Search results for: surgical collaboration

Authors: Kazem Shakouri, Alireza Pishgahi, Homayoun Sadeghi-bBazargani, Shahla Dareshiri

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Introduction: Carpal Tunnel Syndrome has numerous nonsurgical treatments including splint, physical therapy and corticosteroid injections. Aim: The purpose of this study was to evaluate the effectiveness of an ultrasound guided treatment procedure, for individuals with severe carpal tunnel syndrome. Materials and Method: 20 patients with an electrodiagnostic evidence of severe carpal tunnel syndrome were treated by an office-based ultrasound guided procedure (combination of percutaneous needle release of carpal tunnel and corticosteroid injection). Electrodiagnostic (nerve conduction study), clinical (Boston Carpal Tunnel Questionnaire, grip strength) and ultrasonic (median nerve and carpal tunnel cross-sectional area) measurements were recorded at baseline and one month after intervention. Results: Our preliminary data analysis showed that in one month follow up, patients had a significantly smaller cross-sectional area of the median nerve compared to pretreatment values (mean difference 0.06; 95%CI: 0.02-0.1; p < 0.001). In addition, patients had significantly less functional impairment (mean difference 35; 95% CI:28.7-43.4 ; p < 0.001), and an improved hand grip strength in one month follow up (mean difference 5.4; 95%CI: 3.1-7.8; p < 0.001;). There were no significant complications. Conclusion: Patients with severe carpal tunnel syndrome, who are candidates for surgical intervention, can consider office-based ultrasound guided needle release of carpal tunnel as an alternative safe treatment.

Keywords: Carpal Tunnel Syndrome, needle release, pain, ultrasound

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Authors: Caroline Correia, Stefani Perna, John Gaughan, Elizabeth Cerceo

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Introduction: The COVID-19 pandemic has brought unprecedented changes to how hospitals function on a daily basis. Increased personal protective equipment (PPE) usage and measures to pre-package, separate, and decontaminate have the potential to increase the waste load. However, limiting non-essential surgeries drastically reduces operating room (OR) waste, and restricting visitation policies to contain outbreaks may help conserve resources. The impact of these policy changes with increased disposable PPE usage on hospital production of waste is unknown. Methods: Waste produced in pounds (lbs) was measured for January through June during both 2019 and 2020 through Stericycle in Cooper University Hospital in Camden, NJ. This timeframe was selected since the pandemic began in January 2020 in the US. The total waste produced during this time was 328,623 lbs in 2019 and 306,454 lbs in 2020. Using Poisson counts (α=.05), less waste was produced in 2020 (p < 0.001). The amount of sharps and regulated medical waste (grossly bloody items) were both significantly decreased as well (p < 0.0001, p=0.0002), and these account for 10-15% of the total waste produced. Discussion: Despite the increased usage of disposable PPE, overall hospital waste was decreased during the pandemic as compared to prior. As surgeries are estimated to be responsible for up to one-half of waste produced by hospitals, it is possible that constraint on elective procedures contributed to the decreased waste in all three categories; estimates of a 35% decrease in surgical volume would be expected to impact waste production. The effects of the pandemic on waste production should continue to be monitored to understand the environmental impact as health systems resume backlogged surgeries at a higher volume.

Keywords: COVID-19, hospital, surgery, waste

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Authors: Laila Al-Balushi, Suad Al-Kharosui

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Due to the increasing number of breast cancer cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19 on bed situation in the hospital, a policy of early discharge (ED) with drain after breast cancer surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up, conducted after discharge and the main mode of communication was Instagram media. This policy then was evaluated by conducting a quasi-experimental study using a questionnaire with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the questionnaire. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after BC surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.

Keywords: breast cancer, surgery, early discharge, surgical drain

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Authors: Reza Mohammadzadeh

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The major challenges in geotechnical engineering in underground spaces arise from uncertainties and different probabilities. The collection, collation, and collaboration of existing data to incorporate them in analysis and design for given prospect evaluation would be a reliable, practical problem solving method under uncertainty. Machine learning (ML) is a subfield of artificial intelligence in statistical science which applies different techniques (e.g., Regression, neural networks, support vector machines, decision trees, random forests, genetic programming, etc.) on data to automatically learn and improve from them without being explicitly programmed and make decisions and predictions. In this paper, a conceptual database schema of geotechnical risks in underground coal mining based on a cloud system architecture has been designed. A new approach of risk assessment using a three-dimensional risk matrix supported by the level of knowledge (LoK) has been proposed in this model. Subsequently, the model workflow methodology stages have been described. In order to train data and LoK models deployment, an ML platform has been implemented. IBM Watson Studio, as a leading data science tool and data-driven cloud integration ML platform, is employed in this study. As a Use case, a data set of geotechnical hazards and risk assessment in underground coal mining were prepared to demonstrate the performance of the model, and accordingly, the results have been outlined.

