Search results for: clinical performance assessment

Authors: Susan K. Steele-Moses, Aimee Badeaux

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Background Literature: Nurse anesthesia education placed high demands on students both personally and professionally. High levels of anxiety affect student’s mental, emotional, and physical well-being, which impacts their student success. Whereas more research has focused on the health and well-being of graduate students, far less has focused specifically on nurse anesthesia students (SNRAs), who may experience higher levels of anxiety due to the rigor of their academic program. Current literature describes stressors experienced by SRNAs that cause anxiety and affect their performance, including personal, academic, clinical, interpersonal, emotional, and financial. Sample: DNP-NA 2025 and DNP-NA 2024 cohorts (N = 36). Eighteen (66.7%) students participated in the study. Instrumentation: The DASS-21 was used to measure stress (7 items; α = .87) and anxiety (7 items; α = .74) from the participants. Intervention: The mind-shift meditation app, based on cognitive behavioral therapy, is being used daily before clinical and exams to decrease nurse anesthesia students’ stress and anxiety over time. Results: At baseline, the students exhibited a moderate level of stress, but their anxiety levels were low. The range of scores was 4-21 (out of 28) for stress (M = 12.88; SD = 5.40) and 0-16 (out of 28) for anxiety (M = 6.81; SD = 5.04). Both stress and anxiety were normally distributed [SW = .242 (stress); SW = .210 (anxiety)] without any outliers. There was a significant difference between their stress and anxiety levels (t = 5.55; p < .001) at baseline. Stress and anxiety will be measured over time, with the change analyzed using repeated measures ANOVA. Implications for Practice: The use of purposeful mindfulness meditation has been shown to decrease stress and anxiety in nursing students.

Keywords: mindfulness, meditation, graduate nursing education, nursing education

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Authors: Alfred L. Guiffrida

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A review of the literature on supply chain delivery models which use delivery windows to measure delivery performance is presented. The review herein serves to meet the following objectives: (i) provide a synthesis of previously published literature on supply chain delivery performance models, (ii) provide in one paper a consolidation of research that can serve as a single source to keep researchers up to date with the research developments in supply chain delivery models, and (iii) identify gaps in the modeling of supply chain delivery performance which could stimulate new research agendas.

Keywords: delivery performance, delivery window, supply chain delivery models, supply chain performance

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Authors: D. van der Merwe

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Walter Benjamin observed a marked difference in test performances versus final performances, with special regard to film and the cinema setting versus the stage as the site of performance, exhibition, and consumption. The attention given to film is justifiable and valid given its position as the best example of media convergence of Benjamin’s era, that of late modernity. In contemporary terms, however, the film has been supplanted by content as the prime example of convergence at work, and the digital domain, materialized in the form of the mobile internet, as the substituted site for the cinema. By examining the performance of the polymediated self within social media content, this paper hopes to establish the practice of content creation as a cultural artefact evidencing exhibition value on par with -or at least comparable with- performance art.

Keywords: content creation, convergence, stage performance, test performance, polymediation, Walter Benjamin

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Authors: Nega Tesfie Asfaw, Rafik Absi, Labouda B. A, Ikram El Abbassi

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Composite materials have come to the fore a few decades ago because of their superior insulation performances. Recycling natural fiber composites and natural fiber reinforcement of waste materials are other steps for conserving resources and the environment. This paper reviewed the Thermal properties (Thermal conductivity, Effusivity, and Diffusivity) and Mechanical properties (Compressive strength, Flexural strength, and Tensile strength) of bio-composite materials for thermal insulation in the construction industry. For several years, the development of the building materials industry has placed a special emphasis on bio-source materials. According to recent studies, most natural fibers have good thermal insulating qualities and good mechanical properties. To determine the thermal and mechanical performance of bio-composite materials in construction most research used experimental methods. the results of the study show that these natural fibers have allowed us to optimize energy consumption in a building and state that density, porosity, percentage of fiber, the direction of heat flow orientation of the fiber, and the shape of the specimen are the main elements that limit the thermal performance and also showed that density, porosity, Type of Fiber, Fiber length, orientation and weight percentage loading, Fiber-matrix adhesion, Choice of the polymer matrix, Presence of void are the main elements that limit the mechanical performance of the insulation material. Based on the results of this reviewed paper Moss fibers (0.034W/ (m. K)), Wood Fiber (0.043 W/ (m. K)), Wheat straw (0.046 W/ (m. K), and corn husk fibers (0.046 W/ (m. K) are a most promising solution for energy efficiency for construction industry with interesting insulation properties and with good acceptable mechanical properties. Finally, depending on the best fibers used for insulation applications in the construction sector, the thermal performance rate of various fibers reviewed in this article are analyzed. Due to Typha's high porosity, the results indicated that Typha australis fiber had a better thermal performance rate of 89.03% with clay.

Keywords: bio-based materials, thermal conductivity, compressive strength, thermal performance

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Authors: Fei Gao, Rodolfo C. Raga Jr.

