Search results for: clinical research

Authors: Mohamed A. Abdelnaby

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Relevance of the research: A few people known about Autism and also about Sports for Autism. Children with Autism have difficult experience with sport that makes many problems during the sports activities. There are several areas of motor skills development essential for participating daily life and several sports activities. The object of the research is describe the program for the sports activities for children with Autism, and the aim is to improving their movement skills, motor skills and social skills. Research methods and organization: Twenty-five children with Autism perceived barriers to sports activities participation, and functioning. All the program inside the Pegasus Dreamland Sports Club and all the facilities available for the research. Results and discussion: Standard, children were reported to meet or exceeded general PA occurrence guidelines, belonged to active participated in a variety of sports activities. We identified several barriers to optimal sports activities for their children. Conclusions: Children with Autism can achieve optimal sports activities. Exposure to a variety of sports activities opportunities and experiences aids in identifying the model activity for each individual child.

Keywords: autism, sports activates, movement skills, motor skills

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Authors: Ercan Ceyhan, Mehmet Ali Avci

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This research was made during the 2015 growing periods in the trial filed of ‘Research Station for Department of Field Crops, Agricultural Faculty, Selcuk University’ according to ‘Randomized Blocks Design’ with 3 replications. Research material was the following pea lines; PS16, PS18, PS21, PS23, PS24, PS25, PS36, PS47, PS49, PS51, PS54, PS58, PS67, PS69, PS71, PS73, PS83, PS84, PS87 and PSKY and three cultivars and other 2 commercial varieties named as Bolero, Rondo and Ultrello. Some agronomical characteristics such as plant height (cm) number of pod per plant number of seed per pod number of seed per plant 100 seed weight (g) and seed yield (kg ha-1) were determined. Results of the research implicated that the new developed lines were superior compared with the control (commercial) varieties by means of most of the characteristics. Nevertheless, similar researches should be continued in different locations and years.

Keywords: agricultural characters, pea, Pisum sativum, seed yield

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Authors: Lin Xie, Yang Wang

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An extensive body of research studies suggest that students, teachers, and supervisors can enhance the likelihood of reaching their goals by improving their communication skills. It is highly important to learn how and when to provide different kinds of feedback, e.g. anticipatory, corrective and positive) will gain better result and higher morale. The purpose of this mixed methods research is twofold: 1) To find out what factors affect effective communication among different stakeholders and how these factors affect student learning2) What are the good practices for improving communication among different stakeholders and improve student achievement. This presentation first begins with an introduction to the recent research on Marshall’s Nonviolent Communication Techniques (NVC), including four important components: observations, feelings, needs, requests. These techniques can be effectively applied at all levels of communication. To develop an in-depth understanding of the relationship among different techniques within, this research collected, compared, and combined qualitative and quantitative data to better improve communication and support student learning.

Keywords: education, communication, psychology, student learning, language teaching

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Authors: Rajesh Ranjan, Marimuthu Palaniswami, A. A. Hashmi

