Search results for: optimum learning outcomes

Authors: Waleed Jarjoura

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In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in braille, basic Math competencies, braille printing which suggest Gerstmann syndrome in the blind. In addition, significant difficultiesorientation and mobility skills using the Cane, in general, organizational skills, and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctionsin blind individuals due to V/P shunt surgeries.

Keywords: congenital blindness, hydrocephalus, shunt surgery, spatial orientation

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Authors: Kshama Sharma

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Education is one of the most powerful tools to transform the world into a just, sustainable, and more peaceful place for existing lives across the globe. However, its recent objective approach focused on materialistic, factual, and existing knowledge, has a constraint of human experiences that is limited to certain dimensions only. And leads to a materialistic world which is deprived of spiritual approaches and makes it less compassionate, and more grades oriented. To make it more comprehensive, education should explore the subjective approaches towards spiritualism to connect lives with the greater self and consciousness of cosmic intelligence. This approach will bring a major shift in the orientation of pedagogical processes, assessment strategies, and administrative management of the present education system. Spirituality often related to the religious aspect of human civilization and development, however, when universal consciousness /cosmic intelligence (which is often claimed as dark energy) and the human mind competencies works in coherence and coordination then the efficiency of human mind reaches to a different dimension and achieve extraordinary level of human understanding. Quantitative analysis of the existing secondary data from the different agencies working in the field of meditation had been analyzed to conclude its implications on human mind and further how it can effectively use in education to bring the desired and expected results. Any kind of meditation practice affects the cognitive, mental, physical, emotional, and conscious state of mind. If aligned with the teaching and learning methodology will lead to conscious learner and peaceful world.

Keywords: spirituality, cosmic intelligence, consciousness, mind competencies

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Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas

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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.

Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital

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Authors: L. Cruz-Lopes, M. Sell, P. Escudeiro, B. Esteves

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It might be difficult for deaf people to communicate since spoken and written languages are different from sign language. When it comes to getting information, going to places of cultural heritage, or using services and infrastructure, there is a clear lack of inclusiveness. By creating assistive technology that enables deaf individuals to get around communication hurdles and encourage inclusive tourism, the ICHT- Inclusive Cultural Heritage Tourism initiative hopes to increase knowledge of sign language. The purpose of the Inclusive Cultural Heritage Tourism (ICHT) project is to develop online and on-site sign language tools and material for usage at popular tourist destinations in the northern region of Portugal, including Torre dos Clérigos, the Lello bookstore, Maia Zoo, Porto wine cellars, and São Pedro do Sul (Viseu) thermae. The ICHT system consists of an application using holography, a mobile game, an online platform for collaboration with deaf and hearing users, and a collection of International Sign training courses. The project also offers a prospect for a more inclusive society by introducing a method of teaching sign languages to tourism industry professionals. As a result, the teaching and learning of sign language along with the assistive technology tools created by the project sets up an inclusive environment for the deaf community, producing results in the area of automatic sign language translation and aiding in the global recognition of the Portuguese tourism industry.

Keywords: inclusive tourism, games, international sign training, deaf community

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Authors: Sushma Ghogale

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With a surge in user-generated content or feedback or reviews on the internet, it has become possible and important to know consumers' opinions about products and services. This data is important for both potential customers and businesses providing the services. Data from social media is attracting significant attention and has become the most prominent channel of expressing an unregulated opinion. Prospective customers look for reviews from experienced customers before deciding to buy a product or service. Several websites provide a platform for users to post their feedback for the provider and potential customers. However, the biggest challenge in analyzing such data is in extracting latent features and providing term-level analysis of the data. This paper proposes an approach to use topic modeling to classify the reviews into topics and conduct sentiment analysis to mine the opinions. This approach can analyse and classify latent topics mentioned by reviewers on business sites or review sites, or social media using topic modeling to identify the importance of each topic. It is followed by sentiment analysis to assess the satisfaction level of each topic. This approach provides a classification of hotel reviews using multiple machine learning techniques and comparing different classifiers to mine the opinions of user reviews through sentiment analysis. This experiment concludes that Multinomial Naïve Bayes classifier produces higher accuracy than other classifiers.

