connectivity strategy and instance normalization. This approach makes use of their feature extraction capabilities on CXR hazy areas. Lastly, the deep regret gradient penalty technique is utilized to ensure stable training of the model. With the use of 4,062 grape leaf disease images, the Leaf GAN model successfully produces 8,124 COVID-19 CXR images. The COVID-19 GAN model produces COVID-19 CXR images that outperform DCGAN and WGAN in terms of the Fréchet inception distance. Experimental findings suggest that the COVID-19 GAN-generated CXR images possess noticeable haziness, offering a promising approach to address the limited training data available for COVID-19 model training. When the dataset was expanded, CNN-based classification models outperformed other models, yielding higher accuracy rates than those of the initial dataset and other augmentation techniques. Among these models, ImagNet exhibited the best recognition accuracy of 99.70% on the testing set. These findings suggest that the proposed augmentation method is a solution to address overfitting issues in disease identification and can enhance identification accuracy effectively.

Keywords: classification, deep learning, medical images, CXR, GAN.

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Authors: Fossarello Maurizio, Mattana Giorgio, Tatti Filippo.

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The most widely performed surgical procedure in Open-Angle Glaucoma (OAG) is trabeculectomy. Although this filtering procedure is extremely effective, surgical failure and postoperative complications are reported. Due to the its invasive nature and possible complications, trabeculectomy is usually reserved, in practice, for patients who are refractory to medical and laser therapy. Recently, a number of micro-invasive surgical techniques (MIGS: Micro-Invasive Glaucoma Surgery), have been introduced in clinical practice. They meet the criteria of micro-incisional approach, minimal tissue damage, short surgical time, reliable IOP reduction, extremely high safety profile and rapid post-operative recovery. Xen45 Gel Implant (Allergan, Dublin, Ireland) is one of the MIGS alternatives, and consists in a porcine gelatin tube designed to create an aqueous flow from the anterior chamber to the subconjunctival space, bypassing the resistance of the trabecular meshwork. In this study we report the results of this technique as a favorable option in the treatment of OAG for its benefits in term of efficacy and safety, either alone or in combination with cataract surgery. This is a retrospective, single-center study conducted in consecutive OAG patients, who underwent Xen45 Gel Stent implantation alone or in combination with phacoemulsification, from October 2018 to June 2019. The primary endpoint of the study was to evaluate the reduction of both IOP and number of antiglaucoma medications at 12 months. The secondary endpoint was to correlate filtering bleb morphology evaluated by means of anterior segment OCT with efficacy in IOP lowering and eventual further procedures requirement. Data were recorded on Microsoft Excel and study analysis was performed using Microsoft Excel and SPSS (IBM). Mean values with standard deviations were calculated for IOPs and number of antiglaucoma medications at all points. Kolmogorov-Smirnov test showed that IOP followed a normal distribution at all time, therefore the paired Student’s T test was used to compare baseline and postoperative mean IOP. Correlation between postoperative Day 1 IOP and Month 12 IOP was evaluated using Pearson coefficient. Thirty-six eyes of 36 patients were evaluated. As compared to baseline, mean IOP and the mean number of antiglaucoma medications significantly decreased from 27,33 ± 7,67 mmHg to 16,3 ± 2,89 mmHg (38,8% reduction) and from 2,64 ± 1,39 to 0,42 ± 0,8 (84% reduction), respectively, at 12 months after surgery (both p < 0,001). According to bleb morphology, eyes were divided in uniform group (n=8, 22,2%), subconjunctival separation group (n=5, 13,9%), microcystic multiform group (n=9, 25%) and multiple internal layer group (n=14, 38,9%). Comparing to baseline, there was no significative difference in IOP between the 4 groups at month 12 follow-up visit. Adverse events included bleb function decrease (n=14, 38,9%), hypotony (n=8, 22,2%) and choroidal detachment (n=2, 5,6%). All eyes presenting bleb flattening underwent needling and MMC injection. The higher percentage of patients that required secondary needling was in the uniform group (75%), with a significant difference between the groups (p=0,03). Xen45 gel stent, either alone or in combination with phacoemulsification, provided a significant lowering in both IOP and medical antiglaucoma treatment and an elevated safety profile.