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This research proposal will ascertain the major risk factors for diabetes and to design a predictive model for risk assessment. The project aims to improve diabetes early detection and management by utilizing data science techniques, which may improve patient outcomes and healthcare efficiency. The phase relation values of each attribute were used to analyze and choose the attributes that might influence the examiner's survival probability using Diabetes Health Indicators Dataset from Kaggle’s data as the research data. We compare and evaluate eight machine learning algorithms. Our investigation begins with comprehensive data preprocessing, including feature engineering and dimensionality reduction, aimed at enhancing data quality. The dataset, comprising health indicators and medical data, serves as a foundation for training and testing these algorithms. A rigorous cross-validation process is applied, and we assess their performance using five key metrics like accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). After analyzing the data characteristics, investigate their impact on the likelihood of diabetes and develop corresponding risk indicators.

Keywords: diabetes, risk factors, predictive model, risk assessment, data science techniques, early detection, data analysis, Kaggle

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Authors: Ali Osman Güney, Bahattin Kanber

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In this work, the effect of material type, diameter, orientation and closeness of fibers on the general performance of reinforced vulcanized rubbers are investigated using finite element method with experimental verification. Various fiber materials such as hemp, nylon, polyester are used for different fiber diameters, orientations and closeness. 3D finite element models are developed by considering bonded contact elements between fiber and rubber sheet interfaces. The fibers are assumed as linear elastic, while vulcanized rubber is considered as hyper-elastic. After an experimental verification of finite element results, the developed models are analyzed under prescribed displacement that causes tension. The normal stresses in fibers and shear stresses between fibers and rubber sheet are investigated in all models. Large deformation of reinforced rubber sheet also represented with various fiber conditions under incremental loading. A general assessment is achieved about best fiber properties of reinforced rubber sheets for tension-load conditions.

Keywords: reinforced vulcanized rubbers, fiber properties, out of plane loading, finite element method

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Authors: Konstantinos G. Kostinakis, Asimina M. Athanatopoulou

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A key issue in seismic risk analysis within the context of Performance-Based Earthquake Engineering is the evaluation of the expected seismic damage of structures under a specific earthquake ground motion. The assessment of the seismic performance strongly depends on the choice of the seismic Intensity Measure (IM), which quantifies the characteristics of a ground motion that are important to the nonlinear structural response. Several conventional IMs of ground motion have been used to estimate their damage potential to structures. Yet, none of them has been proved to be able to predict adequately the seismic damage. Therefore, alternative, scalar intensity measures, which take into account not only ground motion characteristics but also structural information have been proposed. Some of these IMs are based on integration of spectral values over a range of periods, in an attempt to account for the information that the shape of the acceleration, velocity or displacement spectrum provides. The adequacy of a number of these IMs in predicting the structural damage of 3D R/C buildings is investigated in the present paper. The investigated IMs, some of which are structure specific and some are nonstructure-specific, are defined via integration of spectral values. To achieve this purpose three symmetric in plan R/C buildings are studied. The buildings are subjected to 59 bidirectional earthquake ground motions. The two horizontal accelerograms of each ground motion are applied along the structural axes. The response is determined by nonlinear time history analysis. The structural damage is expressed in terms of the maximum interstory drift as well as the overall structural damage index. The values of the aforementioned seismic damage measures are correlated with seven scalar ground motion IMs. The comparative assessment of the results revealed that the structure-specific IMs present higher correlation with the seismic damage of the three buildings. However, the adequacy of the IMs for estimation of the structural damage depends on the response parameter adopted. Furthermore, it was confirmed that the widely used spectral acceleration at the fundamental period of the structure is a good indicator of the expected earthquake damage level.

Keywords: damage measures, bidirectional excitation, spectral based IMs, R/C buildings

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Authors: Justine Ugochukwu Osuagwu, Sazali Abd Wahab

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The performance and operation of NNPC have faced series of attacks by all stakeholders as many have observed lots of inefficiency not only on the part of the management but the staff. This has raised questions of whether their operations and performance are being seriously affected by lack of transformational leadership, and the political competition prevalent in the country. The author has applied the administrative leadership theory and institutional theory as a guide to this study and empirically relates such theories to the study. The study also has utilized the quantitative approach where questionnaires were distributed to 370 participants, and the correctly filled and returned questionnaires were used for the analysis using structural equation modeling. The path coefficient of transformational leadership to performance is strong and positive with β = 0.672; t-value = 14.245; p-value = 0.000. Also, the result found that political competition does not mediate the relationship between transformational leadership and performance of NNPC. (β = -0.008; t-value = -0.600; p- value > 0.05). However, the indirect path is all insignificant, meaning that transformational leadership has relationship with corporate performance.The study found that,while political competition does not serve as a mediator in the relationship between transformational leadership and corporate performance, these styles of leadership have a direct and positive impact on corporate performance. The direct relationship between transformational leadership and political competition was not discovered, despite the fact that political competition has a direct and significant impact, both positive and negative, on corporate performance. As a result, both political competition and transformational leadership have the potential to significantly alter corporate performance.