Keywords: data model, geotechnical risks, machine learning, underground coal mining

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Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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Authors: Saba Atefyekta

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Aim: Control of bacterial bioburden in wounds is an important step for minimizing the risk of wound infection. An antimicrobial hydrogel wound dressing is developed out of soft polymeric hydrogels that contain antimicrobial peptides (AMPs). Such wound dressings can bind and kill all types of bacteria, even the resistance types at the wound site. Methods: AMPs are permanently bonded onto a soft nanostructured polymer via covalent attachment and physical entanglement. This improves stability, rapid antibacterial activity, and, most importantly, prevents the leaching of AMPs. Major Findings: Antimicrobial analysis of antimicrobial hydrogels using in-vitro wound models confirmed >99% killing efficiency against multiple bacterial trains, including MRSA, MDR, E. Coli. Furthermore, the hydrogel retained its antibacterial activity for up to 4 days when exposed to human serum. Tests confirmed no release of AMPs, and it was proven non-toxic to mammalian cells. An in-vivo study on human intact skin showed a significant reduction of bacteria for part of the subject’s skin treated with antibacterial hydrogels. A similar result was detected through a qualitative study in veterinary trials on different types of surgery wounds in cats, dogs, and horses. Conclusions: Antimicrobial hydrogels wound dressings developed by permanent attachment of AMPs can effectively and rapidly kill bacteria in contact. Such antibacterial hydrogel wound dressings are non-toxic and do not release any substances into the wound.

Keywords: antibacterial wound dressing, antimicrobial peptides, post-surgical wounds, infection

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Authors: A. E. Kobryn

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We present both descriptive and predictive modeling of structural properties of blends of PCBM or organic-inorganic hybrid perovskites of the type CH3NH3PbX3 (X=Cl, Br, I) with P3HT, P3BT or squaraine SQ2 dye sensitizer, including adsorption on TiO2 clusters having rutile (110) surface. In our study, we use a methodology that allows computing the microscopic structure of blends on the nanometer scale and getting insight on miscibility of its components at various thermodynamic conditions. The methodology is based on the integral equation theory of molecular liquids in the reference interaction site representation/model (RISM) and uses the universal force field. Input parameters for RISM, such as optimized molecular geometries and charge distribution of interaction sites, are derived with the use of the density functional theory methods. To compare the diffusivity of the PCBM in binary blends with P3HT and P3BT, respectively, the study is complemented with MD simulation. A very good agreement with experiment and the reports of alternative modeling or simulation is observed for PCBM in P3HT system. The performance of P3BT with perovskites, however, seems as expected. The calculated nanoscale morphologies of blends of P3HT, P3BT or SQ2 with perovskites, including adsorption on TiO2, are all new and serve as an instrument in rational design of organic/hybrid photovoltaics. They are used in collaboration with experts who actually make prototypes or devices for practical applications.

Keywords: multiscale theory and modeling, nanoscale morphology, organic-inorganic halide perovskites, three dimensional distribution

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Authors: Pedro Ferraz-Gameiro

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Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

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Authors: Zahra Emami, Mohammad Ebrahim Khamseh, Nahid Hashemi Madani, Iman Kermani

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The aim of the study was to map scientific research on adrenal gland diseases in the Middle East countries through the Web of Science database using scientometric analysis. Data were analyzed with Excel software; and HistCite was used for mapping of the scientific texts. In this study, from a total of 268 retrieved records, 1125 authors from 328 institutions published their texts in 138 journals. Among 17 Middle East countries, Turkey ranked first with 164 documents (61.19%), Israel ranked second with 47 documents (15.53%) and Iran came in the third place with 26 documents. Most of the publications (185 documents, 69.2%) were articles. Among the universities of the Middle East, Istanbul University had the highest science production rate (9.7%). The Journal of Clinical Endocrinology & Metabolism had the highest TGCS (243 citations). In the scientific mapping, 7 clusters were formed based on TLCS (Total Local Citation Score) & TGCS (Total Global Citation Score). considering the study results, establishment of scientific connections and collaboration with other countries and use of publications on adrenal gland diseases from high ranking universities can help in the development of this field and promote the medical practice in this regard. Moreover, investigation of the formed clusters in relation to Congenital Hyperplasia and puberty related disorders can be research priorities for investigators.