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With the changing lifestyle and environment around us, the prevalence of the critical and incurable disease has proliferated. One such condition is the neurological disorder which is rampant among the old age population and is increasing at an unstoppable rate. Most of the neurological disorder patients suffer from some movement disorder affecting the movement of their body parts. Tremor is the most common movement disorder which is prevalent in such patients that infect the upper or lower limbs or both extremities. The tremor symptoms are commonly visible in Parkinson’s disease patient, and it can also be a pure tremor (essential tremor). The patients suffering from tremor face enormous trouble in performing the daily activity, and they always need a caretaker for assistance. In the clinics, the assessment of tremor is done through a manual clinical rating task such as Unified Parkinson’s disease rating scale which is time taking and cumbersome. Neurologists have also affirmed a challenge in differentiating a Parkinsonian tremor with the pure tremor which is essential in providing an accurate diagnosis. Therefore, there is a need to develop a monitoring and assistive tool for the tremor patient that keep on checking their health condition by coordinating them with the clinicians and caretakers for early diagnosis and assistance in performing the daily activity. In our research, we focus on developing a system for automatic classification of tremor which can accurately differentiate the pure tremor from the Parkinsonian tremor using a wearable accelerometer-based device, so that adequate diagnosis can be provided to the correct patient. In this research, a study was conducted in the neuro-clinic to assess the upper wrist movement of the patient suffering from Pure (Essential) tremor and Parkinsonian tremor using a wearable accelerometer-based device. Four tasks were designed in accordance with Unified Parkinson’s disease motor rating scale which is used to assess the rest, postural, intentional and action tremor in such patient. Various features such as time-frequency domain, wavelet-based and fast-Fourier transform based cross-correlation were extracted from the tri-axial signal which was used as input feature vector space for the different supervised and unsupervised learning tools for quantification of severity of tremor. A minimum covariance maximum correlation energy comparison index was also developed which was used as the input feature for various classification tools for distinguishing the PT and ET tremor types. An automatic system for efficient classification of tremor was developed using feature extraction methods, and superior performance was achieved using K-nearest neighbors and Support Vector Machine classifiers respectively.

Keywords: machine learning approach for neurological disorder assessment, automatic classification of tremor types, feature extraction method for tremor classification, neurological movement disorder, parkinsonian tremor, essential tremor

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: Pikria Vardosanidze

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This presentation entitled ”Higher Education Quality Culture – Case Study: Georgia”is concerned with an urgent and crucial issue. Located at the crossroads of Europe and Asia, Georgia is a transnational, post-soviet country. And it is conditioned the peculiarity of our education system. Higher education in Georgia has an extensive history and a challenging period of development consisting of several phases, especially noteworthy of which are 1918 and 1991, marking there storation of Georgia’s independence. Georgia joined the Bologna Process in 2005. Given its geopolitical location, Georgian culture has developed, and still pursues the path of development against the background of the Western and Eastern cultures. Furthermore, socio-politically and culturally, it represents part of Europe. It is of particular interest how post-Soviet states develop in terms of education. What is the path to the European integration for Georgia as a post-Soviet country? How developed is the higher education quality culture in Georgia? And, what should be done in the future? It is important to answer these questions. The research carried out in the field of education is characterized by a certain specificity as does the post-colonial research. The field of education contributes to the development of democratic society as well as to the European integration, the Eastern Partnership and so on. What is crucial for the educational system, apart from transparency and democratization, is the improvement of the quality of education which is one of the most powerful tools dictating the need for a doctoral research as such. As for the research method, the comparative method of research, and the qualitative research are applied.

Keywords: internationalization, higher education, policies, Georgia

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Authors: E. Olmos-Raya, A. Cascales Martínez, N. Minto de Sousa, M. Alcañiz Raya

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The late detection and subjectivity of the assessment of Autism Spectrum Disorder (ASD) imposed a difficulty for the children’s clinical and familiar environment. The results showed in this paper, are part of a research project about the assessment and training of social skills in children with ASD, whose overall goal is the use of virtual environments together with physiological measures in order to find a new model of objective ASD assessment based on implicit brain processes measures. In particular, this work tries to contribute by studying the differences and changes in the Skin Conductance Response (SCR) and Eye Tracking (ET) between a typical development group (TD group) and an ASD group (ASD group) after several combined stimuli using a low cost Immersive Virtual Environment (IVE). Subjects were exposed to a virtual environment that showed natural scenes that stimulated visual, auditory and olfactory perceptual system. By exposing them to the IVE, subjects showed natural behaviors while measuring SCR and ET. This study compared measures of subjects diagnosed with ASD (N = 18) with a control group of subjects with typical development (N=10) when exposed to three different conditions: only visual (V), visual and auditory (VA) and visual, auditory and olfactory (VAO) stimulation. Correlations between SCR and ET measures were also correlated with the Autism Diagnostic Observation Schedule (ADOS) test. SCR measures showed significant differences among the experimental condition between groups. The ASD group presented higher level of SCR while we did not find significant differences between groups regarding DF. We found high significant correlations among all the experimental conditions in SCR measures and the subscale of ADOS test of imagination and symbolic thinking. Regarding the correlation between ET measures and ADOS test, the results showed significant relationship between VA condition and communication scores.