Keywords: performance, transformational leadership, political competition, corporation performance, Nigeria national petroleum corporation

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Authors: Faraj Ahmed E. Alhegagi, Anagia M. Khamkam Mohamed, Bassam F. Alhajaji

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Duplex stainless steels (DSS) are widely employed in industry for apparatus working with sea water in petroleum, refineries and in chemical plants. Fracture of DSS takes place by cleavage of the ferrite phase and the austenite phase ductile tear off. Pop-in is an important feature takes place during fracture of DSS. The procedure of Pop-ins assessment plays an important role in fracture toughness studies. In present work, Zeron100 DSS specimens were heat treated at different temperatures, cooled and pulled to failure to assess the pop-ins criterion in crack initiation prediction. The outcome results were compared to the British Standard (BS 7448) and the ASTEM standard (E1290) for Crack-Tip Opening Displacement (CTOD) fracture toughness measurement. Pop-in took place during specimens loading specially for those specimens heat treated at higher temperatures. The standard BS7448 was followed to check specimen validity for fractured toughness assessment by direct determination of KIC. In most cases, specimens were invalid for KIC measurement. The two procedures were equivalent only when single pop-ins were assessed. A considerable contrast in fracture toughness value between was observed where multiple pop-ins were assessed.

Keywords: fracture toughness, stainless steels, pop ins, crack assessment

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Authors: Philippe Dillien, Patrice Forget, Harald Engel, Olivier Cornu, Marc De Kock, Jean Cyr Yombi

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Introduction: Hip fracture precedes commonly death in elderly people. Identification of high-risk patients may contribute to target patients in whom optimal management, resource allocation and trials efficiency is needed. The aim of this study is to construct a predictive score of mortality after hip fracture on the basis of the objective prognostic factors available: Neutrophil-to-lymphocyte ratio (NLR), age, and sex. C-Reactive Protein (CRP), is also considered as an alternative to the NLR. Patients and methods: After the IRB approval, we analyzed our prospective database including 286 consecutive patients with hip fracture. A score was constructed combining age (1 point per decade above 74 years), sex (1 point for males), and NLR at postoperative day+5 (1 point if >5). A receiver-operating curve (ROC) curve analysis was performed. Results: From the 286 patients included, 235 were analyzed (72 males and 163 females, 30.6%/69.4%), with a median age of 84 (range: 65 to 102) years, mean NLR values of 6.47+/-6.07. At one year, 82/280 patients died (29.3%). Graphical analysis and log-rank test confirm a highly statistically significant difference (P<0.001). Performance analysis shows an AUC of 0.72 [95%CI 0.65-0.79]. CRP shows no advantage on NLR. Conclusion: We have developed a score based on age, sex and the NLR to predict the risk of mortality at one year in elderly patients after surgery for a hip fracture. After external validation, it may be included in clinical practice as in clinical research to stratify the risk of postoperative mortality.

Keywords: neutrophil-to-lymphocyte ratio, hip fracture, postoperative mortality, medical and health sciences

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Authors: Keping Zuo, Foad Kabinejadian, Gideon Praveen Kumar Vijayakumar, Fangsen Cui, Pei Ho, Hwa Liang Leo

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Carotid artery stenting (CAS) is the standard procedure for patients with severe carotid stenosis at high risk for carotid endarterectomy (CAE). A major drawback of CAS is the higher incidence of procedure-related stroke compared with traditional open surgical treatment for carotid stenosis - CEA, even with the use of the embolic protection devices (EPD). As the currently available bare metal stents cannot address this problem, our research group developed a novel preferential covered-stent for carotid artery aims to prevent friable fragments of atherosclerotic plaques from flowing into the cerebral circulation, and yet maintaining the flow of the external carotid artery. The preliminary animal studies have demonstrated the potential of this novel covered-stent design for the treatment of carotid atherosclerotic stenosis. The purpose of this study is to evaluate the effect of membrane coating on the stent flexibility in order to improve the clinical performance of our novel covered stents. A total of 21 stents were evaluated in this study: 15 self expanding bare nitinol stents and 6 PTFE-covered stents. 10 of the bare stents were coated with 11%, 16% and 22% Polyurethane(PU), 4%, 6.25% and 11% EE, as well as 22% PU plus 5 μm Parylene. Different laser cutting designs were performed on 4 of the PTFE covert stents. All the stents, with or without the covered membrane, were subjected to a three-point flexural test. The stents were placed on two supports that are 30 mm apart, and the actuator is applying a force in the exact middle of the two supports with a loading pin with radius 2.5 mm. The loading pin displacement change, the force and the variation in stent shape were recorded for analysis. The flexibility of the stents was evaluated by the lumen area preservation at three displacement bending levels: 5mm, 7mm, and 10mm. All the lumen areas in all stents decreased with the increase of the displacement from 0 to 10 mm. The bare stents were able to maintain 0.864 ± 0.015, 0.740 ± 0.025 and 0.597 ± 0.031of original lumen area at 5 mm, 7 mm and 10mm displacement respectively. For covered stents, the stents with EE coating membrane showed the best lumen area preservation (0.839 ± 0.005, 0.7334 ± 0.043 and 0.559 ± 0.014), whereas, the stents with PU and Parylene coating were only 0.662, 0.439 and 0.305. Bending stiffness was also calculated and compared. These results provided optimal material information and it was crucial for enhancing clinical performance of our novel covered stents.