Keywords: latent Dirichlet allocation, topic modeling, text classification, sentiment analysis

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Authors: Anne Crescini

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The number of loanwords borrowed into the Japanese language is increasing rapidly in recent years, and many linguists argue that loanwords make up more than 10% of the Japanese lexicon. While these loanwords come from various Western languages, 80%-90% are borrowed from English. Also, there is a separate group of words and phrases categorized as ‘Japanese English’. These made-in-Japan linguistic creations may look and sound like English, but in fact are not used by native speakers and are often incomprehensible to them. Linguistically, the important thing to remember is that these terms are not English ones, but in fact, 100% Japanese words. A problem arises in language teaching, however, when Japanese English learners are unable to distinguish authentic loans from Japanese English terms. This confusion could greatly impede language acquisition and communication. The goal of this paper is to determine to what degree this potential misunderstanding may interfere with communication. Native English speakers living in the United States were interviewed and shown a list of romanized Japanese English terms, which are both commonly used and often mistaken for authentic loans. Then, the words were put into the context of a sentence in order to ascertain if context in any way aided comprehension. The results showed that while some terms are understood on their own, and others are understood better in context, a large number of the terms are entirely incomprehensible to native English speakers. If that is the case, and a Japanese learner mistakes a Japanese English term for an authentic loan, a communication breakdown may occur during interaction in English. With the ever-increasing presence of both groups of terms in the Japanese language, it is more important than ever that teaching professionals address this topic in the language classroom.

Keywords: Japanese, Japanese English, language acquisition, loanwords

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Authors: Salma Hussein, Hadia Aziz

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Entrepreneurship plays a significant and imperative role in economic and social growth, and therefore, is stimulated and encouraged by governments and academics as a mean of creating job opportunities, innovation, and wealth. Indicative of its importance, it is essential to identify factors that encourage and promote entrepreneurial behavior. This is particularly true for developing countries where the need for entrepreneurial development is high and the resources are scarce, thus, there is a need to maximize the outcomes of investing in entrepreneurial development. Entrepreneurial education has been the center of attention and interest among researchers as it is believed to be one of the most critical factors in promoting entrepreneurship over the long run. Accordingly, the urgency to encourage entrepreneurship education and develop an enterprise culture is now a main concern in Egypt. Researchers have postulated that cognition has the potential to make a significant contribution to the study of entrepreneurship. One such contribution that future studies need to consider in entrepreneurship research is the cognitive processes that occur within the individual such as cognitive style. During the past decade, there has been an increasing interest in cognitive style among researchers and practitioners specifically in innovation and entrepreneurship field. Limited studies pay attention to study the antecedent dynamics that fuel entrepreneurial cognition to better understand its role in entrepreneurship. Moreover, while many studies were conducted on entrepreneurship education, scholars are still hesitant regarding the teachability of entrepreneurship due to the lack of clear evidence of its impact. Furthermore, the relation between cognitive style and entrepreneurial intentions, has yet to be discovered. Hence, this research aims to test the impact of entrepreneurship education on cognitive style and subsequent intention in order to evaluate whether student’s and potential entrepreneur’s cognitive styles are affected by entrepreneurial education and in turn affect their intentions. Understanding the impact of Entrepreneurship Education on ways of thinking and intention is critical for the development of effective education and training in entrepreneurship field. It is proposed that students who are exposed to entrepreneurship education programs will have a more balanced thinking style compared to those students who are not exposed. Moreover, it is hypothesized that students having a balanced cognitive style will exhibit higher levels of entrepreneurial intentions than students having an intuitive or analytical cognitive style. Finally, it is proposed that non-formal entrepreneurship education will be more positively associated with entrepreneurial intentions than will formal entrepreneurship education. The proposed methodology is a pre and post Experimental Design. The sample will include young adults, their age range from 18 till 35 years old including both students enrolled in formal entrepreneurship education programs in private universities as well as young adults who are willing to participate in a Non-Formal entrepreneurship education programs in Egypt. Attention is now given on how far individuals are analytical or intuitive in their cognitive style, to what extent it is possible to have a balanced thinking style and whether or not this can be aided by training or education. Therefore, there is an urge need for further research on entrepreneurial cognition in educational contexts.

Keywords: cognitive style, entrepreneurial intention, entrepreneurship education, experimental design

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Authors: Mohammad Bakhshandeh

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Structural Health Monitoring (SHM) is a crucial and necessary practice that plays a vital role in ensuring the safety and integrity of critical structures, and in particular, bridges. The continuous monitoring of bridges for signs of damage or degradation through Bridge Health Monitoring (BHM) enables early detection of potential problems, allowing for prompt corrective action to be taken before significant damage occurs. Although all monitoring techniques aim to provide accurate and decisive information regarding the remaining useful life, safety, integrity, and serviceability of bridges, understanding the development and propagation of damage is vital for maintaining uninterrupted bridge operation. Over the years, extensive research has been conducted on BHM methods, and experts in the field have increasingly adopted new methodologies. In this article, we provide a comprehensive exploration of the various BHM approaches, including sensor-based, non-destructive testing (NDT), model-based, and artificial intelligence (AI)-based methods. We also discuss the challenges associated with BHM, including sensor placement and data acquisition, data analysis and interpretation, cost and complexity, and environmental effects, through an extensive review of relevant literature and research studies. Additionally, we examine potential solutions to these challenges and propose future research ideas to address critical gaps in BHM.