Keywords: mapping, scientific research, adrenal gland diseases, scientometric

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Authors: YU Kaijun, Liang Dong, Zhang Yarong, Jin Zhenzhou, Yang Zhaobao

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For the impact monitoring of distributed structures, the traditional positioning methods are based on the time difference, which includes the four-point arc positioning method and the triangulation positioning method. But in the actual operation, these two methods have errors. In this paper, the Multi-Agent Blackboard Coordination Principle is used to combine the two methods. Fusion steps: (1) The four-point arc locating agent calculates the initial point and records it to the Blackboard Module.(2) The triangulation agent gets its initial parameters by accessing the initial point.(3) The triangulation agent constantly accesses the blackboard module to update its initial parameters, and it also logs its calculated point into the blackboard.(4) When the subsequent calculation point and the initial calculation point are within the allowable error, the whole coordination fusion process is finished. This paper presents a Multi-Agent collaboration method whose agent framework is JADE. The JADE platform consists of several agent containers, with the agent running in each container. Because of the perfect management and debugging tools of the JADE, it is very convenient to deal with complex data in a large structure. Finally, based on the data in Jade, the results show that the impact location method based on Multi-Agent coordination fusion can reduce the error of the two methods.

Keywords: impact monitoring, structural health monitoring(SHM), multi-agent system(MAS), black-board coordination, JADE

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Authors: C. W. F. Che Wan Putra, M. Alshawi, M. S. Al Ahbabi, M. Jabakhanji

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Much of the waste that is generated throughout the life-cycle of a building is mainly related to project stakeholders not having access to information that others have created. This results in waste and high costs. Over the past decade, however, the industry reacted to these challenges by adopting effective procurement approaches, such as partnering and design and build, to improve collaboration and communication among projects’ stakeholders. Most recently, there is a focus on creating and reusing digital project information of stakeholders throughout the life-cycle to facilitate the exchange of information among partners. This shift is based around BIM (Building Information Modelling) and collaborative environment (IPD). The power of collaborative BIM goes beyond improving efficiency. Sustainability, perhaps the most important challenge for the design and construction community, is at the intersection of BIM and collaborative project delivery, drawing strength from both. Due to these benefits, a research study has been carried out to investigate the need of BIM and IPD, on a large scale construction project which is procured on a traditional approach, i.e. design-bid-build. A qualitative research work including a semi-structured interview with project partners was conducted on a typical project in the UAE, whereby the selected project suffered from severe delays and cost overrun. This paper aims to bring about clear evidence to what most likely to happen to a typical construction project in spite of employing very good consultants, project manager and contractors and how these problems could have been avoided if BIM and IPD were deployed.

Keywords: building information modelling (BIM), integrated project delivery (IPD), collaborative environment, case study

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Authors: Shaira L. Kee, Michael Aaron G. Sy, Myles Joshua T. Tan, Hezerul Abdul Karim, Nouar AlDahoul

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Skin diseases are considered the fourth most common disease, with melanoma and non-melanoma skin cancer as the most common type of cancer in Caucasians. The alarming increase in Skin Cancer cases shows an urgent need for further research to improve diagnostic methods, as early diagnosis can significantly improve the 5-year survival rate. Machine Learning algorithms for image pattern analysis in diagnosing skin lesions can dramatically increase the accuracy rate of detection and decrease possible human errors. Several studies have shown the diagnostic performance of computer algorithms outperformed dermatologists. However, existing methods still need improvements to reduce diagnostic errors and generate efficient and accurate results. Our paper proposes an ensemble method to classify dermoscopic images into benign and malignant skin lesions. The experiments were conducted using the International Skin Imaging Collaboration (ISIC) image samples. The dataset contains 3,297 dermoscopic images with benign and malignant categories. The results show improvement in performance with an accuracy of 88% and an F1 score of 87%, outperforming other existing models such as support vector machine (SVM), Residual network (ResNet50), EfficientNetB0, EfficientNetB4, and VGG16.

Keywords: deep learning - VGG16 - efficientNet - CNN – ensemble – dermoscopic images - melanoma

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Authors: M. A. Askari, M. A. Nazari, P. Perrier, Y. Payan

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Growth and remodeling of biological structures have gained lots of attention over the past decades. Determining the response of living tissues to mechanical loads is necessary for a wide range of developing fields such as prosthetics design or computerassisted surgical interventions. It is a well-known fact that biological structures are never stress-free, even when externally unloaded. The exact origin of these residual stresses is not clear, but theoretically, growth is one of the main sources. Extracting body organ’s shapes from medical imaging does not produce any information regarding the existing residual stresses in that organ. The simplest cause of such stresses is gravity since an organ grows under its influence from birth. Ignoring such residual stresses might cause erroneous results in numerical simulations. Accounting for residual stresses due to tissue growth can improve the accuracy of mechanical analysis results. This paper presents an original computational framework based on gradual growth to determine the residual stresses due to growth. To illustrate the method, we apply it to a finite element model of a healthy human face reconstructed from medical images. The distribution of residual stress in facial tissues is computed, which can overcome the effect of gravity and maintain tissues firmness. Our assumption is that tissue wrinkles caused by aging could be a consequence of decreasing residual stress and thus not counteracting gravity. Taking into account these stresses seems therefore extremely important in maxillofacial surgery. It would indeed help surgeons to estimate tissues changes after surgery.