Keywords: carotid artery, covered stent, nonlinear, hyperelastic, stress, strain

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Authors: Li Yin, Xiaoqin Wang

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Background and purpose: Cancer diagnosis is part of a complex stochastic process, in which patients' personal and social characteristics influence the choice of diagnosing methods, diagnosing methods, in turn, influence the initial assessment of cancer stage, the initial assessment, in turn, influences the choice of treating methods, and treating methods in turn influence cancer outcomes such as cancer survival. To evaluate diagnosing methods, one needs to estimate and test the causal effect of a regime of cancer diagnosis and treatments. Recently, Wang and Yin (Annals of statistics, 2020) derived a new general formula, which expresses these causal effects in terms of the point effects of treatments in single-point causal inference. As a result, it is possible to estimate and test these causal effects via point effects. The purpose of the work is to estimate and test causal effects under various regimes of cancer diagnosis and treatments via point effects. Challenges and solutions: The cancer stage has influences from earlier diagnosis as well as on subsequent treatments. As a consequence, it is highly difficult to estimate and test the causal effects via standard parameters, that is, the conditional survival given all stationary covariates, diagnosing methods, cancer stage and prognosis factors, treating methods. Instead of standard parameters, we use the point effects of cancer diagnosis and treatments to estimate and test causal effects under various regimes of cancer diagnosis and treatments. We are able to use familiar methods in the framework of single-point causal inference to accomplish the task. Achievements: we have applied this method to stomach cancer survival from a clinical study in Sweden. We have studied causal effects under various regimes, including the optimal regime of diagnosis and treatments and the effect moderation of the causal effect by age and gender.

Keywords: cancer diagnosis, causal effect, point effect, G-formula, sequential causal effect

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Authors: Kevin William Taylor

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This work draws upon research in the fields of games development and mental health treatments to assess the influence that interactive entertainment has on the populous, and the potential of technology to affect areas of psychiatric assessment and treatment. It will use studies to establish the evolving direction of interactive media in the development of ‘digital self-identity,’ and how this can be incorporated into treatment to the benefit of psychiatry. It will determine that this approach will require collaborative production between developers and psychiatrists in order to ensure precise goals are met, improving the success of serious gaming for psychiatric assessment and treatment. Analysis documents the reach of video games across a growing global community of gamers, highlighting cases of the positives and negatives of video game usage. The games industry is largely oblivious to the psychological negatives, with psychiatrists encountering new conditions such as gaming addiction, which is now recognized by the World Health Organization. With an increasing amount of gamers worldwide, and an additional time per day invested in online gaming and character development, the concept of virtual identity as a means of expressing the id needs further study to ensure successful treatment. In conclusion, the assessment and treatment of game-related conditions are currently reactionary, and while some mental health professionals have begun utilizing interactive technologies to assist with the assessment and treatment of conditions, this study will determine how the success of these products can be enhanced. This will include collaboration between software developers and psychiatrists, allowing new avenues of skill-sharing in interactive design and development. Outlining how to innovate approaches to engagement will reap greater rewards in future interactive products developed for psychiatric assessment and treatment.

Keywords: virtual reality, virtual identity, interactivity, psychiatry

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Authors: Muhammad Ridho Fakhrin, Leni Sagita Riantini, Yusuf Latief

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Based on the 2015-2019 RPJMN data, the realization of toll road infrastructure development in Indonesia experienced a delay of 49% or 904 km of the total plan. One of the major causes of delays in development is caused by institutional factors. The case study taken in this research is the construction of the Trans Sumatra Toll Road (JTTS). The purpose of this research is to identify the institutional forms, functions, roles, duties, and responsibilities of each stakeholder and the risks that occur in the Trans Sumatra Toll Road Infrastructure Development. Risk analysis is implemented on functions, roles, duties, responsibilities of each existing stakeholder and is carried out at the Funding Stage, Technical Planning Stage, and Construction Implementation Stage in JTTS. This research is conducted by collecting data through a questionnaire survey, then processed using statistical methods, such as homogeneity, data adequacy, validity, and reliability test, continued with risk assessment based on a risk matrix. The results of this study are the evaluation and development of institutional functions in risk-based JTTS development can improve time performance and minimize delays in the construction process.

