Search results for: final outcome

Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.

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Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.

Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)

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Authors: Rui Du

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This paper attempts to assess the impact of a major sporting event —the Super Bowl on the local economies. The identification strategy is to compare the winning and losing cities at the National Football League (NFL) conference finals under the assumption of similar pre-treatment trends. The stock market performances of companies headquartered in these cities are used to capture the sudden changes in local economic activities during a short time span. The exogenous variations in the football game outcome allow a straightforward difference-in-differences approach to identify the effect. This study finds that the post-event trends in winning and losing cities diverge despite the fact that both cities have economically and statistically similar pre-event trends. Empirical analysis provides suggestive evidence of a positive, significant local economic impact of conference final wins, possibly through city image enhancement. Further empirical evidence shows the presence of heterogeneous effects across industrial sectors, suggesting that city image enhancing the effect of the Super Bowl participation is empirically relevant for the changes in the composition of local industries. Also, this study also adopts a similar strategy to examine the local economic impact of Super Bowl successes, however, finds no statistically significant effect.

Keywords: Super Bowl Participation, local economies, city image enhancement, difference-in-differences, industrial sectors

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Authors: M. Hilmi Ozdemir, Gokhan Ozkan

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Performance Based Logistics (PBL) is a strategic approach that enables creating long-term and win-win relations among stakeholders in the acquisition. Contrary to the traditional single transactions, the expected value is created by the performance of the service pertaining to the strategic relationships in this approach. PBL motivates all relevant stakeholders to focus on their core competencies to produce the desired outcome in a collective way. The desired outcome can only be assured with a cost effective way as long as it is periodically measured with the right performance parameters. Thus, defining these parameters is a crucial step for the PBL contracts. In performance parameter determination, Analytic Hierarchy Process (AHP), which is a multi-criteria decision making methodology for complex cases, was used within this study for a complex system. AHP has been extensively applied in various areas including supply chain, inventory management, outsourcing, and logistics. This methodology made it possible to convert end-user’s main operation and maintenance requirements to sub criteria contained by a single performance parameter. Those requirements were categorized and assigned weights by the relevant stakeholders. Single performance parameter capable of measuring the overall performance of a complex system is the major outcome of this study. The parameter deals with the integrated assessment of different functions spanning from training, operation, maintenance, reporting, and documentation that are implemented within a complex system. The aim of this study is to show the methodology and processes implemented to identify a single performance parameter for measuring the whole performance of a complex system within a PBL contract. AHP methodology is recommended as an option for the researches and the practitioners who seek for a lean and integrated approach for performance assessment within PBL contracts. The implementation of AHP methodology in this study may help PBL practitioners from methodological perception and add value to AHP in becoming prevalent.

Keywords: analytic hierarchy process, performance based logistics, performance measurement, performance parameters

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Authors: Hassan Karimi, Fred Piercy, Ruoxi Chen, Ana L. Jaramillo-Sierra, Wei-Ning Chang, Manjushree Palit, Catherine Martosudarmo, Angelito Antonio

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Background: The two psychotherapy camps, the randomized clinical trials (RCTs) and the common factors model, have competitively claimed specific explanations for therapy effectiveness. Recently, scholars called for empirical evidence to show the role of common factors in therapeutic outcome in marriage and family therapy. Purpose: This cross-national study aims to explore how clinicians, across different nations and theoretical orientations, attribute the contribution of common factors to therapy outcome. Method: A brief common factors questionnaire (CFQ-with a Cronbach’s Alpha, 0.77) was developed and administered in seven nations. A series of statistical analyses (paired-samples t-test, independent sample t-test, ANOVA) were conducted: to compare clinicians perceived contribution of total common factors versus model-specific factors, to compare each pair of common factors’ categories, and to compare clinicians from collectivistic nations versus clinicians from individualistic nation. Results: Clinicians across seven nations attributed 86% to common factors versus 14% to model-specific factors. Clinicians attributed 34% of therapeutic change to client’s factors, 26% to therapist’s factors, 26% to relationship factors, and 14% to model-specific techniques. The ANOVA test indicated each of the three categories of common factors (client 34%, therapist 26%, relationship 26%) showed higher contribution in therapeutic outcome than the category of model specific factors (techniques 14%). Clinicians with psychology degree attributed more contribution to model-specific factors than clinicians with MFT and counseling degrees who attributed more contribution to client factors. Clinicians from collectivistic nations attributed larger contributions to therapist’s factors (M=28.96, SD=12.75) than the US clinicians (M=23.22, SD=7.73). The US clinicians attributed a larger contribution to client’s factors (M=39.02, SD=1504) than clinicians from the collectivistic nations (M=28.71, SD=15.74). Conclusion: The findings indicate clinicians across the globe attributed more than two thirds of therapeutic change to CFs, which emphasize the training of the common factors model in the field. CFs, like model-specific factors, vary in their contribution to therapy outcome in relation to specific client, therapist, problem, treatment model, and sociocultural context. Sociocultural expectations and norms should be considered as a context in which both CFs and model-specific factors function toward therapeutic goals. Clinicians need to foster a cultural competency specifically regarding the divergent ways that CFs can be activated due to specific sociocultural values.