Keywords: finite element method, growth, residual stress, soft tissue

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Authors: Sushil Kumar Singh, Vivek Tewarson, Sarvesh Kumar, Shobhit Kumar

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Objective: ‘Beating Heart coronary artery bypass grafting on Intermittent Pump Support’ is a more reliable method of coronary revascularization that takes advantage of off and on-pump CABG while eliminating the disadvantage of both techniques. Methods: From January 2015 to December 2021, a new technique, “Intermittent On pump beating heart CABG” using a suction stabilizer was used by putting aortic and venous cannulas electively in all the patients. Patients were supported by a pump intermittently, as and when required (Group 1, n=254). Retrospective data were collected from our record of the patients who underwent off-pump CABG electively by the same surgeon and team (Group 2, n=254). Results: Significant advantage was noted in Group 1 patients in terms of the number of grafts (3.31 ± 1.16 vs. 2.30 ±0.66), grafting of lateral vessels (316 vs.202), mean operating time (1.37 ± 0.23 hrs vs. 2.22 ± 0.45 hrs) and postoperative blood loss (406.30 ± 257.90 ml vs. 567.41 ± 265.20 ml).CPB support time was less than 15 minutes in the majority of patients (n=179, 70.37 %), with a mean of 16.81 minutes. It was required, particularly during the grafting of lateral vessels. A rise in enzymes level (CRP, CKMB, Trop I, and NTPro BNP) was noted in Group 1 patients. But, these did not affect the postoperative course in patients. There was no mortality in Group 1 patients, while four patients in Group 2 died. Coclusions: Intermittent on-pump CABG technique is a promising method of surgical revascularization for all patients requiring CABG. It has shown its superiority in terms of safety, the number of grafts, operating time, and better perioperative course.

Keywords: cardiopulmonary bypass, CABG, beating heart CABG, on-pump CABG

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Authors: Nazym Zhumabayeva, Aleksandr Mezin, Alexandra Knysheva

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Women's underrepresentation in STEM is critical, worsened by ineffective engagement in educational practices. UNICEF Kazakhstan and GameLab KBTU's collaborative initiatives aim to enhance female STEM participation by fostering an inclusive environment. Learning from LEVEL UP's 2023 program, which featured a hackathon, the 2024 strategy pivots towards non-competitive gamification. Although the data from last year's project showed higher than average student engagement, observations and in-depth interviews with participants showed that the format was stressful for the girls, making them focus on points rather than on other values. This study presents a gamified educational system, DPG Lab, aimed at incentivizing young women's participation in STEM through the development of digital public goods (DPGs). By prioritizing collaborative gamification elements, the project seeks to create an inclusive learning environment that increases engagement and interest in STEM among young women. The DPG Lab aims to find a solution to minimize competition and support collaboration. The project is designed to motivate female participants towards the development of digital solutions through an introduction to the concept of DPGs. It consists of a short online course, a simulation videogame, and a real-time online quest with an offline finale at the KBTU campus. The online course offers short video lectures on open-source development and DPG standards. The game facilitates the practical application of theoretical knowledge, enriching the learning experience. Learners can also participate in a quest that encourages participants to develop DPG ideas in teams by choosing missions throughout the quest path. At the offline quest finale, the participants will meet in person to exchange experiences and accomplishments without engaging in comparative assessments: the quest ensures that each team’s trajectory is distinct by design. This marks a shift from competitive hackathons to a collaborative format, recognizing the unique contributions and achievements of each participant. The pilot batch of students is scheduled to commence in April 2024, with the finale anticipated in June. It is projected that this group will comprise 50 female high-school students from various regions across Kazakhstan. Expected outcomes include increased engagement and interest in STEM fields among young female participants, positive emotional and psychological impact through an emphasis on collaborative learning environments, and improved understanding and skills in DPG development. GameLab KBTU intends to undertake a hypothesis evaluation, employing a methodology similar to that utilized in the preceding LEVEL UP project. This approach will encompass the compilation of quantitative metrics (conversion funnels, test results, and surveys) and qualitative data from in-depth interviews and observational studies. For comparative analysis, a select group of participants from the previous year's project will be recruited to engage in the DPG Lab. By developing and implementing a gamified framework that emphasizes inclusion, engagement, and collaboration, the study seeks to provide practical knowledge about effective gamification strategies for promoting gender diversity in STEM. The expected outcomes of this initiative can contribute to the broader discussion on gamification in education and gender equality in STEM by offering a replicable and scalable model for similar interventions around the world.

