Search results for: outcome expectancy

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: 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: Rabeeya Raoof, Abrar Ul-Haq, Muhammad Arshad

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The current study is trying to explain the relationship between entrepreneurial education and entrepreneurial passion. This study introduces multiple mechanisms by which entrepreneurial education may induce entrepreneurial passion in business graduates. With the help of expectancy theory, we proposed that entrepreneurial education develops entrepreneurial passion through the mediation of desirability and feasibility. Furthermore, desirability is also influencing feasibility. Therefore, desirability and feasibility may also play their role as double mediators in the relationship between entrepreneurial education and passion. The role of gender has become very vital in entrepreneurship studies. Therefore, we also incorporated the role of gender as a moderator while studying the indirect effect of entrepreneurial education on entrepreneurial passion via desirability and feasibility. We proposed that entrepreneurial education may influence the passion of male individuals primarily through feasibility. On the other hand, entrepreneurial education may impact on the entrepreneurial passion of female individuals primarily through the mediation of desirability. Learning orientation may increase the direct effect of entrepreneurial education on entrepreneurial passion.

Keywords: entrepreneurial passion, perceived desirability, perceived feasibility, entrepreneurial intention

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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: 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: 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: Mohamed Boubekri, Jaewook Lee

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The assessment of the daylighting performance of a design solution is a complex task due to the changing nature of daylight. A few quantitative metrics are available to designers to assess such a performance, among them are the mean hourly illuminance (MHI), the daylight factor (DF), the daylight autonomy (DA) and the useful daylight illuminance (UDI). Each of these metrics has criteria and limitations that affect the outcome of the evaluation. When to use one metric instead of another depends largely on the design goals to be achieved. Using Design Iterate Validate Adapt (DIVA) daylighting simulation program we set out to examine the performance behavior of these four metrics with the changing dimensions of three shading devices: a horizontal overhang, a horizontal louver system, and a vertical louver system, and compare their performance behavior as the orientation of the window changes. The context is a classroom of a prototypical elementary school in South Korea. Our results indicate that not all four metrics behave similarly as we vary the size of each shading device and as orientations changes. The UDI is the metric that leads to outcome most different than the other three metrics. Our conclusion is that not all daylighting metrics lead to the same conclusions and that it is important to use the metric that corresponds to the specific goals and objectives of the daylighting solution.

Keywords: daylight factor, hourly daylight illuminance, daylight autonomy, useful daylight illuminance

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Authors: Ilham Akbar Rahman, Aflah Dhea Bariz Yasta, Iin Fadhilah Utami Tamasse, Devina Juanita

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Meningioma is adult brain tumors originating from the meninges covering the brain and spinal cord. The females have approximately twice higher 2:1 than male in the incidence of meningioma. This study aimed to analyze the histopathological grading and clinical aspect in predicting the prognosis of meningioma patients. An observational study with cross sectional design was used on 53 meningioma patients treated at Dr. Wahidin Sudirohusodo hospital in 2016. The data then were analyzed using SPSS 20.0. Of 53 patients, mostly 41 (77,4%) were female and 12 (22,6%) were male. The distribution of histopathology patients showed the meningothelial meningioma of 18 (43,9%) as the most type found. Fibroplastic meningioma were 8 (19,5%), while atypical meningioma and psammomatous meningioma were 6 (14,6%) each. The rest were malignant meningioma and angiomatous meningioma which found in respectively 2 (4,9%) and 1 (2,4%). Our result found significant finding that mostly male were fibroblastic meningioma (50%), however meningothelial meningioma were found in the majority of female (54,8%) and also seizure comprised only in higher grade meningioma. On the outcome of meningioma patient treated operatively, histopathological grade remained insignificant (p > 0,05). This study can be used as prognostic value of meningioma patients based on gender, histopathological grade, and clinical manifestation. Overall, the outcome of the meningioma’s patients is good and promising as long as it is well managed.