Keywords: common factors, model-specific factors, cross-national survey, therapist cultural competency, enhancing therapist efficacy

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Authors: Helen Pushkarskaya, Michael Smithson, Jane E. Joseph, Christine Corbly, Ifat Levy

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Studies of decision making under uncertainty generally focus on imprecise information about outcome probabilities (“ambiguity”). It is not clear, however, whether conflicting information about outcome probabilities affects decision making in the same manner as ambiguity does. Here we combine functional Magnetic Resonance Imaging (fMRI) and a simple gamble design to study this question. In this design, the levels of ambiguity and conflict are parametrically varied, and ambiguity and conflict gambles are matched on both expected value and variance. Behaviorally, participants avoided conflict more than ambiguity, and attitudes toward ambiguity and conflict did not correlate across subjects. Neurally, regional brain activation was differentially modulated by ambiguity level and aversion to ambiguity and by conflict level and aversion to conflict. Activation in the medial prefrontal cortex was correlated with the level of ambiguity and with ambiguity aversion, whereas activation in the ventral striatum was correlated with the level of conflict and with conflict aversion. This novel double dissociation indicates that decision makers process imprecise and conflicting information differently, a finding that has important implications for basic and clinical research.

Keywords: decision making, uncertainty, ambiguity, conflict, fMRI

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Authors: Prajamitra Bhuyan

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Transport operators have a range of intervention options available to improve or enhance their networks. But often such interventions are made in the absence of sound evidence on what outcomes may result. Cycling superhighways were promoted as a sustainable and healthy travel mode which aims to cut traffic congestion. The estimation of the impacts of the cycle superhighways on congestion is complicated due to the non-random assignment of such intervention over the transport network. In this paper, we analyse the causal effect of cycle superhighways utilising pre-innervation and post-intervention information on traffic and road characteristics along with socio-economic factors. We propose a modeling framework based on the propensity score and outcome regression model. The method is also extended to doubly robust set-up. Simulation results show the superiority of the performance of the proposed method over existing competitors. The method is applied to analyse a real dataset on the London transport network, and the result would help effective decision making to improve network performance.

Keywords: average treatment effect, confounder, difference-in-difference, intelligent transportation system, potential outcome

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Authors: Eda Yakit Ak, Ergül Aslan

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The study was conducted using the quasi-experimental design to determine the influence of the nursing support program prepared according to the Health Belief Model on reproductive health behaviors of orthopedically disabled women in the physical therapy and rehabilitation clinic at a university hospital between August 2019-October, 2020. The research sample included 50 women (35 in the control group and 15 in the experimental group with orthopedic disability). A 3-week nursing support program was applied to the experimental group of women. To collect the data, Introductory Information Form and Scale for Determining the Protective Attitudes of Married Women towards Reproductive Health (SDPAMW) were applied. The evaluation was made with a follow-up form for four months. In the first evaluation, the total SDPAMW scores were 119.93±20.59 for the experimental group and 122.20±16.71 for the control group. In the final evaluation, the total SDPAMW scores were 144.27±11.95 for the experimental group and 118.00±16.43 for the control group. The difference between the groups regarding the first and final evaluations for the total SDPAMW scores was statistically significant (p<0.01). In the experimental group, between the first and final evaluations regarding the sub-dimensions of SDPAMW, an increase was found in the behavior of seeing the doctor on reproductive health issues, protection from reproductive organ and breast cancer, general health behaviors to protect reproductive health, and protection from genital tract infections (p<0.05). Consequently, the nursing support program based on the Health Belief Model applied to orthopedically disabled women positively affected reproductive health behaviors.

Keywords: orthopedically disabled, woman, reproductive health, nursing support program, health belief model

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Authors: Yeong-Gyeong Choi, Kyoung-Seok Kim

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This study, literature review research, intends to deal with the problem of conceptual ambiguity among research on emotional labor, and to look into the evolutionary trends and changing aspects of defining the concept of emotional labor. In addition, in existing studies, deep acting and surface acting are highly related to a positive outcome variable and a negative outcome variable, respectively. It was confirmed that for employees performing emotional labor, deep acting and surface acting are highly related to OCB and CWB, respectively. While positive emotion that employees come to experience during job performance process can easily trigger a positive non-task behavior such as OCB, negative emotion that employees experience through excessive workload or unfair treatment can easily induce a negative behavior like CWB. The two management behaviors of emotional labor, surface acting and deep acting, can have either a positive or negative effect on non-task behavior of employees, depending on which one they would choose. Thus, the purpose of this review paper is to clarify the relationship between emotional labor and non-task behavior more specifically.