Keywords: structural health monitoring (SHM), bridge health monitoring (BHM), sensor-based methods, machine-learning algorithms, and model-based techniques, sensor placement, data acquisition, data analysis

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Authors: Araceli Martínez Ortiz

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An educational research effort is analyzed using systems theory to document the power of collective impact when addressing multiple factors contributing towards the retention of students majoring in science, technology, engineering and mathematics (STEM) academic programs. This research promotes understanding on how networked communities may work effectively toward a shared vision and mutually aligned activities that result in sustained, large scale change. The actions of a team of researchers in their third year of collaboration are presented to describe a model that positively aligns work efforts resulting in greater total gains. The goals of the multiple programs managed by the funded program team are to: 1) expand the number of students who choose to study a STEM field of study; 2) promote student collaborative learning; 3) support faculty understanding of the funds of knowledge of diverse students and 4) establish innovative and robust STEM education research that will lead to the development of nationally replicable, scalable models for broadening participation in STEM. The impacts of this research effort are measured through quantitative statistical analysis of the changes in second-year STEM undergraduate student retention rates and representation rates of women, Hispanics and African American STEM majors.

Keywords: collaborative impact, diversity, student retention, systems theory, STEM education

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Authors: Vu H. N. Khue, Marian Pavelka, Georg Jocher, Jiří Dušek, Le T. Son, Bui T. An, Ho Q. Bang, Pham Q. Huong

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Agriculture is an important economic sector of Vietnam, the most popular of which is wet rice cultivation. These activities are also known as the main contributor to the national greenhouse gas. In order to understand more about greenhouse gas exchange in these activities and to investigate the factors influencing carbon cycling and sequestration in these types of ecosystems, since 2019, the first eddy covariance station has been installed in a paddy field in Long An province, Mekong Delta. The station was equipped with state-of-the-art equipment for CO₂ and CH₄ gas exchange and micrometeorology measurements. In this study, data from the station was processed following the ICOS recommendations (Integrated Carbon Observation System) standards for CO₂, while CH₄ was manually processed and gap-filled using a random forest model from methane-gapfill-ml, a machine learning package, as there is no standard method for CH₄ flux gap-filling yet. Finally, the carbon equivalent (Ce) balance based on CO₂ and CH₄ fluxes was estimated. The results show that in 2020, even though a new water management practice - alternate wetting and drying - was applied to reduce methane emissions, the paddy field released 928 g Cₑ.m⁻².yr⁻¹, and in 2021, it was reduced to 707 g Cₑ.m⁻².yr⁻¹. On a provincial level, rice cultivation activities in Long An, with a total area of 498,293 ha, released 4.6 million tons of Cₑ in 2020 and 3.5 million tons of Cₑ in 2021.

Keywords: eddy covariance, greenhouse gas, methane, rice cultivation, Mekong Delta

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Authors: Chongya Song, Kang Yen, Alexander Pons, Jin Liu

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In the field of machine learning, the ensemble has been employed as a common methodology to improve the performance upon multiple base classifiers. However, the true predictions are often canceled out by the false ones during consensus due to a phenomenon called “curse of correlation” which is represented as the strong interferences among the predictions produced by the base classifiers. In addition, the existing practices are still not able to effectively mitigate the problem of imbalanced classification. Based on the analysis on our experiment results, we conclude that the two problems are caused by some inherent deficiencies in the approach of consensus. Therefore, we create an enhanced ensemble algorithm which adopts a designed rank-based chain-mode consensus to overcome the two problems. In order to evaluate the proposed ensemble algorithm, we employ a well-known benchmark data set NSL-KDD (the improved version of dataset KDDCup99 produced by University of New Brunswick) to make comparisons between the proposed and 8 common ensemble algorithms. Particularly, each compared ensemble classifier uses the same 22 base classifiers, so that the differences in terms of the improvements toward the accuracy and reliability upon the base classifiers can be truly revealed. As a result, the proposed rank-based chain-mode consensus is proved to be a more effective ensemble solution than the traditional consensus approach, which outperforms the 8 ensemble algorithms by 20% on almost all compared metrices which include accuracy, precision, recall, F1-score and area under receiver operating characteristic curve.

Keywords: consensus, curse of correlation, imbalance classification, rank-based chain-mode ensemble

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Authors: Ririh Rahma Ratinghayu, Jayu Pramudya, Nur Aini Masruroh, Shi-Woei Lin