Keywords: collaborative learning, competitive learning, digital public goods, educational gamification, emerging regions, STEM, underprivileged groups

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Authors: Abdullah Mukhtar, Shehroz Mukhtar, Amina Mukhtar, Choudhry Shahid, Hafiz Raza Razzaq, Saif Ur Rahman

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The aim of this study is to find out the negative and positive impacts of social media platforms on the attitude of learning and educational environment of student’s community. Social Media platforms have become a source of collaboration with one another throughout the globe making it a small world. This study performs focalized investigation of the adverse and constructive factors that have a strong impact not only on the psychological adjustments but also on the academic performance of peers. This study is a quantitative research adopting random sampling method in which the participants were the students of university. Researcher distributed 1000 questionnaires among the university students from different departments and asked them to fill the data on Lickert Scale. The participants are from the age group of 18-24 years. Study applies user and gratification theory in order to examine behavior of students practicing social media in their academic and personal life. Findings of the study reveal that the use of social media platforms in Pakistani context has less positive impact as compared to negative impacts on the behavior of students towards learning. The research suggests that usage of online social media platforms should be taught to students; awareness must the created among the users of social media by the means of seminars, workshops and by media itself to overcome the negative impacts of social media leading towards sustainable education in Pakistan.

Keywords: social media, positive impact, negative impact, learning behaviour

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Authors: M. Mokhber, J. Hedayati

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From the managerial perspective, it is important to devise an operational plan based on top priorities due to limited resources, diversity of measures and high costs needed to improve safety in infrastructure. Dealing with the high-risk corridors across Iran, this study prioritized the corridors according to statistical data on accidents involving fatalities, injury or damage over three consecutive years. In collaboration with the Iranian Police Department, data were collected and modified. Then, the prioritization criteria were specified based on the expertise opinions and international standards. In this study, the prioritization criteria included accident severity and accident density. Finally, the criteria were standardized and weighted (equal weights) to score each high-risk corridor. The prioritization phase involved the scoring and weighting procedure. The high-risk corridors were divided into twelve groups out of 50. The results of data analysis for a three-year span suggested that the first three groups (150 corridors) along with a quarter of Iranian road network length account for nearly 60% of traffic accidents. In the next step, according to variables including weather conditions particular roads for the purpose of winter safety measures were extracted from the abovementioned categories. According to the results ranking, ‎‏9‏‎ roads with the overall ‎length of about ‎‎‏1000‏‎ Km of high-risk corridors are considered as preferences of ‎safety measures‎.

Keywords: high-risk corridors, HRCs, road safety rating, road scoring, winter safety measures

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Authors: Jutamas Wisansing, Thanakarn Vongvisitsin, Udom Hongchatikul

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Designated Areas for Sustainable Tourism Administration (DASTA) is a public organization, dedicating to sustainable tourism development in 6 designated areas in Thailand. This paper provides rich reflections from a decade of DASTA, formulating an advanced model to deepen our understanding of 2 key intertwining issues; 1) what are the new landscapes of actors for community based tourism and 2) who are the benefactors and beneficiaries of tourism development within the community? An action research approach was used, enabling the process and evidence-based cases to be better captured. The aim is to build theoretical foundation through 13 communities/cases, which have engaged in community based tourism pilot projects. Drawing from emic and qualitative research, specific and contextual phenomenon provides succinct patterns of ‘Community Benefitting through Tourism (CbtT)’ model. The re-definition of the 2 key issues helps shape the interlinking of actors; practicalities of inclusive tourism and inter-sectoral framework and its value chain will also be set forth. In tourism sector, community members could be active primarily on the supply side as employees, entrepreneurs and local heritage experts. CbtT when well defined stimulates the entire value chain of local economy while promoting social innovation through positive dialogue with wider actors. Collaboration with a new set of actors who are from the tourism-related businesses and non-tourism related businesses create better impacts on mutual benefits.