Keywords: emotion labor, non-task behavior, OCB, CWB

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Authors: Naqoosh Haidry

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Objective & Goal: Enucleation of the maxillomandibular cysts will lead to the creation of post-surgical bone defects which may take more than a year for complete bone healing. The use of bone grafts is common to aid bone regeneration in large defects. The study aimed to evaluate the healing and bone formation capabilities of polymer of injectable platelet fibrin (i-PRF) and hydroxyapatite (HA) as bone graft substitute in maxilla-mandibular postsurgical defects compared to hydroxyapatite alone. The primary objective was to find out the clinical and radiological assessment of healing postoperatively and compare the outcome of both groups. Material and Methods: After surgical enucleation of 19 maxillomandibular cysts/tumors, either HA or HA+ i-PRF graft was adapted to the defect. Clinical outcome variables such as pain (VAS score), edema, and mucosal color were evaluated on postoperative days 01, 03, and 07 while radiological outcome variables such as volume of defect (cc), density of new bone (HU) on computed tomography were evaluated at 2nd and 4th month. The results obtained were tabulated and compared with the inferential analysis. Results: Clinical parameters seem to be better in the HA + i-PRF group, but the result was non-significant. Radiologically, the mean healing ratios were significantly greater in the HA + i-PRF group (63.5 ± 2.34 at 2nd month, 90.3 ± 7.32 at 4th month) compared to the HA group (57.2 ± 5.21at 2nd month, 80.8 ± 5.33 at 4th month). When comparing the mean density of new bone, there was a statistically significant difference with a mean difference of 95.2 HU more in the HA + i-PRF (623 HU ± 42.9) compared to the HA group (528 HU ± 96.5) in 2nd month. Conclusion: The polymer of i-PRF and HA prepared as the sticky bone yields faster and better bone healing in post-enucleation maxillomandibular bony defects as compared to hydroxyapatite alone based on radiological findings till four months.

Keywords: bone defect, density of new bone, hydroxyapatite, injectable platelet rich fibrin, maxillomandibular cysts, surgical defect

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Authors: Bo-Huei Huang, Chih-Hsun Yang, Meng-Tsan Tsai

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Optical coherence tomography (OCT) enables to provide advantages of noninvasive imaging, high resolution, and high imaging speed. In this study, we integrated OCT and a CW laser for tumor diagnosis and treatment. The axial and transverse resolutions of the developed OCT system are 3 μm and 1 μm, respectively. The frame rate of OCT system is 30 frames/s. In this study, the tumor cells were implanted into the mice skin and scanned by OCT to observe the morphological and angiographic changes. With OCT imaging, 3D microstructures and skin angiography of mice skin can be simultaneously acquired, which can be utilized for identification of the tumor distribution. Then, the CW laser beam can be accurately controlled to expose on the center of the tumor, according to the OCT results. Moreover, OCT was used to monitor the induced photothermolysis and to evaluate the treatment outcome. The results showed that OCT-guided laser therapy could efficiently improve the treatment outcome and the extra damage induced by CW can be greatly reduced. Such OCT-guided laser therapy system could be a potential tool for dermatological applications.

Keywords: optical coherence tomography, laser therapy, skin tumor, position guide

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Authors: Dmitry K. Shaytan, Georgy D. Laptev

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In our research we aimed to test a managerial approach for the fuzzy front end (FFE) of innovation by creating controlled experiment/ business case in a breakthrough innovation development. The experiment was in the sport industry and covered all aspects of the customer discovery stage from ideation to prototyping followed by patent application. In the paper we describe and analyze mile stones, tasks, management challenges, decisions made to create the break through innovation, evaluate overall managerial efficiency that was at the considered FFE stage. We set managerial outcome of the FFE stage as a valid product concept in hand. In our paper we introduce hypothetical construct “Q-factor” that helps us in the experiment to distinguish quality of FFE outcomes. The experiment simulated for entrepreneur the FFE of innovation and put on his shoulders responsibility for the outcome of valid product concept. While developing managerial approach to reach the outcome there was a decision to look on product concept from the cognitive psychology and cognitive science point of view. This view helped us to develop the profile of a person whose projection (mental representation) of a new product could optimize for a manager or entrepreneur FFE activities. In the experiment this profile was tested to develop breakthrough innovation for swimmers. Following the managerial approach the product concept was created to help swimmers to feel/sense water. The working prototype was developed to estimate the product concept validity and value added effect for customers. Based on feedback from coachers and swimmers there were strong positive effect that gave high value for customers, and for the experiment – the valid product concept being developed by proposed managerial approach for the FFE. In conclusions there is a suggestion of managerial approach that was derived from experiment.

Keywords: concept development, concept testing, customer discovery, entrepreneurship, entrepreneurial management, idea generation, idea screening, startup management

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Authors: Boukhiar Aissa, Iguergaziz Nadia, Halladj Fatima, Lamrani Yasmina, Benamara Salem

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Determining the alcohol content in alcoholic fermentation bioprocess has a great importance. In fact, it is a key indicator for monitoring this fermentation bioprocess. Several methodologies (chemical, spectrophotometric, chromatographic...) are used to the determination of this parameter. However, these techniques are very long and require: rigorous preparations, sometimes dangerous chemical reagents, and/or expensive equipment. In the present study, the date juice is used as a substrate of alcoholic fermentation. The extracted juice undergoes an alcoholic fermentation by Saccharomyces cerevisiae. The study of the possible use of refractometry as a sole means for the in situ control of this process revealed a good correlation (R2 = 0.98) between initial and final ° Brix: ° Brix f = 0.377× ° Brixi. In addition, we verified the relationship between the variation in final and initial ° Brix (Δ ° Brix) and alcoholic rate produced (A exp): CΔ° Brix / A exp = 1.1. This allows the tracing of abacus isoresponses that permit to determine the alcoholic and residual sugar rates with a mean relative error (MRE) of 5.35%.