Keywords: autism, electrodermal activity, eye tracking, immersive virtual environment, virtual reality

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Authors: E. T. Svahn

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Knowledge about the factors that influence the exchange between research and society is of the utmost importance for developing collaboration between different actors, especially in future science policy development and the creation of support structures for researchers. Among other things, how researchers look at the surrounding open science policy environment and what conditions and attitudes they have for interacting with it. This paper examines the Finnish researchers' attitudes towards open science policies in 2020. Open science is an integrated part of researchers' daily lives and supports not only the effectiveness of research outputs but also the quality of research. Open science policy in ideal situation is seen as a supporting structure that enables the exchange between research and society, but in other situation, it can end up being red tape generating obstacles and hindering possibilities of making science in an efficient way. Results of this study were carried out through focus group interviews. This qualitative research method was selected because it aims to understand the phenomenon under study. In addition, focus group interviews produce diverse and rich material that would not be available with other research methods. Focus group interviews have well-established applications in social science, especially in understanding the perspectives and experiences of research subjects. In this study, focus groups were used in studying the mindset and actions of researchers. Each group's size was between 4-10 people, and the aim was to bring out different perspectives on the subject. The interviewer enabled the presentation of different perceptions and opinions, and the focus group interviews were recorded and written as text. The material was analysed using grounded theory method. The results are presented as thematic areas, theoretical model, and as direct quotations. Attitudes towards open science policy can vary greatly depending on the research area. This study shows that the open science policy demands in medicine, technology, and natural sciences compared to social sciences, educational sciences, and the humanities, varies somewhat. The variation in attitudes between different research areas can thus be largely explained by the fact that the research output and ethical code vary significantly between certain subjects. This study aims to increase understanding of the nuances to what extent open science policies should be tailored for different disciplines and research areas.

Keywords: focus group interview, grounded theory, open science policy, science policy

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Authors: Sally Selden, Jyoti Aggarwal

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The research on generational expectations about leadership is developing, but little scholarship exists on this topic for public sector organizations. Given the size of the federal workforce, this research study fills an important gap in the knowledge base and will inform public organizations how to approach managing and leading a multigenerational workforce. The research objectives of this study are to explore leadership preferences and motivation within generations and to determine whether these qualities differ by type of federal agency (e.g., law enforcement, human services, etc.). This paper will review the research on generational differences, expectations, and leadership with a focus on studies of public organizations. Using hierarchical linear modeling (HLM), this study will examine how leadership and motivation vary by generation in the federal government workforce, controlling for other demographic characteristics. The study will also examine whether generational differences impact satisfaction and performance. The study will utilize the 2019 Federal Employee Viewpoint Survey.

Keywords: multigenerational workforce, leadership, generational differences, federal workforce

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Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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Authors: Magdy I. A. Alshourbagi

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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.

Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)

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Authors: Yun-Hsiang Lee

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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).

Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy

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Authors: Mohammad Reza Dawoudi

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With the increasing rate of patients suffering from chronic pain, several methods for evaluating of chronic pain are suggested. Motion of morbid has been defined as the rate of pine and it is linked with various co-morbid conditions. This study provides a summary of procedure useful to statistics performing direct behavioral observation in hospital settings. We describe the need for and usefulness of comprehensive “morbid motions” observations; provide a primer on the identification, definition, and assessment of morbid behaviors; and outline and discuss specific statistical procedures, including formulating referral motions, describing and conducting the observation. We also provide practical devices for observing and analyzing the obtained information into a report that guides clinical intervention.