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This research studies pricing strategy in cooperative setting of hotel duopoly selling perishable product under fixed capacity constraint by using the perspective of managers. In hotel revenue management, competitor’s average room rate and occupancy rate should be taken into manager’s consideration in determining pricing strategy to generate optimum revenue. This information is not provided by business intelligence or available in competitor’s website. Thus, Information Sharing (IS) among players might result in improved performance of pricing strategy. IS is widely adopted in the logistics industry, but IS within hospitality industry has not been well-studied. This research put IS as one of cooperative game schemes, besides Mutual Price Setting (MPS) scheme. In off-peak season, hotel manager arranges pricing strategy to offer promotion package and various kinds of discounts up to 60% of full-price to attract customers. Competitor selling homogenous product will react the same, then triggers a price war. Price war which generates lower revenue may be avoided by creating collaboration in pricing strategy to optimize payoff for both players. In MPS cooperative game, players collaborate to set a room rate applied for both players. Cooperative game may avoid unfavorable players’ payoff caused by price war. Researches on horizontal cooperative game in logistics show better performance and payoff for the players, however, horizontal cooperative game in hotel revenue management has not been demonstrated. This paper aims to develop hotel revenue management models under duopoly cooperative schemes (IS & MPS), which are compared to models under non-cooperative scheme too. Each scheme has five models, Capacity Allocation Model; Demand Model; Revenue Model; Optimal Price Model; and Equilibrium Price Model. Capacity Allocation Model and Demand Model employs self-hotel and competitor’s full and discount price as predictors under non-linear relation. Optimal price is obtained by assuming revenue maximization motive. Equilibrium price is observed by interacting self-hotel’s and competitor’s optimal price under reaction equation. Equilibrium is analyzed using game theory approach. The sequence applies for three schemes. MPS Scheme differently aims to optimize total players’ payoff. The case study in which theoretical models are applied observes two hotels offering homogenous product in Indonesia during a year. The Capacity Allocation, Demand, and Revenue Models are built using multiple regression and statistically tested for validation. Case study data confirms that price behaves within demand model in a non-linear manner. IS Models can represent the actual demand and revenue data better than Non-IS Models. Furthermore, IS enables hotels to earn significantly higher revenue. Thus, duopoly hotel players in general, might have reasonable incentives to share information horizontally. During off-peak season, MPS Models are able to predict the optimal equal price for both hotels. However, Nash equilibrium may not always exist depending on actual payoff of adhering or betraying mutual agreement. To optimize performance, horizontal cooperative game may be chosen over non-cooperative game. Mathematical models can be used to detect collusion among business players. Empirical testing can be used as policy input for market regulator in preventing unethical business practices potentially harming society welfare.

Keywords: horizontal cooperative game theory, hotel revenue management, information sharing, mutual price setting

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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Authors: P. Bharathiraja

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Computer Aided decision making system is used to enhance diagnosis and prognosis of diseases and also to assist clinicians and junior doctors in clinical decision making. Medical Data used for decision making should be definite and consistent. Data Mining and soft computing techniques are used for cleaning the data and for incorporating human reasoning in decision making systems. Fuzzy rule based inference technique can be used for classification in order to incorporate human reasoning in the decision making process. In this work, missing values are imputed using the mean or mode of the attribute. The data are normalized using min-ma normalization to improve the design and efficiency of the fuzzy inference system. The fuzzy inference system is used to handle the uncertainties that exist in the medical data. Equal-width-partitioning is used to partition the attribute values into appropriate fuzzy intervals. Fuzzy rules are generated using Class Based Associative rule mining algorithm. The system is trained and tested using heart disease data set from the University of California at Irvine (UCI) Machine Learning Repository. The data was split using a hold out approach into training and testing data. From the experimental results it can be inferred that classification using fuzzy inference system performs better than trivial IF-THEN rule based classification approaches. Furthermore it is observed that the use of fuzzy logic and fuzzy inference mechanism handles uncertainty and also resembles human decision making. The system can be used in the absence of a clinical expert to assist junior doctors and clinicians in clinical decision making.

Keywords: decision making, data mining, normalization, fuzzy rule, classification

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Authors: Ahmad Tijani Surajudeen, Muhammad Zahiri Awang Mat, Aliy Abdulwahid Adebisi

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With arrival of Islam in the South-Western Nigeria in the late fifteenth and early sixteenth centuries, various masājid established in different parts of the area played vital roles towards the betterment and unity of the Muslims. However, despite the fact that the masājid in the South-Western part of Nigeria contributed immensely to the spiritual and educational enhancement of the Muslims, it has not fully captured the holistic educational roles as a unique model used by the Prophet (S.A.W). Therefore, the primary objective of this paper is to investigate and broaden the roles of masjid towards its compartmentalized and holistic contributions among the Muslims in the south-western Nigeria. The findings from the paper have identified five holistic roles of masjid, namely, spiritual, intellectual, physical, social and emotional contributions which have been exemplified in the prophetic model of masjid. The paper has argued that the five factors must be unreservedly unified towards the betterment of the Muslims and enhancement of Islamic education and Arabic Language in the South-Western Nigeria. However, the challenges of masjid management in the South-Western Nigeria are the main hindrance in achieving the holistic roles of masjid. It is thereby suggested that, the management of masjid should take the identified prophetic model of masjid into account in order to positively improve the affairs of Muslims as well as promoting the teaching and learning of Islamic education and Arabic language among the Muslims in the South-Western Nigeria.