Keywords: refractometry, alcohol, residual sugar, fermentation, brix, date, juice

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Authors: Neeraj Malhotra, Ramya Shenoy

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Objective: To assess the effect of clinical parameters (bonding agent, preparation design & storage media) on the strength of reattached anterior tooth fragment. Methodology: This is a systematic review and meta-analysis for articles referred from MEDLINE, PUBMED, and GOOGLE SCHOLAR. The articles on tooth reattachment and clinical factors affecting fracture strength/bond strength/fracture resistance of the reattached tooth fragment in anterior teeth and published in English from 1999 to 2016 were included for final review. Results: Out of 120 shortlisted articles, 28 articles were included for the systematic review and meta-analysis based on 3 clinical parameters i.e. bonding agent, tooth preparation design & storage media. Forest plot & funnel plots were generated based on individual clinical parameter and their effect on strength of reattached anterior tooth fragment. Results based on analysis suggest combination of both conclusive evidence favoring the experimental group as well as in-conclusive evidence for individual parameter. Conclusion: There is limited evidence as there are fewer articles supporting each parameter in human teeth. Bonding agent had showed better outcome in selected studies.

Keywords: bonding agent, bond strength, fracture strength, preparation design, reattachment, storage media

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Authors: Rachel Byrne

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Background: Due to patient and student safety concerns, combined with clinical teachers being redeployed to clinical practice, COVID-19 has resulted in a reduction in face-to-face teaching sessions for medical students. Traditionally such sessions are particularly important for final year medical students, especially in preparing for their final practical exams. A reduced student presence on the wards has also resulted in fewer opportunities for junior doctors to provide teaching sessions. This has implications for junior doctors achieving their own curriculum outcomes for teaching, as well as potentially hindering the development of a future interest in medical education. Aims: The aims of the study are 1) To create a safe face-to-face teaching environment during COVID-19 which focussed on exam preparation for final year medical students, 2) To provide a platform for doctors to gain teaching experience, 3 ) to enable doctors to gain feedback or assessments on their teaching, 4) To create beginners guide to designing a new teaching program for future junior doctors. Methods: We created a program of timed clinical stations consisting of four sessions every five weeks during the student’s medicine attachment. Each session could be attended by 6 students and consisted of 6 stations ran by junior doctors, with each station following social distancing and personal protective equipment requirements. Junior doctors were asked to design their own stations. The sessions ran out-of-hours on weekday evenings and were optional for the students. Results: 95/95 students and 20/40 doctors involved in the programme completed feedback. 100% (n=95) of students strongly agreed/agreed that sessions were aimed at an appropriate level and provided constructive feedback. 100% (n=95) of students stated they felt more confident in their abilities and would recommend the session to peers. 90% (n=18) of the teachers strongly agreed/agreed that they felt more confident in their teaching abilities and that the sessions had improved their own medical knowledge. 85% (n=17) of doctors had a teaching assessment completed, and 83% (n=16) said the program had made them consider a career in medical education. The difficulties of creating such a program were highlighted throughout, and a beginner’s guide was created with the hopes of helping future doctors who are interested in teaching address the common obstacles.

Keywords: COVID-19, education, safety, medical

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Authors: Mohamed Chabi, Mahmoud I. Syam, Sarah Aw

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In Summer 2012, the Foundation Program Unit of Qatar University has started implementing new ways of teaching Math by introducing MML (MyMathLab) as an innovative interactive tool to support standard teaching. In this paper, we focused on the effect of proper use of the Study Plan component of MML on student’s performance. Authors investigated the results of students of pre-calculus course during Fall 2013 in Foundation Program at Qatar University. The results showed that there is a strong correlation between study plan results and final exam results, also a strong relation between homework results and final exam results. In addition, the attendance average affected on the student’s results in general. Multiple regression is determined between passing rate dependent variable and study plan, homework as independent variable.

Keywords: MyMathLab, study plan, assessment, homework, attendance, correlation, regression

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Authors: R. Velvarska, A. Vrablik, M. Fiedlerova, R. Cerny

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Near-infrared spectrometry (NIR) was tested as a rapid and alternative tool for determination of biodiesel oxidation stability. A PetroOxy method is standardly used for the determination, but this method is hazardous due to the possibility of explosion and ignition of flammable fuels. The second disadvantage is time consuming. The near-infrared spectrometry served for the development of the calibration model which was composed of 133 real samples (calibration standards). The reference values of these standards were obtained by PetroOxy method. Many chemometric diagnostics were used for the development of the final NIR model with the aim to have accurate prediction of the oxidation stability. The final NIR model was validated by 30 validation standards. The repeatability was determined as well with the acceptable residual standard deviation (8.59 %). The NIR spectrometry has proved to be an accurate alternative method for the determination of biodiesel oxidation stability with advantages as the time and cost saving, non-destructive character of analyzing and the possibility of online monitoring in safe mode.