Keywords: community based tourism, community benefitting through tourism -CbtT DASTA model, sustainable tourism in thailand, value chain and inclusive business

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Authors: Nassim Salmi

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This study aimed to identify the administrative, social, cultural, economic and psychological challenges facing the nursing s ector in the Tebessa Algeria. It also seeks to identify whether there are differences between the opinions of managers in public and private hospitals about these challenges. To achieve the objectives of the study, the descriptive analytical method was adopted. The study also used the questionnaire as a tool for collecting the necessary data and information, which was applied to a sample of directors of public and private hospitals in the Tebessa, which amounted to (114) individuals. The study reached a set of results, including: that there are no statistically significant differences between the opinions of managers in public and private hospitals about the administrative, social, cultural, economic and psychological challenges facing the nursing sector in the Tebessa . The results also showed agreement between the views of managers in private public hospitals that the most important administrative challenges are the lack of training programs that affect the efficiency and performance of nursing work, and that the most important social and cultural challenges are the hospital’s failure to provide suitable nurseries for Saudi female nurses, and that the most important economic challenges are the lack of Availability of medical equipment and devices, and the most important psychological challenge is the tense relationship between the administration and the hospital's nursing staff. The study recommended focusing on the importance of rehabilitation and training together, activating the role of training in the ministry and making it compulsory and a condition of renewal for practicing and continuing the nursing profession, and providing the social and economic needs of the nursing staff.

Keywords: postoperative care, gynecology, nursing documentation, database

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Authors: B.Shukir, H.Woo, P.Barzo, D.Kis

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Preoperative brain mapping in tumors involving the speech areas has an important role to reduce surgical risks. Functional magnetic resonance imaging (fMRI) is the gold standard method to localize cortical speech areas preoperatively, but its availability in clinical routine is difficult. Diffusion MRI based probabilistic tractography is available in head MRI. It’s used to segment cortical subregions by their structural connectivity. In our study, we used probabilistic tractography to localize the frontal and temporal cortical speech areas. 15 patients with left frontal tumor were enrolled to our study. Speech fMRI and diffusion MRI acquired preoperatively. The standard automated anatomical labelling atlas 3 (AAL3) cortical atlas used to define 76 left frontal and 118 left temporal potential speech areas. 4 types of tractography were run according to the structural connection of these regions to the left arcuate fascicle (FA) to localize those cortical areas which have speech functions: 1, frontal through FA; 2, frontal with FA; 3, temporal to FA; 4, temporal with FA connections were determined. Thresholds of 1%, 5%, 10% and 15% applied. At each level, the number of affected frontal and temporal regions by fMRI and tractography were defined, the sensitivity and specificity were calculated. At the level of 1% threshold showed the best results. Sensitivity was 61,631,4% and 67,1523,12%, specificity was 87,210,4% and 75,611,37% for frontal and temporal regions, respectively. From our study, we conclude that probabilistic tractography is a reliable preoperative technique to localize cortical speech areas. However, its results are not feasible that the neurosurgeon rely on during the operation.

Keywords: brain mapping, brain tumor, fMRI, probabilistic tractography

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Authors: Jyoti Srivastava, Sandhya S. Kaushik, Mallika Tewari, Hari S. Shukla

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Little information is available about the development of psychological well being over time among women who have been undergoing treatment for breast cancer. The aim of this study was to identify the trajectories of depression anxiety and stress among women with early-stage breast cancer. Of the 48 Indian women with newly diagnosed early-stage breast cancer recruited from surgical oncology unit, 39 completed an interview and were assessed for depression anxiety and stress (Depression Anxiety Stress Scale-DASS 21) before their first course of chemotherapy (baseline) and follow up interviews at 3, 6 and 9 months thereafter. Growth mixture modeling was used to identify distinct trajectories of Depression Anxiety and Stress symptoms. Logistic Regression analysis was used to evaluate the characteristics of women in distinct groups. Most women showed mild to moderate level of depression and anxiety (68%) while normal to mild level of stress (71%). But one in 11 women was chronically anxious (9%) and depressed (9%). Young age, having a partner, shorter education and receiving chemotherapy but not radiotherapy might characterize women whose psychological symptoms remain strong nine months after diagnosis. By looking beyond the mean, it was found that several socio-demographic and treatment factors characterized the women whose depression, anxiety and stress level remained severe even nine months after diagnosis. The results suggest that support provided to cancer patients should have a special focus on a relatively small group of patient most in need.