Keywords: institutional, risk management, time performance, toll road

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Authors: Muhammad nor Farhan Sa'At, Xin Y. Lim, Terence Y. C. Tan, Siti Hajar M. Rosli, Syazwani S. Ali, Ami F. Syed Mohamed

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INTRODUCTION: Hemp (Cannabis sativa subsp. sativa), commonly used for industrial purposes, differs from marijuana by containing lower levels of delta-9-tetrahydronannabidiol- the principal psychoactive constituent in cannabis. Due to its non-psychoactive nature, there has been growing interest in hemp’s therapeutic potential, which has been investigated through pre-clinical and clinical study modalities. OBJECTIVE: To provide an overview of the current landscape of hemp research, through recent scientific findings specific to the pharmacological effects of the medicinal hemp plant and its derived compounds. METHODS: This review was conducted through a systematic search strategy according to the preferred reporting items for systematic review and meta-analysis-ScR (PRISMA-ScR) checklist on electronic databases including MEDLINE, OVID (OVFT, APC Journal Club, EBM Reviews), Cochrane Library Central and Clinicaltrials.gov. RESULTS: From 65 primary articles reviewed, there were 47 pre-clinical studies related to medicinal hemp. Interestingly, the hemp derivatives showed several potential activities such as anti-oxidative, anti-hypertensive, anti-inflammatory, anti-diabetic, anti-neuroinflammatory, anti-arthritic, anti-acne, and anti-microbial activities. Renal protective effects and estrogenic properties were also exhibited in vitro. CONCLUSION: Medicinal hemp possesses various pharmacological effects tested in vitro and in vivo. Information provided in this review could be used as tool to strengthen the study design of future clinical trial research.

Keywords: Preclinical, Herbal Medicine, Hemp, Cannabis

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Authors: Tomasz L. Nawrocki, Danuta Szwajca

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The growing importance of reputation in building enterprise value and achieving long-term competitive advantage creates the need for its measurement and evaluation for the management purposes (effective reputation and its risk management). The paper presents practical application of self-developed corporate reputation assessment model from the viewpoint of stock market investors. The model has a pioneer character and example analysis performed for selected industry is a form of specific test for this tool. In the proposed solution, three aspects - informational, financial and development, as well as social ones - were considered. It was also assumed that the individual sub-criteria will be based on public sources of information, and as the calculation apparatus, capable of obtaining synthetic final assessment, fuzzy logic will be used. The main reason for developing this model was to fulfill the gap in the scope of synthetic measure of corporate reputation that would provide higher degree of objectivity by relying on "hard" (not from surveys) and publicly available data. It should be also noted that results obtained on the basis of proposed corporate reputation assessment method give possibilities of various internal as well as inter-branch comparisons and analysis of corporate reputation impact.

Keywords: corporate reputation, fuzzy logic, fuzzy model, stock market investors

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Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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Authors: Guilherme Giacomini, Ana Luiza Menegatti Pavan, Allan Felipe Fattori Alves, Marcela de Oliveira, Fernando Antonio Bacchim Neto, José Ricardo de Arruda Miranda, Seizo Yamashita, Diana Rodrigues de Pina

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The maxillary sinus (MS), part of the paranasal sinus complex, is one of the most enigmatic structures in modern humans. The literature has suggested that MSs function as olfaction accessories, to heat or humidify inspired air, for thermoregulation, to impart resonance to the voice and others. Thus, the real function of the MS is still uncertain. Furthermore, the MS anatomy is complex and varies from person to person. Many diseases may affect the development process of sinuses. The incidence of rhinosinusitis and other pathoses in the MS is comparatively high, so, volume analysis has clinical value. Providing volume values for MS could be helpful in evaluating the presence of any abnormality and could be used for treatment planning and evaluation of the outcome. The computed tomography (CT) has allowed a more exact assessment of this structure, which enables a quantitative analysis. However, this is not always possible in the clinical routine, and if possible, it involves much effort and/or time. Therefore, it is necessary to have a convenient, robust, and practical tool correlated with the MS volume, allowing clinical applicability. Nowadays, the available methods for MS segmentation are manual or semi-automatic. Additionally, manual methods present inter and intraindividual variability. Thus, the aim of this study was to develop an automatic tool to quantity the MS volume in CT scans of paranasal sinuses. This study was developed with ethical approval from the authors’ institutions and national review panels. The research involved 30 retrospective exams of University Hospital, Botucatu Medical School, São Paulo State University, Brazil. The tool for automatic MS quantification, developed in Matlab®, uses a hybrid method, combining different image processing techniques. For MS detection, the algorithm uses a Support Vector Machine (SVM), by features such as pixel value, spatial distribution, shape and others. The detected pixels are used as seed point for a region growing (RG) segmentation. Then, morphological operators are applied to reduce false-positive pixels, improving the segmentation accuracy. These steps are applied in all slices of CT exam, obtaining the MS volume. To evaluate the accuracy of the developed tool, the automatic method was compared with manual segmentation realized by an experienced radiologist. For comparison, we used Bland-Altman statistics, linear regression, and Jaccard similarity coefficient. From the statistical analyses for the comparison between both methods, the linear regression showed a strong association and low dispersion between variables. The Bland–Altman analyses showed no significant differences between the analyzed methods. The Jaccard similarity coefficient was > 0.90 in all exams. In conclusion, the developed tool to quantify MS volume proved to be robust, fast, and efficient, when compared with manual segmentation. Furthermore, it avoids the intra and inter-observer variations caused by manual and semi-automatic methods. As future work, the tool will be applied in clinical practice. Thus, it may be useful in the diagnosis and treatment determination of MS diseases. Providing volume values for MS could be helpful in evaluating the presence of any abnormality and could be used for treatment planning and evaluation of the outcome. The computed tomography (CT) has allowed a more exact assessment of this structure which enables a quantitative analysis. However, this is not always possible in the clinical routine, and if possible, it involves much effort and/or time. Therefore, it is necessary to have a convenient, robust and practical tool correlated with the MS volume, allowing clinical applicability. Nowadays, the available methods for MS segmentation are manual or semi-automatic. Additionally, manual methods present inter and intraindividual variability. Thus, the aim of this study was to develop an automatic tool to quantity the MS volume in CT scans of paranasal sinuses. This study was developed with ethical approval from the authors’ institutions and national review panels. The research involved 30 retrospective exams of University Hospital, Botucatu Medical School, São Paulo State University, Brazil. The tool for automatic MS quantification, developed in Matlab®, uses a hybrid method, combining different image processing techniques. For MS detection, the algorithm uses a Support Vector Machine (SVM), by features such as pixel value, spatial distribution, shape and others. The detected pixels are used as seed point for a region growing (RG) segmentation. Then, morphological operators are applied to reduce false-positive pixels, improving the segmentation accuracy. These steps are applied in all slices of CT exam, obtaining the MS volume. To evaluate the accuracy of the developed tool, the automatic method was compared with manual segmentation realized by an experienced radiologist. For comparison, we used Bland-Altman statistics, linear regression and Jaccard similarity coefficient. From the statistical analyses for the comparison between both methods, the linear regression showed a strong association and low dispersion between variables. The Bland–Altman analyses showed no significant differences between the analyzed methods. The Jaccard similarity coefficient was > 0.90 in all exams. In conclusion, the developed tool to automatically quantify MS volume proved to be robust, fast and efficient, when compared with manual segmentation. Furthermore, it avoids the intra and inter-observer variations caused by manual and semi-automatic methods. As future work, the tool will be applied in clinical practice. Thus, it may be useful in the diagnosis and treatment determination of MS diseases.