Keywords: assessing pain, DNA modeling, image matching technique, pain scale

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Authors: Punrapha Praditpong, Surangkana Pipatchokchaiyo

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The objectives of this study were to study the consumer behavior of the Baby boomers, the X & the Y generation towards Online Travel Agents in purchasing tourism-related products and services. The research methodology of this research used the quantitative study and the sample size consisted of 400 questionnaires in five districts of Bangkok. The data was analyzed by frequency, percentage, mean and SD. Moreover, all the hypotheses were tested by One-Way ANOVA and Pearson-Correlation statistics. The research findings were as follows: 1) There were significant effects to the purchasing decision making process towards purchasing tourism related products and services via OTAs; 2) There were different consumer behaviors from the Baby boomers, the X generation and the Y generation towards purchasing tourism related products and services via OTAs, which are explained in detail in finding. The research offers a discussion and presents some recommendations for the OTA websites.

Keywords: consumer behavior, online travel agent, x generations, y generations

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Authors: Ferreira R., Rocha K.

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Ozone therapy is indicated for improving skin aesthetics, adjusting oxidative tissue levels, increasing collagen production, and even skin volumizing. This paper aims to carry out a case report that demonstrates the positive results of ozone therapy in association with superficial peeling. The application in association showed positive results for bio-stimulating activities in the reported case demonstrating to be a viable clinical technique. The bio-stimulating effect of ozone therapy in association with peeling is a promising aesthetic therapeutic modality with fast and safe results as an aesthetic therapeutic option.

Keywords: bio-stimulating effect, ozone therapy, neocollagenesis, peeling

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Authors: Roland Lachmayer, Mahtab Afsari

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Research is the cornerstone for advancement of human communities. So that it is one of the indexes for evaluating advancement of countries. Research projects are usually cost and time-consuming and do not end in result in short term. Project scheduling is one of the integral parts of project management. The present article offers a new method by using C# and Matlab software to solve Fuzzy GERT networks for Exclusive-OR kind of nodes to schedule the network. In this article we concentrate on flowcharts that we used in Matlab to show how we apply Matlab to schedule Exclusive-OR nodes.

Keywords: research projects, fuzzy GERT, fuzzy CPM, CPM, α-cuts, scheduling

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Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

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Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

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Authors: Alyamama Alsaidi

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This research has been conducted in order to analyse the impact of outsourcing on telecommunication industry in Oman. The research is conducted by collecting qualitative and quantitative data in order to widen the area of comprehension. The data has been collected from genuine sources which showcased that results were reliable and possess validity. The outsourcing is very important because it helps the organisation in saving the cost and efforts of the workers. In Oman, the telecommunication industry largely uses the outsourcing service which is provided by the third party. The third party is responsible for providing outsourcing to the telecommunication companies. This research gives an overall view of the outsourcing in the telecommunication companies of Oman. The IT companies of Oman give their work to the outsourcing services as this will help in reducing the cost the project. Rather employing the experts to do the projects, the organization can easily give their products to the outsourcing services in which they complete the work for a cheaper rate for the telecommunication company of Oman. It will help in reducing the work load on the staffs and management of the telecommunication companies in Oman. The IT outsourcing in Oman is very common because some of the staff are not well experienced to do the IT work. The outsourcing has positive as well as negative impact on the telecommunication industry in Oman. The research has been done while considering ethical aspect in an effective and efficient manner. Furthermore, the literature is adequately reviewed so that views of various specialists can be considered for future guidance.

Keywords: IT outsourcing, client company, services company, telecommunication

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Authors: Juha Kettunen

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This study analyzes collaborative and networked academic authorship in higher education. The literature review shows evidence that single authorship has made a gradual paradigm shift to joint authorship. The empirical evidence from the Turku University of Applied Sciences indicates that collaborative authorship has notably increased in the last few years. Co-authorship has extended outside the institution to other domestic and international academic organizations. Co-authorship not only increase the merits of academic scholars but builds and maintains networks of research and development. The results of this study help the authors, editors and partners of research and development projects to have a more concrete understanding of how co-authorship has developed and spread beyond higher education institutions.