Keywords: worship, Islamic education, Arabic language, prophetic holistic model

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Authors: Fatemeh Torabi, Jamal El-Den, Narumon Sriratanviriyakul

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Perpetual changes in the workplace and daily business activities bring a need for imbedding organizational knowledge sharing within the organizations’ culture, routines and processes. Organizations should adapt to the changing in the environment in order to survive. Accordingly, the management should promote a knowledge sharing culture which might result in knowledge accumulation, hence better response to these changing environmental conditions. Researchers in the field of strategy and marketing stressed that employees’, as well as the overall performance of the organization, would improve as a result of implementing a knowledge-oriented culture. The research investigated the significant impact of knowledge sharing on market response and the competitiveness of organizations. A knowledge sharing framework was developed based on current literary frameworks with additional constructs such as employees’ learning commitments, experiences and prior knowledge. Linear regression was used to analyze the relationships among dependent and independent variables. The research’s results indicated strong positive correlation between the dependent and independent variables, especially in organizational market sharing. We anticipate that this correlation would improve organizational knowledge sharing related practices and the associated knowledge entities. The research posits the introduced framework could be a solid ground for further investigations on how some organizational factors would influence the organization’s response to the market as well as on competitiveness. Final results support all hypotheses. Finding of this research show that knowledge sharing intention had the significant and positive effect on market response and competitiveness of organizations.

Keywords: knowledge management, knowledge sharing, market response, organizational competitiveness

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Authors: Jonas Colin

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Standing at the vanguard of AI development, Alpha represents an unprecedented synthesis of logical rigor and human abstraction, meticulously crafted to mirror the user's unique persona and personality, a feat previously unattainable in AI development. Alpha, an avant-garde artefact in the realm of artificial intelligence, epitomizes a paradigmatic shift in personalized digital interaction, amalgamating user-specific dialogic patterns with the sophisticated algorithmic prowess of OpenAI's GPT-3.5 to engender a platform for enhanced metacognitive engagement and individualized user experience. Underpinned by a sophisticated algorithmic framework, Alpha integrates vast datasets through a complex interplay of neural network models and symbolic AI, facilitating a dynamic, adaptive learning process. This integration enables the system to construct a detailed user profile, encompassing linguistic preferences, emotional tendencies, and cognitive styles, tailoring interactions to align with individual characteristics and conversational contexts. Furthermore, Alpha incorporates advanced metacognitive elements, enabling real-time reflection and adaptation in communication strategies. This self-reflective capability ensures continuous refinement of its interaction model, positioning Alpha not just as a technological marvel but as a harbinger of a new era in human-computer interaction, where machines engage with us on a deeply personal and cognitive level, transforming our interaction with the digital world.

Keywords: chatbot, GPT 3.5, metacognition, symbiose

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Authors: Chih-Chieh Yang, Chung-Neng Huang

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In power system, how to improve the fault diagnosis technology of transmission line has always been the primary goal of power grid operators. In recent years, due to the rise of green energy, the addition of all kinds of distributed power also has an impact on the stability of the power system. Because the smart meters are with the function of data recording and bidirectional transmission, the adaptive Fuzzy Neural inference system, ANFIS, as well as the artificial intelligence that has the characteristics of learning and estimation in artificial intelligence. For transmission network, in order to avoid misjudgment of the fault type and location due to the input of these unstable power sources, combined with the above advantages of smart meter and ANFIS, a method for identifying fault types and location of faults is proposed in this study. In ANFIS training, the bus voltage and current information collected by smart meters can be trained through the ANFIS tool in MATLAB to generate fault codes to identify different types of faults and the location of faults. In addition, due to the uncertainty of distributed generation, a wind power system is added to the transmission network to verify the diagnosis correctness of the study. Simulation results show that the method proposed in this study can correctly identify the fault type and location of fault with more efficiency, and can deal with the interference caused by the addition of unstable power sources.

Keywords: ANFIS, fault diagnosis, power system, smart meter

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Authors: Oluwole Victor Falobi, Lawrence Olusola Ige

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The cardinal drawing force of this study is to examine the influence of audio-visual resources in teaching business subjects in selected secondary schools in IfakoIjaiye Local Government Area of Lagos State, Nigeria. A descriptive survey research design was employed for the study. By using a quantitative research approach and a sample size of 120 students were randomly selected from four public schools. Three research questions with one hypothesis guided the study. Data collected were analysed using frequency, the mean and standard deviation for the research questions, and Pearson Product Moment Correlation PPMC were used to analysed the inferential statistic. Findings from the study revealed that the Influence of audio-visual resources in teaching business subjects in selected secondary schools in IfakoIjaiye Local Government Area of Lagos State is low. It further revealed data the knowledge of teachers on the use of audio-visual resources is high in Ifako Local Government Area. It was recommended that government should create a timely monitoring system in other to check secondary school laboratories and classrooms to replace outdated facilities and also purchase needed facilities for effective teaching and learning to take place.