Keywords: maxillary sinus, support vector machine, region growing, volume quantification

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Authors: Tugrul Oktay, Mehmet Konar, Mustafa Soylak, Firat Sal, Murat Onay, Orhan Kizilkaya

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In this paper, autonomous performance of a small manufactured unmanned helicopter is tried to be increased. For this purpose, a small unmanned helicopter is manufactured in Erciyes University, Faculty of Aeronautics and Astronautics. It is called as ZANKA-Heli-I. For performance maximization, autopilot parameters are determined via minimizing a cost function consisting of flight performance parameters such as settling time, rise time, overshoot during trajectory tracking. For this purpose, a stochastic optimization method named as simultaneous perturbation stochastic approximation is benefited. Using this approach, considerable autonomous performance increase (around %23) is obtained.

Keywords: small helicopters, hierarchical control, stochastic optimization, autonomous performance maximization, autopilots

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Authors: Zheming Cao

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Control loops are the most important components in the wind turbine system. Product quality, operation safety, and the economic performance are directly or indirectly connected to the performance of control systems. This paper proposed a performance evaluation method based on minimum-variance for wind turbine control system. This method can be applied on PID controller for pitch control system in the wind turbine. The good performance result demonstrated in the paper was achieved by retuning and optimizing the controller settings based on the evaluation result. The concepts presented in this paper are illustrated with the actual data of the industrial wind farm.

Keywords: control performance, evaluation, minimum-variance, wind turbine

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Authors: Akerele Akintunde Hareef

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GIS is an integrating tool for storing, retrieving, manipulating, and analyzing spatial data. It is a tool which defines an area with respect to features and other relevant thematic delineations. On the other hand, Environmental Impact Assessment in short is both positive and negative impact of an infrastructure on an environment. Impact of infrastructural projects on the environment is an aspect of development that barely get extensive portion of pre-project execution phase and when they do, the effects are most times not implemented to cushion the impact they have on human and the environment. In this research, infrastructural projects like road constructions, water reticulation projects, building constructions, bridge etc. have immense impact on the environment and the people that reside in location of construction. Hence, the need for this research tends to portray the relevance of Environmental Impact assessment in calculating the vulnerability of human and the environment to imbalance necessitated by this infrastructural development and how the use of GIS application can be optimally applied to annul or minimize the effect.