Keywords: co-authorship, social networking, higher education, research and development

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Authors: Jao Jo-Chi, Chen Yen-Ku, Jaw Twei-Shiun, Chen Po-Chou

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This study aimed to investigate the magnetic resonance (MR) signal enhancement ratio (ER) of contrast-enhanced MR angiography (CE-MRA) in normal rats with gadobenate dimeglumine (Gd-BOPTA) using a clinical 3T scanner and an extremity coil. The relaxivities of Gd-BOPTA with saline only and with 4.5 % human serum albumin (HSA) were also measured. Compared with Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), Gd-BOPTA had higher relaxivities. The maximum ER of Aorta (ERa), kidney, liver and muscle with Gd-BOPTA were higher than those with Gd-DTPA. The maximum ERa appeared at 1.2 min and decayed to half at 10 min after Gd-BOPTA injection. This information is helpful for the design of CE-MRA study of rats.

Keywords: contrast-enhanced magnetic resonance angiography, Gd-BOPTA, Gd-DTPA, rat

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Authors: Francisca Alves, Diana Figueiredo, Paula Vagos, Luiza Lima, Maria do Céu Salvador, Daniel Rijo

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In recent years, Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of numerous anxiety disorders, including social anxiety disorder (SAD). However, limited evidence exists on its therapeutic gains for adolescents with SAD. The current work presents a weekly 10-session manualized online ACT approach to adolescent SAD, being the first study to do so in a clinical sample of adolescents. The intervention ACT@TeenSAD addresses the six proposed processes of psychological inflexibility (i.e., experiential avoidance, cognitive fusion, lack of values clarity, unworkable action, dominance of the conceptualized past and future, attachment to the conceptualized self) in social situations relevant to adolescents (e.g., doing a presentation). It is organized into four modules. The first module explores the role of psychological (in)flexibility in SAD (session 1 and 2), addressing psychoeducation (i.e., functioning of the mind) according to ACT, the development of an individualized model, and creative hopelessness. The second module focuses on the foundation of psychological flexibility (session 3, 4, and 5), specifically on the development and practice of strategies to promote clarification of values, contact with the present moment, the observing self, defusion, and acceptance. The third module encompasses psychological flexibility in action (sessions 6, 7, 8, and 9), encouraging committed action based on values in social situations relevant to the adolescents. The fourth modules’ focus is the revision of gains and relapse prevention (session 10). This intervention further includes two booster sessions after therapy has ended (3 and 6-month follow-up) that aim to review the continued practice of learned abilities and to plan for their future application to potentially anxious social events. As part of an ongoing clinical trial, the intervention will be assessed on its feasibility with adolescents diagnosed with SAD and on its therapeutic efficacy based on a longitudinal design including pretreatment, posttreatment, 3 and 6-month follow-up. If promising, findings may support the online delivery of ACT interventions for SAD, contributing to increased treatment availability to adolescents. This availability of an effective therapeutic approach will be helpful not only in relation to adolescents who face obstacles (e.g., distance) when attending to face-to-face sessions but also particularly to adolescents with SAD, who are usually more reluctant to look for specialized treatment in public or private health facilities.