Keywords: audio-visual resources, business subjects, school, teaching

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Authors: Vincent Ballola, Raymund Dilan, Thelma Palaoag

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The Smart Online Library Catalog System with Query Expansion seeks to address the low usage of the library because of the emergence of the Internet. Library users are not accustomed to catalog systems that need a query to have the exact words without any mistakes for decent results to appear. The graphical user interface of the current system has a rather skewed learning curve for users to adapt with. With a simple graphical user interface inspired by Google, users can search quickly just by inputting their query and hitting the search button. Because of the query expansion techniques incorporated into the new system such as stemming, thesaurus search, and weighted search, users can have more efficient results from their query. The system will be adding the root words of the user's query to the query itself which will then be cross-referenced to a thesaurus database to search for any synonyms that will be added to the query. The results will then be arranged by the number of times the word has been searched. Online queries will also be added to the results for additional references. Users showed notable increases in efficiency and usability due to the familiar interface and query expansion techniques incorporated in the system. The simple yet familiar design led to a better user experience. Users also said that they would be more inclined in using the library because of the new system. The incorporation of query expansion techniques gives a notable increase of results to users that in turn gives them a wider range of resources found in the library. Used books mean more knowledge imparted to the users.

Keywords: query expansion, catalog system, stemming, weighted search, usability, thesaurus search

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Authors: Lynne McCormack, Andrew Digges

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Since 2013, the Australian government has enforced mandatory detention of anyone arriving in Australia without a valid visa, including those subsequently identified as a refugee or seeking asylum. While consistent with the increased use of immigration detention internationally, Australia’s use of offshore processing facilities both during and subsequent to refugee status determination processing has until recently remained a unique feature of Australia’s program of deterrence. The commonplace detention of refugees and asylum seekers following displacement is a significant and independent source of trauma and a contributory factor in adverse psychological outcomes. Officially, these individuals have no prospect of resettlement in Australia, are barred from applying for substantive visas, and are frequently and indefinitely detained in closed facilities such as immigration detention centres, or alternative places of detention, including hotels. It is also important to note that the limited access to Australia’s immigration detention population made available to researchers often means that data available for secondary analysis may be incomplete or delayed in its release. Further, studies into the lived experience of refugees and asylum seekers are typically cross-sectional and convenience sampled, employing a variety of designs and research methodologies that limit comparability and focused on the immediacy of the individual’s experience. Consequently, how former detainees make sense of their experience, redefine their future trajectory upon release, and recover a sense of authenticity and purpose, is unknown. As such, the present study sought the positive and negative subjective interpretations of 6 participants in Australia regarding their lived experiences as refugees and asylum seekers within Australia’s immigration detention system and its impact on their future sense of self. It made use of interpretative phenomenological analysis (IPA), a qualitative research methodology that is interested in how individuals make sense of, and ascribe meaning to, their unique lived experiences of phenomena. Underpinned by phenomenology, hermeneutics, and critical realism, this idiographic study aimed to explore both positive and negative subjective interpretations of former refugees and asylum seekers held in detention in Australia. It sought to understand how they make sense of their experiences, how detention has impacted their overall journey as displaced persons, and how they have moved forward in the aftermath of protracted detention in Australia. Examining the unique lived experiences of previously detained refugees and asylum seekers may inform the future development of theoretical models of posttraumatic growth among this vulnerable population, thereby informing the delivery of future mental health and resettlement services.

Keywords: mandatory detention, refugee, asylum seeker, authenticity, Interpretative phenomenological analysis

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Authors: Claudio Díaz, Mabel Ortiz

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An EFL teacher education programme in Chile takes five years to train a future teacher of English. Preservice teachers are prepared to learn an advanced level of English and teach the language from 5th to 12th grade in the Chilean educational system. In the context of their first EFL Methodology course in year four, preservice teachers have to create a five-minute digital story that starts from a critical incident they have experienced as teachers-to-be during their observations or interventions in the schools. A critical incident can be defined as a happening, a specific incident or event either observed by them or involving them. The happening sparks their thinking and may make them subsequently think differently about the particular event. When they create their digital stories, preservice teachers put technology, teaching practice and theory together to narrate a story that is complemented by still images, moving images, text, sound effects and music. The story should be told as a personal narrative, which explains the critical incident. This presentation will focus on the creation process of 50 Chilean preservice teachers’ digital stories highlighting the critical incidents they started their stories. It will also unpack preservice teachers’ beliefs and reflections when approaching their teaching practices in schools. These beliefs will be coded and categorized through content analysis to evidence preservice teachers’ most rooted conceptions about English teaching and learning in Chilean schools. The findings seem to indicate that preservice teachers’ beliefs are strongly mediated by contextual and affective factors.