Keywords: biodiesel, fatty acid methyl ester, NIR, oxidation stability

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Antonia Harold-Barry, Eugene Dempsey

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Background: The objective is to examine the survival and outcome of infants born under 26 weeks gestation in an Irish tertiary maternity hospital from 2007-2016 and to describe the survival and neurodevelopmental outcomes of these extremely preterm infants. Method: The population is 132 infants born at 23, 24, and 25 weeks in Cork University Maternity Hospital from 2007 to 2016. Ethical approval was granted by the Cork Clinical Research Ethics Committee. Patient details were obtained from the Vermont Oxford and Badger Networks. Survival rates and Bayley scores were calculated to assess neurodevelopmental outcomes. Statistical analysis with SPSS included frequencies, distributions, and comparisons between data from 2007-2011 and 2012-2016. Results: Overall survival rate was 63%. Of the surviving babies, 61% had Bayley scores calculated. Survival stood at 39% for delivery at 23 weeks, 50% at 24 weeks, and 83% at 25 weeks. The 2012 to 2016 cohort has shown further increases in survival, with 50% of babies at 23 weeks, 58% at 24 weeks, and 89% at 25 weeks. Corresponding figures for 2007-2011 are 20%, 39%, and 75%. Gestational age and incidence of periventricular leukomalacia were statistically significant, with a p-value of 0.022. Gestational age and delivery room deaths had a p-value of 0.025, as did gestational age and birth weight. A comparison of the two cohorts (2007-2011 and 2012-2016) with the administration of antenatal steroids showed a statistically significant p-value of 0.044. Conclusion: There is less morbidity and mortality in infants born at 25 than at 23 or 24 weeks. Survival of extremely premature infants has increased significantly over the past ten years. Survival rates with normal neurodevelopmental outcomes are comparable with international standards and reflect positive changes in attitude and practices in neonatal intensive care. This study will inform parents about the potential outcomes of extreme prematurity and policy regarding the management of extreme prematurity.

Keywords: extreme of viability, neurodevelopmental outcome, periventricular leukomalacia, prematurity

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Authors: Hamad Al-Turaif, Usman Saeed

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The development of nanofibers with the help of electrospinning is being prioritized as a method of choice because of the simplicity and efficiency of the process. The parameters of the electrospinning process effectively convert the polymer solution into an electrospun final product made of the desired diameter of nanofiber. The aim of the study presented is to recognize and analyze the effect of proposed parameters on biodegradable and biocompatible polylactic acid (PLA)/polybutylene succinate (PBS) nanofiber developed by the electrospinning process. The morphology of the fiber is characterized by implementing Scanning Electron Microscope. Studies were conducted to characterize the result of using different electrospinning parameters on the final diameter and orientation of fiber. It was determined that varying polymer solution concentration, feed rate, and applied voltage show different outcomes. The best results were obtained at 6% polymer solution concentration, 20 kV, and 0.5 ml/h, which can be applicable for biomedical applications. Finally, protein adsorption and mechanical testing were conducted on the PLA/PBS fiber.

Keywords: electrospinning, polylactic acid, polybutylene succinate, morphology

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Authors: A. Askerov, Y. Teterin, P. Yartcev, S. Novikov