Keywords: acceptance and commitment therapy, social anxiety disorder, adolescence, manualized online approach

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Authors: Gail Louw, Helena Boshoff, Taeksun Song, Clifton Barry

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Drug resistance in Mycobacterium tuberculosis is primarily attributed to mutations in target genes. These mutations incur a fitness cost and result in bacterial generations that are less fit, which subsequently acquire compensatory mutations to restore fitness. We hypothesize that mutations in specific drug target genes influence bacterial metabolism and cellular function, which affects its ability to develop subsequent resistance to additional agents. We aim to determine whether the sequential acquisition of drug resistance and specific mutations in a well-defined clinical M. tuberculosis strain promotes or limits the development of additional resistance. In vitro mutants resistant to pretomanid, linezolid, moxifloxacin, rifampicin and kanamycin were generated from a pan-susceptible clinical strain from the Beijing lineage. The resistant phenotypes to the anti-TB agents were confirmed by the broth microdilution assay and genetic mutations were identified by targeted gene sequencing. Growth of mono-resistant mutants was done in enriched medium for 14 days to assess in vitro fitness. Double resistant mutants were generated against anti-TB drug combinations at concentrations 5x and 10x the minimum inhibitory concentration. Subsequently, mutation frequencies for these anti-TB drugs in the different mono-resistant backgrounds were determined. The initial level of resistance and the mutation frequencies observed for the mono-resistant mutants were comparable to those previously reported. Targeted gene sequencing revealed the presence of known and clinically relevant mutations in the mutants resistant to linezolid, rifampicin, kanamycin and moxifloxacin. Significant growth defects were observed for mutants grown under in vitro conditions compared to the sensitive progenitor. Mutation frequencies determination in the mono-resistant mutants revealed a significant increase in mutation frequency against rifampicin and kanamycin, but a significant decrease in mutation frequency against linezolid and sutezolid. This suggests that these mono-resistant mutants are more prone to develop resistance to rifampicin and kanamycin, but less prone to develop resistance against linezolid and sutezolid. Even though kanamycin and linezolid both inhibit protein synthesis, these compounds target different subunits of the ribosome, thereby leading to different outcomes in terms of fitness in the mutants with impaired cellular function. These observations showed that oxazolidinone treatment is instrumental in limiting the development of multi-drug resistance in M. tuberculosis in vitro.

Keywords: oxazolidinones, mutations, resistance, tuberculosis

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Authors: Meenakshi Chaubey

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A principle proposed in the cross-cultural adaption of behavior among Indian and Tibetan societies in which there are not any great variations between their young adults on the mindset of day-to-day marriage, Marriage plays a dominant position in constructing the society, which in large part comprises underneath the domain of lifestyle. Way of life is a social behavior and norm located in human societies where an extensive range of phenomena can be transmitted thru social studying. It acts characteristic of the individual has been the diploma day-to-day which they have got cultivated a specific stage of class in arts, science, architecture. The existing studies preliminarily on young adults of each community, wherein we carried out a comparative observe of the mindset of daily marriage among Indian and Tibetan teens. Further, we studied statistics comprehensively on the mindset closer day by day the marriage between Indian adult males and Tibetan younger males. With the extension of a complete look, we considered the mindset of an everyday marriage of Indian girls and Tibetan young ladies. Studies 1 showed that there might be no sizable distinction within the attitude of the day-to-day marriage of Indian and Tibetan teenagers. It, in addition, showed that they followed each different marriage beliefs and customs. Studies 2 showed that there might be no important difference in the attitude toward the everyday marriage of Indian and Tibetan young males. It similarly showcased that day-to-day secular schooling gadget in Tibetan society complements their clinical approach and changes their point of view on distinct social issues along with marriage. Research three confirmed that there is no substantial difference in the mindset of the daily marriage of Indian and Tibetan younger females. It similarly spread out the strict authorities' recommendations that they may no longer be allowed day-to-day comply with their marriage practices, including polygamy and polyandry. Thus, the information showed that there's a shift of lifestyle from one network every day to some other community because of social every day, which affects the conduct and results of daily past cultural adaptation.