Keywords: meningioma, prognostic value, histopathological grading, clinical manifestation

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Authors: Anu S. Krishna

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The paper tries to analyse the UN involvement/intervention in the case of intra-state armed conflict of El Salvador and Nepal comparatively. The peace mission in El Salvador is considered to be the most successful missions of UN ever since it started involving in the peace-building activities. Meanwhile, in the armed conflict of South Asian country, Nepal, the result seemed to be disappointing in comparison with its counterpart. The study on this paper takes three variables as the success or failure of international mediation, i.e., a) signing of the peace agreement, b) disarmament/demobilization and c) constitutional mechanism. A significant amount of scholarship looks at the case of ONUSAL (United Nations Mission in El Salvador). Meanwhile, the armed conflict of Nepal and the role of UNMIN (United Nations Mediation in Nepal) are under researched so far. The paper thus tries to throw light on these cross-regional contexts that share certain similarities and dissimilarities in the nature of conflict. In addition, the international third-party involvement and their way of approaching both the cases differ, which again affected the mediation outcome. The paper tries to argue that, since the approach of the UN led international mediation in theses peace missions were contextual and varied from case to case, thus, finally affected the mediation outcome too.

Keywords: Nepal, UNMIN, El Salvador, ONUSAL, international mediation, armed conflict

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Jing Ding

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The present study will propose a Randomized Controlled Trial (RCT) that will assess the efficacy of group Cognitive Behavioral Therapy (CBT) in treating depressive symptoms among menopausal women in China. Considering the high prevalence of menopausal symptoms and depressive disorders among this population, the present study is intended to explore whether group CBT can provide relief for these psychological disturbances commonly linked with hot flashes and night sweats during menopause. Thus, participants will be recruited through gynecologic and psychological outpatient clinics in Beijing, China, and then randomly assigned to either the CBT intervention group or the waitlist control group. The primary outcome measures for major depression will include the PHQ-9, while for menopausal symptoms, the main outcome measure will be the KMI. Secondary measures will include the assessment of sleep quality, quality of life, and general well-being. The current study offers evidence-based intervention for non-pharmacological menopausal symptoms in women and underlines the benefits that group CBT can have, both at a mental health level and for physical symptoms during menopause. This study could set the stage for the wider clinical practice of CBT with this demographic.

Keywords: group CBT, depression, women's mental health, menopause

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Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.

Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program

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Authors: Joni Agung Sudarmanto

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The concept of design has historically been elusive and characterized by its fluidity, leading to divergent viewpoints on its fundamental nature. Guy Julier views design as inherent in material culture, while Sanders sees it as a collective endeavor focusing on the outcome. Design's dualistic nature, procedural and outcome-oriented, spans various domains, including objects, individuals, and the environment. This comprehensive view of design challenges the notion that design practice is distinct from research, highlighting their shared exploratory nature. The article explores methodological techniques in design research and the three prevalent approaches: "into design," "through design," and "for design." The contradictory meanings of design arise from its etymology and its duality as both process and result, leading to its integrative nature across objects, humans, and the environment. The parallels between design and research activities, underscoring their exploratory and knowledge-generating nature, are situated within creative research, challenging the perception of design practice as separate from research endeavors. The "into design" approach encourages interdisciplinary collaboration, enriching design research with diverse perspectives. The "through design" approach bridges theory and practice, producing more practical outcomes. The "for design" approach supports specific design solutions, providing designers with valuable guidance.

Keywords: dualistic nature of design, integrative perspectives, methodological approaches, design research