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Introduction: Acute pancreatitis (AP) is a socially significant problem for public health and continues to be one of the most common causes of hospitalization of patients with pathology of the gastrointestinal tract. It is characterized by high mortality rates, which reaches 62-65% in infected pancreatic necrosis. Aims & Methods: The study group included 63 patients who underwent transluminal drainage (TLD) fluid collection (FC). All patients were performed transabdominal ultrasound, computer tomography of the abdominal cavity and retroperitoneal organs and endoscopic ultrasound (EUS) of the pancreatobiliary zone. The EUS was used as a final diagnostic method to determine the characteristics of FC. The indications for TLD were: the distance between the wall of the hollow organ and the FC was not more than 1 cm, the absence of large vessels on the puncture trajectory (more than 3 mm), and the size of the formation was more than 5 cm. When a homogeneous cavity with clear, even contours was detected, a plastic stent with rounded ends (“double pig tail”) was installed. The indication for the installation of a fully covered self-expanding stent was the detection of nonhomogeneous anechoic FC with hyperechoic inclusions and cloudy purulent contents. In patients with necrotic forms after drainage of the purulent cavity, a cystonasal drainage with a diameter of 7Fr was installed in its lumen under X-ray control to sanitize the cavity with a 0.05% aqueous solution of chlorhexidine. Endoscopic necrectomy was performed every 24-48 hours. The plastic stent was removed in 6 month, the fully covered self-expanding stent - in 1 month after the patient was discharged from the hospital. Results: Endoscopic TLD was performed in 63 patients. The FC corresponding to interstitial edematous pancreatitis was detected in 39 (62%) patients who underwent TLD with the installation of a plastic stent with rounded ends. In 24 (38%) patients with necrotic forms of FC, a fully covered self-expanding stent was placed. Communication with the ductal system of the pancreas was found in 5 (7.9%) patients. They underwent pancreaticoduodenal stenting. A complicated postoperative period was noted in 4 (6.3%) cases and was manifested by bleeding from the zone of pancreatogenic destruction. In 2 (3.1%) cases, this required angiography and endovascular embolization a. gastroduodenalis, in 1 (1.6%) case, endoscopic hemostasis was performed by filling the cavity with 4 ml of Hemoblock hemostatic solution. The combination of both methods was used in 1 (1.6%) patient. There was no evidence of recurrent bleeding in these patients. Lethal outcome occurred in 4 patients (6.3%). In 3 (4.7%) patients, the cause of death was multiple organ failure, in 1 (1.6%) - severe nosocomial pneumonia that developed on the 32nd day after drainage. Conclusions: 1. EUS is not only the most important method for diagnosing FC in AP, but also allows you to determine further tactics for their intraluminal drainage.2. Endoscopic intraluminal drainage of fluid zones in 45.8% of cases is the final minimally invasive method of surgical treatment of large-focal pancreatic necrosis. Disclosure: Nothing to disclose.

Keywords: acute pancreatitis, fluid collection, endoscopy surgery, necrectomy, transluminal drainage

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Authors: N. Bolong, J. Makinda, I. Saad

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Laboratory activities have produced benefits in student learning. With current drives of new technology resources and evolving era of education methods, renewal status of learning and teaching in laboratory methods are in progress, for both learners and the educators. To enhance learning outcomes in laboratory works particularly in engineering practices and testing, learning via hands-on by instruction may not sufficient. This paper describes and compares techniques and implementation of traditional (expository) with open-ended laboratory (problem-based) for two consecutive cohorts studying environmental laboratory course in civil engineering program. The transition of traditional to problem-based findings and effect were investigated in terms of course assessment student feedback survey, course outcome learning measurement and student performance grades. It was proved that students have demonstrated better performance in their grades and 12% increase in the course outcome (CO) in problem-based open-ended laboratory style than traditional method; although in perception, students has responded less favorable in their feedback.

Keywords: engineering education, open-ended laboratory, environmental engineering lab

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Authors: Hamed Saremi, Shahla Saremi

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In this study, control and management of construction projects is evaluated through developing a dynamic model in which some means are used in order to evaluating planning assumptions and reviewing the effectiveness of some project control policies based on previous researches about time, cost, project schedule pressure management, source management, project control, adding elements and sub-systems from cost management such as estimating consumption budget from budget due to costs, budget shortage effects and etc. using sensitivity analysis, researcher has evaluated introduced model that during model simulation by VENSIM software and assuming optimistic times and adding information about doing job and changes rate and project is forecasted with 373 days (2 days sooner than forecasted) and final profit $ 1,960,670 (23% amount of contract) assuming 15% inflation rate in year and costs rate accordance with planned amounts and other input information and final profit.

Keywords: dynamic planning, cost, time, performance, project management

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Authors: Inje Cho

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The leading health risks threatening the world today are associated with a modern lifestyle characterized by sedentary behavior, stress, anxiety, and an obesogenic food environment. To counter this alarming trend, the Centers for Disease Control and Prevention have proffered Physical Activity guidelines to bolster physical engagement. Concurrently, the burgeon of smartphones and mobile applications has witnessed a proliferation of fitness applications aimed at invigorating exercise adherence and real-time activity monitoring. Grounded in the Uses and gratification theory, this study delves into the technological affordances of mobile fitness applications, discerning the mediating influences of escapism and social outcome expectations on attitudes and exercise intention. The theory explains how individuals employ distinct communication mediums to satiate their exigencies and desires. Technological affordances manifest as attributes of emerging technologies that galvanize personal engagement in physical activities. Several features of mobile fitness applications include affordances for goal setting, virtual rewards, peer support, and exercise information. Escapism, denoting the inclination to disengage from normal routines, has emerged as a salient motivator for the consumption of new media. This study postulates that individual’s perceptions technological affordances within mobile fitness applications, can affect escapism and social outcome expectations, potentially influencing attitude, and behavior formation. Thus, the integrated model has been developed to empirically examine the interrelationships between technological affordances, escapism, social outcome expectations, and exercise intention. Structural Equation Modelling serves as the methodological tool, and a cohort of 400 Fitbit users shall be enlisted from the Prolific, data collection platform. A sequence of multivariate data analyses will scrutinize both the measurement and hypothesized structural models. By delving into the effects of mobile fitness applications, this study contributes to the growing of new media studies in sport management. Moreover, the novel integration of the uses and gratification theory, technological affordances, via the prism of escapism, illustrates the dynamics that underlies mobile fitness user’s attitudes and behavioral intentions. Therefore, the findings from this study contribute to theoretical understanding and provide pragmatic insights to developers and practitioners in optimizing the impact of mobile fitness applications.