Keywords: culture, marriage, attitude, society, young adults, Indian, Tibetan

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Authors: Marzieh Moattari Mitra Abbasi, Masoud Mousavinasab, Poorahmad

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Background: Nurses in their daily practice need to communicate with patients and their families as well as health professional team members. Effective communication contributes to patients’ satisfaction which is a fundamental outcome of nursing practice. There are some evidences in support of patients' dissatisfaction with nurses’ performance in communication process. Therefore improving nurses’ communication skills is a necessity for nursing scholars and nursing administrators. Objective: The aim of the present study was to evaluate the effect of a 2-days workshop on nurses’ competencies and performances in communication in a central hospital located in the sought of Iran. Materials and Method: This is a randomized controlled trial which comprised of a convenient sample of 70 eligible nurses, working in a central hospital. They were randomly divided into 2 experimental and control groups. Nurses’ competencies was measured by an Objective Structured Clinical Examination (OSCE) and their performance was measured by asking eligible patients hospitalized in the nurses work setting during a one month period to evaluate nurses' communication skills before and 2 months after intervention. The experimental group participated in a 2 day workshop on communication skills. Content included in this workshop were: the importance of communication (verbal and non verbal), basic communication skills such as initiating the communication, active listening and questioning technique. Other subjects were patient teaching, problem solving, and decision making, cross cultural communication and breaking bad news. Appropriate teaching strategies such as brief didactic sessions, small group discussion and reflection were applied to enhance participants learning. The data was analyzed using SPSS 16. Result: A significant between group differences was found in nurses’ communication skills competencies and performances in the posttest. The mean scores of the experimental group was higher than that of the control group in the total score of OSCE as well as all stations of OSCE (p<0.003). Overall posttest mean scores of patient satisfaction with nurse's communication skills and all of its four dimensions significantly differed between the two groups of the study (p<0.001). Conclusion: This study shows that the education of nurses in communication skills, improves their competencies and performances. Measurement of Nurses’ communication skills as a central component of efficient nurse patient relationship by valid and reliable methods of evaluation is recommended. Also it is necessary to integrate teaching of communication skills in continuing nursing education programs. Trial Registration Number: IRCT201204042621N11

Keywords: communication skills, simulation, performance, competency, objective structure, clinical evaluation

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Authors: Vidya Nimkar Tayade

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Introduction: Intellectual capital of an organization is a key factor to success. Many companies invest a huge amount in their Research and development activities. Any innovation is helpful not only to that particular company but also to many other companies, industry and mankind as a whole. Companies undertake innovative changes for increasing their capital profitability and indirectly increase in pay packages of their employees. The quality of human capital can also improve due to such positive changes. Employees become more skilled and experienced due to such innovations and inventions. For increasing intangible capital, the author has referred to a couple of books and referred case studies to come to a conclusion. Different charts and tables are also referred to by the author. Case studies are more important because they are proven and established techniques. They enable students to apply theoretical concepts in real-world situations. It gives solutions to an open-ended problem with multiple potential solutions. There are three different strategies for undertaking intellectual capital increase. They are: Research push strategy/ Technology pushed approach, Market pull strategy/ approach and Open innovation strategy/approach. Research push strategy, In this strategy, research is undertaken and innovation is achieved on its own. After invention inventor company protects such invention and finds buyers for such invention. In this way, the invention is pushed into the market. In this method, research and development are undertaken first and the outcome of this research is commercialized. Market pull strategy, In this strategy, commercial opportunities are identified first and our research is concentrated in that particular area. For solving a particular problem, research is undertaken. It becomes easier to commercialize this type of invention. Because what is the problem is identified first and in that direction, research and development activities are carried on. Open invention strategy, In this type of research, more than one company enters into an agreement of research. The benefits of the outcome of this research will be shared by both companies. Internal and external ideas and technologies are involved. These ideas are coordinated and then they are commercialized. Due to globalization, people from the outside company are also invited to undertake research and development activities. Remuneration of employees of both the companies can increase and the benefit of commercialization of such invention is also shared by both the companies. Conclusion: In modern days, not only can tangible assets be commercialized, but also intangible assets can also be commercialized. The benefits of such an invention can be shared by more than one company. Competition can become more meaningful. Pay packages of employees can improve. It Is a need for time to adopt such strategies to benefit employees, competitors, stakeholders.