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Fae Princess Bermudez

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Background: One of the least significant leads on a 12-lead electrocardiogram is the augmented right lead (aVR), as it is not as specific compared to the other leads. In this case series, the value of lead aVR, which is more often than not ignored, is highlighted. Three cases of aVR ST segment elevation on 12-lead electrocardiogram are described, with the end outcome of demise of all three patients. The importance of immediate revascularization is described to improve prognosis in this group of patients. Objectives: This case series aims to primarily present under-reported cases of isolated aVR ST-segrment elevation myocardial infarction (STEMI), their course and outcome. More specific aims are to identify the criteria in determination of isolated aVR STEMI, know its clinical significance, and determine appropriate management for patients with this ECG finding. Method: A short review of previous studies, case reports, articles and guidelines from 2011-2016 was done. The author reviewed available literature, sorted out those that proved to be significant for the presented cases, and described them in conjunction with the aforementioned cases. Findings: Based on the limited information on these rare or under-reported cases, it was found that isolated aVR STEMI had a poorer prognosis that led to significant mortality and morbidity of patients. The significance of aVR ST-elevation was that of an occlusion of the left coronary artery or a severe three-vessel disease in the presence of an Acute Coronary Syndrome. Guidelines from American Heart Association/American College of Cardiology Foundation in 2013 already recognized ST-elevation of lead aVR in isolation as a STEMI; hence, recommended that patients with this particular ECG finding should undergo reperfusion strategies to improve prognosis. Conclusion: The indispensability of isolated aVR ST-segment elevation on ECG should alert physicians, especially Emergency physicians, to the high probability of Acute Coronary Syndrome with a very poor prognosis. If this group of patients is not promptly managed, demise may ensue, with cardiogenic shock as the most probable cause. With this electrocardiogram finding, physicians must be quick to make clinical decisions to increase chances of survival of this group of patients.

Keywords: AVR ST-elevation, diffuse ST-segment depression, left coronary artery infarction, myocardial infarction

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Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

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With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization

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Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

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The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: clique, clan, electronic health records, physician collaboration

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Authors: Priya Kedia, Kiranmoy Das

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There is a rich literature on variable selection in regression setting. However, most of these methods assume normality for the response variable under consideration for implementing the methodology and establishing the statistical properties of the estimates. In many real applications, the distribution for the response variable may be non-Gaussian, and one might be interested in finding the best subset of covariates at some predetermined quantile level. We develop dynamic Bayesian approach for variable selection in quantile regression framework. We use a zero-inflated mixture prior for the regression coefficients, and consider the asymmetric Laplace distribution for the response variable for modeling different quantiles of its distribution. An efficient Gibbs sampler is developed for our computation. Our proposed approach is assessed through extensive simulation studies, and real application of the proposed approach is also illustrated. We consider the data from health and retirement study conducted by the University of Michigan, and select the important predictors when the outcome of interest is out-of-pocket medical cost, which is considered as an important measure for financial risk. Our analysis finds important predictors at different quantiles of the outcome, and thus enhance our understanding on the effects of different predictors on the out-of-pocket medical cost.

Keywords: variable selection, quantile regression, Gibbs sampler, asymmetric Laplace distribution

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Authors: Proud Arunrangsiwed, Sarinya Kongtieng

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Teachers and university lecturers face an unsolved problem, which is students’ multitasking behaviors during class time, such as texting or playing a game. It is important to examine the most powerful predictor that can result in students’ educational performances. Meta-analysis was used to analyze the research articles, which were published with the keywords, multitasking, class performance, and texting. We selected 14 research articles published during 2008-2013 from online databases, and four articles met the predetermined inclusion criteria. Effect size of each pair of variables was used as the dependent variable. The findings revealed that the students’ expectancy and value on SNSs usages is the best significant predictor of their educational performances, followed by their motivation and ability in using SNSs, prior educational performances, usage behaviors of SNSs in class, and their personal characteristics, respectively. Future study should conduct a longitudinal design to better understand the effect of multitasking in the classroom.

Keywords: meta-regression analysis, social networking sites, academic Performances, multitasking, motivation

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Authors: Muna Mohamed Omer Mirghani

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This paper responds to one of the key national development strategies and a typical challenge in the Gash Basin as well as in different parts of Sudan, namely managing water scarcity in view of climate change impacts in minor water systems sustaining over 50% of the Sudan population. While now focusing on the Gash river basin, the ultimate aim is to replicate the same approach in similar water systems in central and west Sudan. The key objective of the paper is the identification of outcome-based water governance interventions in Gash Basin, guided by the global Sustainable Development Goal six (SDG 6 on water and sanitation) and the Sudan water resource policy framework. The paper concluded that improved water resources management of the Gash Basin is a prerequisite for ensuring desired policy outcomes of groundwater use and flood risk management purposes. Analysis of various water governance dimensions in the Gash indicated that the operationalization of a Basin-level institutional reform is critically focused on informed actors and adapted practices through knowledge and technologies along with the technical data and capacity needed to make that. Adapting the devolved Institutional structure at state level is recommended to strengthen the Gash basin regulatory function and improve compliance of groundwater users.