Keywords: beliefs, digital stories, preservice teachers, practicum

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Authors: Rune Bjerke

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Psychologists incline to see creativity as a mental and psychological process. However, creativity is as well results of cultural and social interactions. Therefore, creativity is not a product of individuals in isolation, but of social systems. Creative people get ideas from the influence of others and the immediate cultural environment – a space of knowledge, situations, and practices. Therefore, in this study we apply the systems theory in practice to activate creativity processes in the production of our novel and screenplay writing. We, as storytellers actively seek to get into situations in our everyday lives, our systems, to generate ideas. Within our personal systems, we have the potential to induce situations to realise ideas to our texts, which may be accepted by our gate-keepers and can become socially validated. This is our method of writing – get into situations, get ideas to texts, and test them with family and friends in our social systems. Example of novel text as an outcome of our method is as follows: “Is it a matter of obviousness or had I read it somewhere, that the one who increases his knowledge increases his pain? And also, the other way around, with increased pain, knowledge increases, I thought. Perhaps such a chain of effects explains why the rebel August Strindberg wrote seven plays in ten months after the divorce with Siri von Essen. Shortly after, he tried painting. Neither the seven theatre plays were shown, nor the paintings were exhibited. I was standing in front of Munch's painting Women in Three Stages with chaotic mental images of myself crumpled in a church and a laughing x-girlfriend watching my suffering. My stomach was turning at unpredictable intervals and the subsequent vomiting almost suffocated me. Love grief at the worst. Was it this pain Strindberg felt? Despite the failure of his first plays, the pain must have triggered a form of creative energy that turned pain into ideas. Suffering, thoughts, feelings, words, text, and then, the reader experience. Maybe this negative force can be transformed into something positive, I asked myself. The question eased my pain. At that moment, I forgot the damp, humid air in the Munch Museum. Is it the similar type of Strindberg-pain that could explain the recurring, depressive themes in Munch's paintings? Illness, death, love and jealousy. As a beginning art student at the master's level, I had decided to find the answer. Was it the same with Munch's pain, as with Strindberg - a woman behind? There had to be women in the case of Munch - therefore, the painting “Women in Three Stages”? Who are they, what personality types are they – the women in red, black and white dresses from left to the right?” We, the writers, are using persons, situations and elements in our systems, in a systems theory perspective, to prompt creative ideas. A conceptual model is provided to advance creativity theory.

Keywords: creativity theory, systems theory, novel writing, screenplay writing, sources of creativity in social systems

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Authors: Mustapha Rilwan Adewale, Salau Ayobami Muhammed

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This study focuses on the heat transfer analysis of magneto-hydrodynamics (MHD) squeezing flow between parallel disks, considering a viscous incompressible fluid. The upper disk exhibits both upward and downward motion, while the lower disk remains stationary but permeable. By employing similarity transformations, a system of nonlinear ordinary differential equations is derived to describe the flow behavior. To solve this system, a numerical approach, namely the Chebyshev collocation method, is utilized. The study investigates the influence of flow parameters and compares the obtained results with existing literature. The significance of this research lies in understanding the heat transfer characteristics of MHD squeezing flow, which has practical implications in various engineering and industrial applications. By employing the similarity transformations, the complex governing equations are simplified into a system of nonlinear ordinary differential equations, facilitating the analysis of the flow behavior. To obtain numerical solutions for the system, the Chebyshev collocation method is implemented. This approach provides accurate approximations for the nonlinear equations, enabling efficient computations of the heat transfer properties. The obtained results are compared with existing literature, establishing the validity and consistency of the numerical approach. The study's major findings shed light on the influence of flow parameters on the heat transfer characteristics of the squeezing flow. The analysis reveals the impact of parameters such as magnetic field strength, disk motion amplitude, fluid viscosity on the heat transfer rate between the disks, the squeeze number(S), suction/injection parameter(A), Hartman number(M), Prandtl number(Pr), modified Eckert number(Ec), and the dimensionless length(δ). These findings contribute to a comprehensive understanding of the system's behavior and provide insights for optimizing heat transfer processes in similar configurations. In conclusion, this study presents a thorough heat transfer analysis of magneto-hydrodynamics squeezing flow between parallel disks. The numerical solutions obtained through the Chebyshev collocation method demonstrate the feasibility and accuracy of the approach. The investigation of flow parameters highlights their influence on heat transfer, contributing to the existing knowledge in this field. The agreement of the results with previous literature further strengthens the reliability of the findings. These outcomes have practical implications for engineering applications and pave the way for further research in related areas.