Keywords: technological affordances, uses and gratification, mobile fitness apps, escapism, physical activity

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Authors: Vasilis C. Hristidis, Ricardo Caceda, Ji Soo Kim, Brian Bronson, Emily A. Hill

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Objective: Leave passes to provide authorized leave for hospitalized patients from a psychiatric inpatient unit. Though providing day passes was once a relatively common practice, there is relatively little data describing their safety and efficacy. Methods: This descriptive study examines the use of leave passes in an adult inpatient unit at a university hospital between 2017 and 2021, with attention to reasons for granting the day pass, duration, and outcome of the pass. Results: During the study period, ten patients with primary psychotic or mood disorders received 12 passes for either housing coordination, COVID-19 vaccination, or major family events. There were no fatalities or elopements. One patient experienced severe agitation and engaged in non-suicidal self-injurious behavior. A second patient showed mild, redirectable psychomotor agitation upon return to the unit. The remaining 10 passes were uneventful. Conclusions: Our findings support the view that patients with diverse diagnoses can safely be provided leave from an inpatient setting with adequate planning and support, yielding a low incidence of adverse events.

Keywords: passes, inpatient, psychiatry, inpatient leave, outcome

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Authors: Rigas Dimakopoulos, Marianna Papadopoulou, Roser Pons

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Background: Participation in family, recreational activities and self-care is an integral part of health. It is also the main outcome of rehabilitation services for children and adolescents with motor disabilities. There are currently no tools in Greek to assess participation in young children. Purpose: To culturally adapt and validate the Greek version of the Child Engagement in Daily Living (CEDL). Method: The CEDL was cross-culturally translated into Greek using forward-backward translation, review by the expert committee, pretest application and final review. Internal consistency was evaluated using the Cronbach alpha and test-retest reliability using the intra-class correlation coefficient (ICC). Parents of children aged 18 months to 5 years and with motor disabilities were recruited. Participants completed the CEDL and the children’s gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Results: Eighty-three children were included, GMFCS I-V. Mean ± standard deviation of the CEDL domains “frequency of participation” “enjoyment of participation” and “self-care” were 58.4±14.0, 3.8±1.0 and 49.9±24, respectively. Internal consistency of all domains was high; Cronbach alpha for “frequency of participation” was 0.83, for “enjoyment of participation” was 0.76 and for “self-care” was 0.92. Test-retest reliability (ICC) was excellent for the “self-care” (0.95) and good for “frequency of participation” and “enjoyment of participation” domains (0.90 and 0.88, respectively). Conclusion: The Greek CEDL has good reliability. It can be used to evaluate participation in Greek young children with motor disabilities GMFCS levels I-V.

Keywords: participation, child, disabilities, child engagement in daily living

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Authors: Nane Giloyan

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The rapid development of social networks in the 21st century increases the interests towards the role and impact of social media on the success or failure of a revolution. Even though studies are investigating the role of social media on the outcome of a revolution, still, the conclusions on this matter are ambiguous so far. Hence, this research aims to investigate the role of social media in the success or failure of a revolution and make a contribution to the literature gap. The study aims to examine the research question whether the use of social media explains the success or failure of revolutions in 2008 and 2018 in Armenia. The research question is investigated through content analysis of two cases; failed revolution in 2008 and the successful revolution in 2018 in Armenia. The secondary data analysis was based on information devoted to two revolutions using local and major international news articles, journal and critical articles, in Armenian, Russian and English, also videos, posts and live streams of the revolutionary leaders. There can be many factors explaining the success or failure of a revolution. However, the investigation of the factors and their role to explain the outcome of a revolution other than the use of social media is beyond the scope of this research study. The study holds other variables constant and concludes that in the cases of 2008 and 2018 revolutions in Armenia the mobilization of society through social media explains the differences in the outcomes (failed or successful). The comparative case study of the revolutions in 2008 and 2018 in Armenia emphasizes the important role and impact of the use of social media on the success or failure of a revolution. The results highlight that the use of the Internet, particularly social media and live streams, by the opposition was the essential difference between two revolutions. Social media platforms, live streams, and communication apps that were absent in the revolutionary situation in 2008 were fundamental to the Armenian Velvet Revolution in 2018. The changes in the situation in favor of the opposition, so the outcome of the protests, were mainly based on the Internet-based mobilization of the society. It is also important to take into consideration that the country experienced a great increase in penetration rates over the decade. The percentage of access to the Internet drastically increased between 2008 and 2018. This fact may help to have a clearer understanding of the use of the Internet and social media by the opposition and the reliance on social media by society. According to the results of the continent analysis, the use of social media to direct the protests and to mobilize the society, have a vital role and positive impact on the outcome of a revolution. Thus the study concludes that it is the use of social media to initiate, organize, and direct the protests that explain the success or failure of two Armenian revolutions.