Keywords: environmental impact assessment (EIA), geographic information system (GIS), infrastructural projects, environment

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Authors: S. K. Ashiquer Rahman

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A cutting-edge online knowledge mediation system called "ePLANETe" provides a framework for building knowledge, tools and methods for all education, research and sustainable practices and elsewhere, as well as the deliberative assessment support of sustainability, biodiversity, and stakeholder involvement issues of the territorial development sector, e.g., agriculture.The purpose is to present, as sectorial and institutional perception, the 'ePLANETe' concept and functionalities as an experimental online platform for contributing the sustainability assessment, biodiversity, and stakeholder involvement. In the upshot, the concept of 'ePLANETe'isan investigation of the challenges of "online things, technology and application". The new digital technologies are exploited to facilitate collaborative technology and application to territorial development issues, e.g., agriculture. In order to investigate the dealing capacity (Qualitative and Quantitative) of sustainability, biodiversity, and stakeholder involvement of the agriculture sector through the stakeholder-based integrated assessment "Deliberation Support Tools (DST) and INTEGRAAL method" of collective resources. Specifically, this paper focuses on integrating system methodologies with deliberation tools for collective assessment and decision-making in implementing regional plans of agriculture. The aim of this report is to identify effective knowledge and tools and to enable deliberation methodologies regarding practices on the sustainability of agriculture and biodiversity issues, societal responsibilities, and regional planning that will create the scope for qualitative and quantitative assessments of sustainability as a new landmark of the agriculture sector.

Keywords: sustainability, biodiversity, stakeholder, dst, integraal

Procedia PDF Downloads 116

Authors: Sibongiseni Thabethe, Ian Korir

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The effective management of spent fuel pool (SFP) safety has been raised as one of the emerging issues to further enhance nuclear installation safety after the Fukushima accident on March 11, 2011. Before then, SFP safety-related issues have been mainly focused on (a) controlling the configuration of the fuel assemblies in the pool with no loss of pool coolants and (b) ensuring adequate pool storage space to prevent fuel criticality owing to chain reactions of the fission products and the ability for neutron absorption to keep the fuel cool. A probabilistic safety (PSA) assessment was performed using the systems analysis program for hands-on integrated reliability evaluations (SAPHIRE) computer code. Event and fault tree analysis was done to develop a PSA model for the Koeberg SFP. We present preliminary PSA results of events that lead to boiling and cause fuel uncovering, resulting in possible fuel damage in the Koeberg SFP.

Keywords: computer code, fuel assemblies, probabilistic risk assessment, spent fuel pool

Procedia PDF Downloads 169

Authors: Fakhr Eddin Alnaal, Angela Dahdal, Duaa Aladib, Sabeen Ibrahim, Ibrahim Ghoraibi, Bissan Ahmed

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Dementia is one of the diseases which had several stages and Alzheimer’s term was selected in respect for the first doctor Alzheimer who defined the first symptoms of this diseases in a woman whom was well treated by him. The fact that this is a type of a silent disease on which you have a long-term process of neurological degradation and suddenly gives symptoms which are most often irreversible, on clinical level likely we can consider it as a malignancy, one in terms of that it is sudden shocking irreversible and on the level of behavior and some mortality beside the lack of early detection tools for diagnosis. Therefore, the goal of our project is to test the concept of the ability of Statin in prevention of such disease and we investigated that both on experimental level and most importantly on clinical one, the clinical part was performed in a recognized house of aged people who had accidently a high cholesterol and were for years given Statin to treat that elevation, however after the symptoms of Alzheimer’s appeared and when diagnosed, they were well treated and rapidly recovered compared to Alzheimer’s patients in the same house who did not receive Statin had a mild improvement in their symptoms after the therapy, on the other hand we confirmed such observation by a well-organized experimental work.

Keywords: Alzheimer's, dementia, silent disease, statin

Procedia PDF Downloads 133

Authors: R. Christopher, C. Brandt, N. Damons

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Background: The sequence of prevention model states that by constant assessment of injury, injury mechanisms and risk factors are identified, highlighting that collecting and recording of data is a core approach for preventing injuries. Several screening tools are available for use in the clinical setting. These screening techniques only recently received research attention, hence there is a dearth of inconsistent and controversial data regarding their applicability, validity, and reliability. Several systematic reviews related to common soccer injuries have been conducted; however, none of them addressed the screening tools for common soccer injuries. Objectives: The purpose of this study was to conduct a review of screening tools and their accuracy for common injuries in soccer. Methods: A systematic scoping review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were used to access suitable studies. Some of the key search terms included: injury screening, screening, screening tool accuracy, injury prevalence, injury prediction, accuracy, validity, specificity, reliability, sensitivity. All types of English studies dating back to the year 2000 were included. Two blind independent reviewers selected and appraised articles on a 9-point scale for inclusion as well as for the risk of bias with the ACROBAT-NRSI tool. Data were extracted and summarized in tables. Plot data analysis was done, and sensitivity and specificity were analyzed with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The initial search yielded 95 studies, of which 21 were duplicates, and 54 excluded. A total of 10 observational studies were included for the analysis: 3 studies were analysed quantitatively while the remaining 7 were analysed qualitatively. Seven studies were graded low and three studies high risk of bias. Only high methodological studies (score > 9) were included for analysis. The pooled studies investigated tools such as the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS), and the conventional hamstrings to quadriceps ratio. The accuracy of screening tools was of high reliability, sensitivity and specificity (calculated as ICC 0.68, 95% CI: 52-0.84; and 0.64, 95% CI: 0.61-0.66 respectively; I² = 13.2%, P=0.316). Conclusion: Based on the pooled results from the included studies, the FMS™ has a good inter-rater and intra-rater reliability. FMS™ is a screening tool capable of screening for common soccer injuries, and individual FMS™ scores are a better determinant of performance in comparison with the overall FMS™ score. Although meta-analysis could not be done for all the included screening tools, qualitative analysis also indicated good sensitivity and specificity of the individual tools. Higher levels of evidence are, however, needed for implication in evidence-based practice.