Keywords: psychological well being, growth mixture modeling, logistic regression analysis, socio-demographic factors

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Authors: Ghada E. Esheba, Ghadeer F. Alharthi, Duaa A. Alhejaili, Rawan E. Hudairy, Wafaa A. Altaezi, Raghad M. Alhejaili

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Background: Inflammatory bowel disease (IBD) consists of two specific gastrointestinal disorders: ulcerative colitis (UC) and Crohn's disease (CD). Despite their distinct natures, these two diseases share many similar etiologic, clinical and pathological features, as a result, their accurate differential diagnosis may sometimes be difficult. Correct diagnosis is important because surgical treatment and long-term prognosis differ from UC and CD. Aim: This study aims to study the characteristic clinicopathological features which help in the differential diagnosis between UC and CD, and assess the disease activity in ulcerative colitis. Materials and methods: This study was carried out on 50 selected cases. The cases included 27 cases of UC and 23 cases of CD. All the cases were examined using H& E and immunohistochemically for bcl-2 expression. Results: Characteristic features of UC include: decrease in mucous content, irregular or villous surface, crypt distortion, and cryptitis, whereas the main cardinal histopathological features seen in CD were: epitheloid granuloma, transmural chronic inflammation, absence of mucin depletion, irregular surface, or crypt distortion. 3 cases of UC were found to be associated with dysplasia. UC mucosa contains fewer Bcl-2+ cells compared with CD mucosa. Conclusion: This study using multiple parameters such clinicopathological features and Bcl-2 expression as studied by immunohistochemical stain, helped to gain an accurate differentiation between UC and CD. Furthermore, this work spotted the light on the activity and different grades of UC which could be important for the prediction of relapse.

Keywords: Crohn's disease, dysplasia, inflammatory bowel disease, ulcerative colitis

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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: Lin Li, Farshad Amini

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The flipped classroom has been introduced to promote collaborative learning and higher-order learning objectives. In contrast to the traditional classroom, the flipped classroom has students watch prerecorded lecture videos before coming to class and then “class becomes the place to work through problems, advance concepts, and engage in collaborative learning”. In this paper, the active flipped learning combines flipped classroom with active learning that is to establish an active flipped learning (AFL) model, aiming to promote active learning, stress deep learning, encourage student engagement and highlight data-driven personalized learning. Because students have watched the lecture prior to class, contact hours can be devoted to problem-solving and gain a deeper understanding of the subject matter. The instructor is able to provide students with a wide range of learner-centered opportunities in class for greater mentoring and collaboration, increasing the possibility to engage students. Currently, little is known about the extent to which AFL improves engineering students’ performance. This paper presents the preliminary study on the core course of sophomore students in Engineering Mechanics. A series of survey and interviews have been conducted to compare students’ learning engagement, empowerment, self-efficacy, and satisfaction with the AFL. It was found that the AFL model taking advantage of advanced technology is a convenient and professional avenue for engineering students to strengthen their academic confidence and self-efficacy in the Engineering Mechanics by actively participating in learning and fostering their deep understanding of engineering statics and dynamics

Keywords: active learning, engineering mechanics, flipped classroom, performance

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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: Abdullah Mukhtar, Shehroz Mukhtar, Amina Mukhtar, Choudhry Shahid, Hafiz Raza Razzaq, Saif Ur Rahman

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The aim of this study is to find out the negative and positive impacts of social media platforms on the attitude toward learning and the educational environment of the student community. Social Media platforms have become a source of collaboration with one another throughout the globe, making it a small world. This study performs a focalized investigation of the adverse and constructive factors that have a strong impact not only on psychological adjustments but also on the academic performance of peers. This study is quantitative research adopting a random sampling method in which the participants were the students at the university. The researcher distributed 1000 questionnaires among the university students from different departments and asked them to fill in the data on the Lickert Scale. The participants are from the age group of 18-24 years. The study applies user and gratification theory in order to examine the behavior of students practicing social media in their academic and personal lives. The findings of the study reveal that the use of social media platforms in the Pakistani context has less positive impact as compared to negative impacts on the behavior of students towards learning. The research suggests that usage of online social media platforms should be taught to students; awareness must the created among the users of social media by means of seminars, workshops and by media itself to overcome the negative impacts of social media, leading towards sustainable education in Pakistan.

Keywords: social media, positive impacts, negative impacts, sustainable education, learning behaviour

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Authors: Shirin Shaideh, Nina Shirkhanloo

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Creative public spaces were needed to foster conviviality in an urban form. The conviviality could be enhanced by facilitating variety of opportunities to participate in communal activities and promoting collective experiences. In this regard, The Namik Kemal Square as a major public space of Walled City of Famagusta in North Cyprus was found as the creative public space because it supports collective practices by leisure activities which enclosed the space. The square also utilized creative collaboration such as festivals and outdoor exhibition. Accordingly this paper focuses on the issue of conviviality in urban public space, in the perspective of square, as a major indicator of their success. The survey firstly provides a theoretical framework for understanding conviviality in creative public space to empower collective experience. Secondly it discusses the essential components of conviviality in form of square and finally investigating conviviality and also its determinants in Namik Kemal square. Hence, the main challenges of this study are going to focus on how convivial public spaces impact collective experience, what people expect from a kind of public space, or what they perceive as a good place to be in. Since it seems essential to respond positively, inclusively to the needs of people to socialize in public spaces by involving them in collective and common practices, this article aims to tease out what gives some places personality and conviviality so that we can learn to design, maintain and manage better quality built environment in future.