Keywords: innovation, protection, management, commercialization

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Authors: A. Rana, M. Badri, D. Lopez Behar, O. Yee, H. Al Bqaei

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The building sector is one of the largest emitters of greenhouse gases. However, as operation energy demands of this sector decrease with more effective energy policies and strategies, there is an urgent need to parallel focus on the growing proportion of embodied carbons. In this regard, benchmarks on embodied carbon of buildings can provide a point of reference to compare and improve the environmental performance of buildings for the stakeholders. Therefore, embodied carbon benchmarks can serve as a useful tool to address climate change challenges. This research utilizes the method to provide a knowledge roadmap of embodied carbon benchmarks development and implementation trends. Two main databases, Web of Science and Engineering Village, are considered for the study. The mapping was conducted with the help of VosViewer tool to provide information regarding: the critical research areas; most cited authors and publications; and countries with the highest publications. It is revealed that the role of benchmarks in energy policies is an emerging trend. In addition, the research highlighted that in policies, embodied carbon benchmarks are gaining importance at the material, whole building, and building portfolio levels. This research reveals direction for improvement and future research and of relevance to building industry professionals, policymakers, and researchers.

Keywords: buildings embodied carbon benchmark, methods, policy

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: skeletal scintigraphy, SPECT/CT, imaging, procedure

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Authors: Syue-Wen Lin

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Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.

Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns

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Authors: Katharina Fellnhofer, Kaisu Puumalainen

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Despite the current worldwide increasing interest in entrepreneurship education (EE), little attention has been paid to innovative web-based ways such as the narrative approach by telling individual stories of entrepreneurs via multimedia for demonstrating the impact on individuals towards entrepreneurship. In addition, this research discipline is faced with no consensus regarding its effective content of teaching materials and tools. Therefore, a qualitative hypothesis-generating research contribution is required to aim at drawing new insights from published works in the EE field of research to serve for future research related to multimedia entrepreneurial narratives. Based on this background, our effort will focus on finding support regarding following introductory statement: Multimedia success and failure stories of real entrepreneurs show potential to change perceptions towards entrepreneurship in a positive way. The proposed qualitative conceptual paper will introduce the underlying background for this research framework. Therefore, as a qualitative hypothesis-generating research contribution it aims at drawing new insights from published works in the EE field of research related to entrepreneurial narratives to serve for future research. With the means of the triangulation of multiple theories, we will utilize the foundation for multimedia-based entrepreneurial narratives applying a learning-through-multimedia-real-entrepreneurial-narratives pedagogical tool to facilitate entrepreneurship. Our effort will help to demystify how value-oriented entrepreneurs telling their stories multimedia can simultaneously enhance EE. Therefore, the paper will build new-fangled bridges between well-cited theoretical constructs to build a robust research framework. Overall, the intended contribution seeks to emphasize future research of currently under-researched issues in the EE sphere, which are considered to be essential not only to academia, as well as to business and society having future jobs-providing growth-oriented entrepreneurs in mind. The Authors would like to thank the Austrian Science Fund FWF: [J3740 – G27].

Keywords: entrepreneurship education, entrepreneurial attitudes and perceptions, entrepreneurial intention, entrepreneurial narratives

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Authors: Renaud Gaucher

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Research on happiness has developed significantly in the past fifty years and economics and the political science are starting to be influenced by advances in the field. Until recently, finance has stayed outside this movement. The goal of our research is to integrate finance into this movement conceptually. We explain the why, the what and the how of the finance of happiness. We then study the relationship between corporate finance and happiness. We discuss the optimization of the relationship between the financial performance of a firm and the happiness at work of its employees, and the reduction of financial risk by developing goods that foster the happiness of their users. Finally we look at the development of happiness investment funds, that is investment funds founded on happiness research, and the best ways to share risks and earnings to build a happier society.

Keywords: finance, happiness, investment fund, risk

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