Keywords: accuracy, screening tools, sensitivity, soccer injuries, specificity

Procedia PDF Downloads 179

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

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

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

Procedia PDF Downloads 255

Authors: M. F. Yilmaz, B. Ö. Çağlayan

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Fragility curve is an effective common used tool to determine the earthquake performance of structural and nonstructural components. Also, it is used to determine the nonlinear behavior of bridges. There are many historical bridges in the Turkish railway network; the earthquake performances of these bridges are needed to be investigated. To derive fragility curve Intensity measures (IMs) and Engineering demand parameters (EDP) are needed to be determined. And the relation between IMs and EDP are needed to be derived. In this study, a typical simply supported steel girder riveted railway bridge is studied. Fragility curves of this bridge are derived by two parameters lognormal distribution. Time history analyses are done for selected 60 real earthquake data to determine the relation between IMs and EDP. Moreover, efficiency, practicality, and sufficiency of three different IMs are discussed. PGA, Sa(0.2s) and Sa(1s), the most common used IMs parameters for fragility curve in the literature, are taken into consideration in terms of efficiency, practicality and sufficiency.

Keywords: railway bridges, earthquake performance, fragility analyses, selection of intensity measures

Procedia PDF Downloads 357

Authors: Wilfred Fritz

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The accreditation process of engineering degree programmes is based on various reports evaluated by the relevant governing bodies of the institution of higher education. One of the aforementioned reports for the accreditation process is a self-assessment report which is to be completed by the applying institution. This paper seeks to emphasise the importance of analysis of internal quality management systems and self-examination processes in the engineering accreditation processes. A description of how the programme fulfils the criteria should be given. Relevant stakeholders all need to contribute in the writing and structuring of the self-assessment report. The last step is to gather evidence in the form of supporting documentation. In conclusion, the paper also identifies learning outcomes in a case study in seeking accreditation from an international relevant professional body.

Keywords: accreditation, governing bodies, self-assessment report, quality management

Procedia PDF Downloads 123

Authors: Ergin Toros, Manar Aslan

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This study was planned as a descriptive study in order to learn the opinions of the students who are studying in nursing undergraduate program about their theoretical/practical lessons and departments. The education in the undergraduate nursing programs has great importance because it contains the knowledge and skills to prepare student nurses to the clinic in the future. In order to provide quality-nursing services in the future, the quality of nursing education should be measured, and opinions of student nurses about education should be taken. The research population was composed of students educated in a university with 1-4 years of theoretical and clinical education (N=550), and the sample was composed of 460 students that accepted to take part in the study. It was reached to 83.6% of target population. Data collected through a survey developed by the researchers. Survey consists of 48 questions about sociodemographic characteristics (9 questions), theoretical courses (9 questions), laboratory applications (7 questions), clinical education (14 questions) and services provided by the faculty (9 questions). It was determined that 83.3% of the nursing students found the nursing profession to be suitable for them, 53% of them selected nursing because of easy job opportunity, and 48.9% of them stayed in state dormitory. Regarding the theoretical courses, 84.6% of the students were determined to agree that the question ‘Course schedule is prepared before the course and published on the university web page.’ 28.7% of them were determined to do not agree that the question ‘Feedback is given to students about the assignments they prepare.’. It has been determined that 41,5% of the students agreed that ‘The time allocated to laboratory applications is sufficient.’ Students said that physical conditions in laboratory (41,5%), and the materials used are insufficient (44.6%), and ‘The number of students in the group is not appropriate for laboratory applications.’ (45.2%). 71.3% of the students think that the nurses view in the clinics the students as a tool to remove the workload, 40.7% of them reported that nurses in the clinic area did not help through the purposes of the course, 39.6% of them said that nurses' communication with students is not good. 37.8% of students stated that nurses did not provide orientation to students, 37.2% of them think that nurses are not role models for students. 53.7% of the students stated that the incentive and support for the student exchange program were insufficient., %48 of the students think that career planning services, %47.2 security services,%45.4 the advisor spent time with students are not enough. It has been determined that nursing students are most disturbed by the approach of the nurses in the clinical area within the undergraduate education program. The clinical area education which is considered as an integral part of nursing education is important and affect to student satisfaction.

Keywords: nursing education, student, clinical area, opinion

Procedia PDF Downloads 176

Authors: Branci Sarra, Branci Saadia

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Because of the multiplied data growth, many computer science tools have been developed to process and analyze these Big Data. High-performance computing architectures have been designed to meet the treatment needs of Big Data (view transaction processing standpoint, strategic, and tactical analytics). The purpose of this article is to provide a historical and global perspective on the recent trend of high-performance computing architectures especially what has a relation with Analytics and Data Mining.

Keywords: high performance computing, HPC, big data, data analysis

Procedia PDF Downloads 520