Keywords: social media, revolution, Armenia, success, failure

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Authors: Manal Mohammed Hisham Said Najjar

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The Arab Grammarians shed light on the redundant kana (was) and gave it a considerable attention. However, their considerations and interpretations pertaining to using this verb varied: is it used to determine tense? Or used for further emphasis or for another function? Does it have a syntactic function? Morphologically, could it be used in other forms than the past? In addition, Arab Grammarians discussed the possibility of using kana to locate itself in between the syntactic constructs of a sentence, a phrase, or a collocation. Others questioned its position whether it is in initial or final. This study found out that the redundant kana (was) is cited in Quran and was used by the Arabs in their speech and poetry. This redundant kana, whether used in initial position or in a final position, or in between the constructs of a sentence, a phrase, or a collocation, implies pragmatic meanings intended by the speaker or the poet to serve different functions, such as to indicate the past tense, to provide emphasis, and to refer to the continuity of the effect and meaning of a verb or adjective. The study concludes that this verb kana can be utilized in different contexts to achieve a specific effect as did the old Arabs who used it to add specific shades of meanings. Kana as a redundant word could be added to further highlight the meaning aimed at in a specific utterance. In addition, this verb can be used in both the past and the present morphological form; and its availability in an utterance could be functional and could not be. In other words, the study found out that the redundant kana can be used in various positions in an utterance, initial, final, or in between a syntactic structure, provided that this use is pragmatically functional. In conclusion, this paper seeks to invite the scholars of the Arabic language to coin a new term which is the “pragmatic kana” to replace the term “kana alzae’da (redundant kana)” which might mean that its use is redundant and void of significance – a fact that is illogical due to its recurrent use in the Holy Quran. NOTE: Please take this study not the other one (sent by mistake) and titled kana alnaqisa

Keywords: redundan, kana, grammarians, quran

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Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

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Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

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Authors: Diane M. Bender

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In design education, professional education is delivered in a studio, where students learn and understand their discipline. This learning methodology culminates in a final review, where students present their work before instructors and invited reviewers, known as jurors. These jurors are recognized experts who add a wide diversity of opinions in their feedback to students. This feedback can be provided in multiple formats, mainly a verbal critique of the work. To better understand how these expert reviewers prepare for a studio review, a survey was distributed to reviewers at a multi-disciplinary design school within the United States. Five design disciplines are involved in this case study: architecture, graphic design, industrial design, interior design, and landscape architecture. Respondents (n=122) provided information about if and how they received training on how to critique and participate in a final review. Common forms of training included mentorship, modeled behavior from other designers/past professors, workshops on critique from the instructing faculty prior to the crit session, and by being a practicing design professional. Respondents also gave feedback about how much the instructor provided course materials prior to the review in order to better prepare for student interaction. Finally, respondents indicated if they had interaction, and in what format, with students prior to the final review. Typical responses included participation in studio desk crits, a midterm jury member, meetings with students, and email or social media correspondence. While the focus of this study is the studio review, the findings are equally applicable to other disciplines. Suggestions will be provided on how to improve the preparation of guests in the learning process and how their interaction can positively influence student engagement.

Keywords: critique, design, education, evaluation, juror

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Authors: Muhammad Umar Usman

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This study investigates the entrepreneurial intentions, drivers and challenges of starting a business among final year students in Jigawa State polytechnic. Nigeria. Final year students of Jigawa State Polytechnic from the department of accounting, business administration and management and public administration were used as a case study. The study became necessary due to the alarming rate of graduate unemployment in Nigeria. The study adopted a holistic case study approach involving a multiple methods of questionnaires involving (182) Higher National Diploma (HND) and National Diploma (ND) final year students and a telephone interview with two lecturers teaching entrepreneurship in the college. The findings clearly indicate that exposer to entrepreneurship education increases students’ entrepreneurial intentions. The result found that desire for independence, confidence and strong intention are the most important factors that influence students’ entrepreneurial intention. The study identified 3 key drivers of students’ entrepreneurial intentions. These are to earn a living, to seek job security and provision of employment. The result again identified 4 factors namely lack of support, finance, insecurity and erratic power supply as the major challenges in starting a business in Nigeria. It was also revealed that the current entrepreneurship education programme prepares students on how to open up a business not becoming an entrepreneur. The study concluded entrepreneurship helps students toward building and driving their intention to venture into business. However, the challenges of entrepreneurship in Nigeria need to be addressed in order to enable individuals to become an entrepreneur and create employment opportunities that will lead to the development of Nigerian economy. Thus, the government should provide adequate support particularly the issue of infrastructures. The Federal Government of Nigeria in collaboration with the National Board for Technical Education should fashion out the curriculum thereby making it more practically-oriented so that students may become more interested. Polytechnics should develop an internship programme for students to work in firms so as to put theory learnt in the class to practice. Students should try to align the theory learnt in college with the practical application in dynamic economic environment. Hence, this will help in building their capabilities toward entrepreneurship development in Nigeria.

Keywords: entrepreneurial intention, entrepreneurial drivers, challenges, entrepreneurial education

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