Keywords: conviviality, creative public space, collective experience, Namik Kemal square

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Authors: Alessandra Marino

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This paper thoroughly investigates the design characteristics necessary for intergenerational living and evaluates their applicability within the Italian social panorama in order to identify a model that can serve as a reference for subsequent regulatory adjustments of a new building typology. The applied methodology involves the collaboration of people with various background and architects, all representing the three main ages of life - childhood or youth, adulthood, seniority - through questionnaires aimed at researching the peculiar characteristics that contemporary intergenerational housing should include; the questionnaires are then compared with each other in order to identify any recurring patterns by age group and/or influenced by the specialist knowledge on the subject of the architects compared to the rest of the user sample. The results indicate that among specialist users in the field of architecture, young students identify home automation as the key to the inclusion of the weakest groups within the building, adult architects believe that the identification of intergenerational/community services within the building is the cornerstone, and senior architects focus on widespread spatial accessibility. At the same time, the results among non-specialist users do not identify a significantly diversified model by age group but are generally in agreement in the importance of separation between private environments and collective spaces. The interpretation of the results obtained leads to a compositional study of a new building typology with the future objective of channeling the subsequent outcomes within the regulatory adjustments of the sector.

Keywords: intergenerational living, social sustainability, health, lifestyle, well-being

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Authors: Festus Epetimehin

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Agriculture remains the dominant sector in the rural areas where over 70% of Nigerian reside and it’s still the backbone of our economy. The observed poor performance of farmers in agricultural productivity is due to the nature of risks and uncertainties in agriculture.Agricultural insurance is one of the mechanisms by which farmers can stabilize farm income and investment. The study examined the relationship between agricultural insurance scheme (AIS) and performance of agribusiness in Nigeria. The study adopted exploratory research design which is an ex-ante research approach. One hundred copies of structured questionnaire were administered for the purpose of the study. Correlation analysis and regression analysis were employed for the study. The correlation analysis of the finding revealed that the independent variable; agricultural insurance scheme (AIS) is positively and significantly correlated with the set of dependent variables; where turnover (ABT)=0.582**, profitability (ABP)=0.321**, solvency (ABS)=0.418**and cost of production (ABC)=0.23** respectively. The regression analysis result also revealed the degree of relationship between the independent variable (AIS) and set of dependent variables where one(1%) percent increase in independent variable will lead to 33.9% (ABT), 9.7% (ABP), 17.5%(ABS) and 1.5%(ABC).The study recommended that the Federal Government in collaboration with the participating Agricultural insurers embark on awareness campaign through to the length and breadth of Nigeria on government support and insurance scheme for farmers. Government should also ensure that the loan and insurance scheme should extend beyond the mechanized farmers and include the intensive subsistence farmers in view of the fact that they are the dominants in most of the farm produce markets.

Keywords: agribusiness, agricultural insurance, performance, turnover, solvency, agricultural risks

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Authors: Prakash Singh

Abstract:

Far-reaching organizational and structural changes are required to address the severe imbalances in the provision and strong bureaucratic controls in many organizations at all levels. Transformational collegial leadership (TCL) is a collective action generated by transforming leadership which empowers all individuals who participate in this process, whether it is in business or education, or in any other organization. Recent research is strongly supportive of collegiality as a key factor in transforming traditional bureaucratic management practices (TBMPs) in organizations. The primary objective of this study was therefore to gauge the extent to which organizations have affected a shift from TBMPs towards TCL and how this can affect the development of human resources. This qualitative study investigated the impact of TCL on developing human resources in two organizations which were purposively selected to participate in this study. The findings of this study affirm that human resource development and TCL embrace the values of collaboration, confrontation, authenticity, trust, support and openness. In order to overcome TBMPs, a clear sense of direction must be communicated by collegial leaders throughout their organizations so that lower-level employees can initiate actions without the same degree of vulnerability. The TCL approach must respond to needs amongst followers and must look for motives, extrinsic and intrinsic, to satisfy those needs by enhancing opportunities, empowering people and giving more freedom, performance evaluation and the full support of the leader. Evidently, the collegial model emphasizes the valuing of individuals where there is a breadth of leadership and an absence of hierarchy.

Keywords: bureaucratic management model, human resource development, transformational collegial leadership model, transforming leader

Procedia PDF Downloads 417