Keywords: anterior segment OCT, bleb morphology, micro-invasive glaucoma surgery, open angle glaucoma, Xen45 gel implant

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Authors: Talar Agopian

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Teaching English as a Second Language (ESL) is a common practice in many Lebanese schools. However, ESL teaching is done in traditional ways. Methods such as constructivism are seldom used, especially in villages. Here lies the significance of this research which joins constructivism and Piaget’s theory of cognitive development in ESL classes in Lebanese villages. The purpose of the present study is to explore the effects of applying constructivist student-centered strategies in teaching grammar, reading comprehension, and poetry on students in elementary ESL classes in two villages in Lebanon, Zefta in South Lebanon and Boqaata in Mount Lebanon. 20 English teachers participated in a training titled “Teaching English with Fun”, which focused on strategies that create a student-centered class where active learning takes place and there is increased learner engagement and autonomy. The training covered three main areas in teaching English: grammar, reading comprehension, and poetry. After participating in the training, the teachers applied the new strategies and methods in their ESL classes. The methodology comprised two phases: in phase one, practice-based research was conducted as the teachers attended the training and applied the constructivist strategies in their respective ESL classes. Phase two included the reflections of the teachers on the effects of the application of constructivist strategies. The results revealed the educational benefits of constructivist student-centered strategies; the students of teachers who applied these strategies showed improved engagement, positive attitudes towards poetry, increased motivation, and a better sense of autonomy. Future research is required in applying constructivist methods in the areas of writing, spelling, and vocabulary in ESL classrooms of Lebanese villages.

Keywords: active learning, constructivism, learner engagement, student-centered strategies

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Authors: Mirzaii Khadigeh

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Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

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Authors: Siti Nurhidayah Naqiah Abdull Rani, Herlina Abdul Rahim, Rashidah Ghazali, Noramli Abdul Razak

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Near infrared (NIR) spectroscopy has always been of great interest in the food and agriculture industries. The development of prediction models has facilitated the estimation process in recent years. In this study, 110 crude palm oil (CPO) samples were used to build a free fatty acid (FFA) prediction model. 60% of the collected data were used for training purposes and the remaining 40% used for testing. The visible peaks on the NIR spectrum were at 1725 nm and 1760 nm, indicating the existence of the first overtone of C-H bands. Principal component regression (PCR) was applied to the data in order to build this mathematical prediction model. The optimal number of principal components was 10. The results showed R2=0.7147 for the training set and R2=0.6404 for the testing set.

Keywords: palm oil, fatty acid, NIRS, regression

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Authors: Mari Murakami, Hiromi Kawasaki, Saori Fujimoto, Yoko Ueno

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Background: In Japan, one of the goals of midwifery education is the development of one’s ability to comprehensively support the child-rearing generation in collaboration with professionals from other disciplines. However, in order to prevent the spread of Covid-19, it has become extremely difficult to provide face-to-face support for mothers and children. Early on in the pandemic, we sought help from three parenting midwives as an alternative and attempted an online visit. Since midwives who are raising children respond to the training as both mothers who are care recipients and midwives as care providers. Therefore, we attempted to verify the usefulness of midwives experiencing training as mothers by clarifying the effects on those midwives who are raising children and who have experienced online visit training by students. Methods: The online visitations were conducted in June 2020. The collaborators were three midwives who were devoted to childcare. During the online visit training, we used the feedback records of their questions given by the collaborators (with their permission) to the students. The verbatim record was created from the records. Qualitative descriptive analysis was used, and subcategories and categories were extracted. This study was approved by the Ethical Committee for Epidemiology of Hiroshima University. Results: The average age of the three midwives was 36.3 years, with an average of 12.3 years of experience after graduation. They were each raising multiple children (ranging between a minimum of 2 and a maximum of 4 children). Their youngest infants were 6.7 months old on average for all. Five categories that emerged were: contributing to the development of midwifery students as a senior; the joy of accepting the efforts of a mother while raising children; recalling the humility of beginners through the integrity of midwifery students; learning opportunities about the benefits of online visits; and suggesting further challenges for online visits. Conclusion: The online visit training was an opportunity for midwives who are raising their own children to reinforce an honest and humble approach based on the attitude of the students, for self-improvement, and to reflect on the practice of midwifery from another person’s viewpoint. It was also noted that the midwives contributed to the education of midwifery students. Furthermore, they also agreed with the use of online visitations and considered the advantages and disadvantages of its use from the perspective of mothers and midwives. Online visits were seen to empower midwives on childcare leave, as their child-rearing was accepted and admired. Online visits by students were considered to be an opportunity to not only provide a sense of fulfillment as a recipient of care but also to think concretely about career advancement, during childcare leave, regarding the ideal way for midwifery training and teaching.

Keywords: child-rearing midwife, COVID-19 pandemic, online visit practice, qualitive descriptive study

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