Keywords: water governance, Gash Basin, integrated groundwater management, Sudan

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Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

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Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

Abstract:

Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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Authors: Reda Mankbadi

Abstract:

There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is imbedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating and cooling, Etc. In this work will present an overview of the development of this field. Some examples will include: Airfoil Noise Suppression: LES is used to simulate the effect of the synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In a vertical takeoff of Aircraft or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protect the structure and pay load from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aerodynamics, simulations, aeroacoustics, active flow control (AFC), Large-Eddy Simulations (LES)

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Authors: Ali Bakari Mohammed

Abstract:

Transitioning is a continuous process of radical change in a society which involves co-evolution of institutional, technological, socio-cultural, and ecological developments at different scales and levels. Transition management model is a methodology that influences structural change of complex systems over a period (0-30 years) by experimenting and implementing new techniques. A transition management in the context of groundwater is a radical change from the current operate and control system to a next generation integrated and sustainable system that takes into account quality protection and sustained supply into the future. This study evaluates the transition management model in adopting it as a viable tool for the attainment of sustainable groundwater management. The outcome of the evaluation shows that there are three levels (strategic, tactical and operational) of operating the transition management model. At the strategic level, long-term goals for sustainable groundwater management are formulated, at the tactical level activities such as inter institutional networking, negotiation, planning and financing are carried out, and at the operational level, transition experiments and strategic niche management are carried out at the societal level. Overall, different actors and set of activities are required to partake at each management level. The outcome of this paper will provide basis for the implementation of the Sustainable Development Goal (SDG) 6 in Nigeria.

Keywords: transition management, groundwater, sustainable management, tool, Nigeria

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Authors: R. R. Mankbadi

Abstract:

There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is embedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating, and cooling, etc. In this work will present an overview of the development of this field. Some examples will include Airfoil Noise Suppression: Large-Eddy Simulations (LES) is used to simulate the effect of synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In vertical takeoff of Aircrafts or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protecting the structure and payload from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aeroacoustics, flow control, aerodynamics, large eddy simulations

Procedia PDF Downloads 287

Authors: Salwa Hagag Abdelaziz, Dorria Salem, Hoda Zaki, Suzan Atteya

Abstract:

Early detection of breast cancer saves many thousands of lives each year via application of mammography and genetic screening and many more lives could be saved if nurses are involved in breast care screening practices. So, the aim of the study was to identify nurse's role in early detection of breast cancer through mammography and genetic screening and its impact on patient's outcome. In order to achieve this aim, 400 women above 40 years, asymptomatic were recruited for mammography and genetic screening. In addition, 50 nurses and 6 technologists were involved in the study. A descriptive analytical design was used. Five tools were utilized: sociodemographic, mammographic examination and risk factors, women's before, during and after mammography, items relaying to technologists, and items related to nurses were also obtained. The study finding revealed that 3% of women detected for malignancy and 7.25% for fibroadenoma. Statistically, significant differences were found between mammography results and age, family history, genetic screening, exposure to smoke, and using contraceptive pills. Nurses have insufficient knowledge about screening tests. Based on these findings the present study recommended involvement of nurses in breast care which is very important to in force population about screening practices.

Keywords: mammography, early detection, genetic screening, breast cancer

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Authors: A. A. Betah

Abstract:

This research was performed to evaluate the attitudes of rural women towards education, health and work outside the home. The study was based on a random sample of 147 rural women, Kafr-Rahmaniyah village was chosen for the study because its life expectancy at birth for females, education and percentage of females in the labor force, were the highest in the district. The study data were collected from rural female respondents, using a face-to-face questionnaire. In addition, the study estimated several factors like age, main occupation, family size, monthly household income, geographic cosmopolites, and degree of social participation for rural women respondents. Using Statistical Package for the Social Sciences (SPSS), data were analyzed by non-parametric statistical methods. The main finding in this study was a significant relationship between each of the previous variables and each of rural women’s attitudes toward education, health, and work outside home. The study concluded with some recommendations. The most important element is ensuring attention to rural women’s needs, requirements and rights via raising their health awareness, education and their contributions in their society.