Keywords: squeezing flow, magneto-hydro-dynamics (MHD), chebyshev collocation method(CCA), parallel manifolds, finite difference method (FDM)

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Authors: Sabitha Rahim

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In the context of teaching vocabulary of English as Foreign Language (EFL), the confluence of memory and retention is one of the most significant factors in students' language acquisition. The progress of students engaged in foreign language acquisition is often stymied by vocabulary attrition, which leads to learners' lack of confidence and motivation. However, among other factors, little research has investigated the importance of neuroplasticity in Foreign Language acquisition and how underused neural pathways lead to the loss of plasticity, thereby affecting the learners’ vocabulary retention and motivation. This research explored the effect of enhancing vocabulary acquisition of EFL students in the Foundation Year at King Abdulaziz University through various methods and neuroplasticity exercises that reinforced their attention, motivation, and engagement. It analyzed the results to determine if stimulating the brain of EFL learners by various physical and mental activities led to the improvement in short and long term memory in vocabulary retention. The main data collection methods were student surveys, assessment records of teachers, student achievement test results, and students' follow-up interviews. A key implication of this research is for the institutions to consider having multiple varieties of student activities promoting brain plasticity within the classrooms as an effective tool for foreign language acquisition. Building awareness among the faculty and adapting the curriculum to include activities that promote brain plasticity ensures an enhanced learning environment and effective language acquisition in EFL classrooms.

Keywords: language acquisition, neural paths, neuroplasticity, vocabulary attrition

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Authors: Olubiyi Johnson Ezekiel

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Basic science curriculum is an on-going effort towards developing the potential of manner to produce individuals in a holistic and integrated person, who are intellectually, spiritually, emotionally and physically balanced and harmonious. The main focus of this study is to determine the relationship between students’ achievement in junior school certificate examination (JSCE) and senior school basic science achievement test (SSBSAT) on the basis of all the components of basic science. The study employed the descriptive research of the survey type and utilized junior school certificate examination and senior school basic science achievement test(r = .87) scores as instruments. The data collected were subjected to Pearson product moment correlation, Spearman rank correlation, regression analysis and analysis of variance. The result of the finding revealed that the mean effects of the achievement in all the components of basic science on SSBSAT are significantly different from zero. Based on the results of the findings, it was concluded that the relationship between students’ achievement in JSCE and SSBSAT was weak and to achieve a unit increase in the students’ achievement in the SSBSAT when other subjects are held constant, we have to increase the learning of: -physics by 0.081 units; -chemistry by 0.072 units; -biology by 0.025 units and general knowledge by 0.097 units. It was recommended among others, that general knowledge aspect of basic science should be included in either physics or chemistry aspect of basic science.

Keywords: basic science curriculum, students’ achievement, science test, secondary school students

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Authors: Brianne Nichols, John A. Parkinson

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Positive Psychology has provided a rich understanding of the beneficial effects of positive emotions in relation to optimal functioning, and research has been devoted to promote states of positive feeling and thinking. While this is a worthwhile pursuit, positive emotions are not useful in all contexts - some situations may require the individual to make use of their negative emotions to reach a desired end state. To account for the potential value of a wider range of emotional experiences that are common to the human condition, Positive Psychology needs to expand its horizons and investigate how individuals achieve positive outcomes using varied means. The current research seeks to understand the positive psychology of fear of failure (FF), which is a commonly experienced negative emotion relevant to most life domains. On the one hand, this emotion has been linked with avoidance motivation and self-handicap behaviours, on the other; FF has been shown to act as a drive to move the individual forward. To fully capture the depth of this highly subjective emotional experience and understand the circumstances under which FF may be adaptive, this study adopted a mixed methods design using SenseMaker; a web-based tool that combines the richness of narratives with the objectivity of numerical data. Two hundred participants consisting mostly of undergraduate university students shared a story of a time in the recent past when they feared failure of achieving a valued goal. To avoid researcher bias in the interpretation of narratives, participants self-signified their stories in a tagging system that was based on researchers’ aim to explore the role of past failures, the cognitive, emotional and behavioural profile of individuals high and low in FF, and the relationship between these factors. In addition, the role of perceived personal control and self-esteem were investigated in relation to FF using self-report questionnaires. Results from quantitative analyses indicated that individuals with high levels of FF, compared to low, were strongly influenced by past failures and preoccupied with their thoughts and emotions relating to the fear. This group also reported an unwillingness to accept their internal experiences, which in turn was associated with withdrawal from goal pursuit. Furthermore, self-esteem was found to mediate the relationship between perceived control and FF, suggesting that self-esteem, with or without control beliefs, may have the potential to buffer against high FF. It is hoped that the insights provided by the current study will inspire future research to explore the ways in which ‘acceptance’ may help individuals keep moving towards a goal despite the presence of FF, and whether cultivating a non-contingent self-esteem is the key to resilience in the face of failures.

Keywords: fear of failure, goal-pursuit, negative emotions, optimal functioning, resilience

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Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu

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Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.

Keywords: adults, bacterial meningitis, outcomes, therapy

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