Keywords: attitudes, education, health, rural women, work outside home

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Authors: Rasha Elsawy

Abstract:

Aside from the rapid growth of global information technology and the Internet, another key trend is the swift proliferation of wearable technologies. The future of wearable technologies is very bright as an emerging revolution in this technological world. Beyond this, individual continuance intention toward IT is an important area that drew academics' and practitioners' attention. The literature review exhibits that continuance usage is an important concern that needs to be addressed for any technology to be advantageous and for consumers to succeed. However, consumers noticeably abandon their wearable devices soon after purchase, losing all subsequent benefits that can only be achieved through continued usage. Purpose-This thesis aims to develop an integrated model designed to explain and predict consumers' behavioural intention(BI) and continued use (CU) of wearable fitness technology (WFT) to identify the determinants of the CU of technology. Because of this, the question arises as to whether there are differences between technology adoption and post-adoption (CU) factors. Design/methodology/approach- The study employs the unified theory of acceptance and use of technology2 (UTAUT2), which has the best explanatory power, as an underpinning framework—extending it with further factors, along with user-specific personal characteristics as moderators. All items will be adapted from previous literature and slightly modified according to the WFT/SW context. A longitudinal investigation will be carried out to examine the research model, wherein a survey will include these constructs involved in the conceptual model. A quantitative approach based on a questionnaire survey will collect data from existing wearable technology users. Data will be analysed using the structural equation modelling (SEM) method based on IBM SPSS statistics and AMOS 28.0. Findings- The research findings will provide unique perspectives on user behaviour, intention, and actual continuance usage when accepting WFT. Originality/value- Unlike previous works, the current thesis comprehensively explores factors that affect consumers' decisions to continue using wearable technology. That is influenced by technological/utilitarian, affective, emotional, psychological, and social factors, along with the role of proposed moderators. That novel research framework is proposed by extending the UTAUT2 model with additional contextual variables classified into Performance Expectancy, Effort Expectancy, Social Influence (societal pressure regarding body image), Facilitating Conditions, Hedonic Motivation (to be split up into two concepts: perceived enjoyment and perceived device annoyance), Price value, and Habit-forming techniques; adding technology upgradability as determinants of consumers' behavioural intention and continuance usage of Information Technology (IT). Further, using personality traits theory and proposing relevant user-specific personal characteristics (openness to technological innovativeness, conscientiousness in health, extraversion, neuroticism, and agreeableness) to moderate the research model. Thus, the present thesis obtains a more convincing explanation expected to provide theoretical foundations for future emerging IT (such as wearable fitness devices) research from a behavioural perspective.

Keywords: wearable technology, wearable fitness devices/smartwatches, continuance use, behavioural intention, upgradability, longitudinal study

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Authors: Nik Azmah Nik Yusuff, Faridah Hassan Basri, Rosnidar Mansor

Abstract:

The purpose of the study is to find out the effectiveness of using Graphic calculators (GC) with Calculator Based Laboratory 2 (CBL2) in teaching and learning of form four biology for these topics: Nutrition, Respiration and Dynamic Ecosystem. Sixty form four science stream students were the participants of this study. The participants were divided equally into the treatment and control groups. The treatment group used GC with CBL2 during experiments while the control group used the ordinary conventional laboratory apparatus without using GC with CBL2. Instruments in this study were a set of pre-test and post-test and a questionnaire. T-Test was used to compare the student’s biology achievement while a descriptive statistic was used to analyze the outcome of the questionnaire. The findings of this study indicated the use of GC with CBL2 in biology had significant positive effect. The highest mean was 4.43 for item stating the use of GC with CBL2 had saved collecting experiment result’s time. The second highest mean was 4.10 for item stating GC with CBL2 had saved drawing and labelling graphs. The outcome from the questionnaire also showed that GC with CBL2 were easy to use and save time. Thus, teachers should use GC with CBL2 in support of efforts by Malaysia Ministry of Education in encouraging technology-enhanced lessons.

Keywords: biology experiments, Calculator-Based Laboratory 2 (CBL2), graphic calculators, Malaysia Secondary School, teaching/learning

Procedia PDF Downloads 403