Search results for: Hisham A. Hashem
Commenced in January 2007
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Edition: International
Paper Count: 72

Search results for: Hisham A. Hashem

12 A Traditional Settlement in a Modernized City: Yanbu, Saudi Arabia

Authors: Hisham Mortada

Abstract:

Transition in the urban configuration of Arab cities has never been as radical and visible as it has been since the turn of the last century. The emergence of new cities near historical settlements of Arabia has spawned a series of developments in and around the old city precincts. New developments are based on advanced technology and conform to globally prevalent standards of city planning, superseding the vernacular arrangements based on traditional norms that guided so-called ‘city planning’. Evidence to this fact are the extant Arab buildings present at the urban core of modern cities, which inform us about intricate spatial organization. Organization that subscribed to multiple norms such as, satisfying gender segregation and socialization, economic sustainability, and ensuring security and environmental coherence etc., within settlement compounds. Several participating factors achieved harmony in such an inclusive city—an organization that was challenged and apparently replaced by the new planning order in the face of growing needs of globalized, economy-centric and high-tech models of development. Communities found it difficult to acclimatize with the new western planning models that were implemented at a very large scale throughout the Kingdom, which later experienced spatial re-structuring to suit users’ needs. A closer look the ancient city of Yanbu, now flanked with such new developments, allows us to differentiate and track the beginnings of this unprecedented transition in settlement formations. This paper aims to elaborate the Arabian context offered to both the ‘traditional’ and ‘modern’ planning approaches, in order to understand challenges and solutions offered by both at different times. In the process it will also establish the inconsistencies and conflicts that arose with the shift in planning paradigm, from traditional-'cultural norms’, to modern-'physical planning', in the Arabian context. Thus, by distinguishing the two divergent planning philosophies, their impact of the Arabian morphology, relevance to lifestyle and suitability to the biophysical environment, it concludes with a perspective on sustainability particularly for in case of Yanbu.

Keywords: Yanbu, traditional architecture, Hijaz, coral building, Saudi Arabia

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11 Geological Mapping of Gabel Humr Akarim Area, Southern Eastern Desert, Egypt: Constrain from Remote Sensing Data, Petrographic Description and Field Investigation

Authors: Doaa Hamdi, Ahmed Hashem

Abstract:

The present study aims at integrating the ASTER data and Landsat 8 data to discriminate and map alteration and/or mineralization zones in addition to delineating different lithological units of Humr Akarim Granites area. The study area is located at 24º9' to 24º13' N and 34º1' to 34º2'45"E., covering a total exposed surface area of about 17 km². The area is characterized by rugged topography with low to moderate relief. Geologic fieldwork and petrographic investigations revealed that the basement complex of the study area is composed of metasediments, mafic dikes, older granitoids, and alkali-feldspar granites. Petrographic investigations revealed that the secondary minerals in the study area are mainly represented by chlorite, epidote, clay minerals and iron oxides. These minerals have specific spectral signatures in the region of visible near-infrared and short-wave infrared (0.4 to 2.5 µm). So that the ASTER imagery processing was concentrated on VNIR-SWIR spectrometric data in order to achieve the purposes of this study (geologic mapping of hydrothermal alteration zones and delineate possible radioactive potentialities). Mapping of hydrothermal alterations zones in addition to discriminating the lithological units in the study area are achieved through the utilization of some different image processing, including color band composites (CBC) and data transformation techniques such as band ratios (BR), band ratio codes (BRCs), principal component analysis(PCA), Crosta Technique and minimum noise fraction (MNF). The field verification and petrographic investigation confirm the results of ASTER imagery and Landsat 8 data, proposing a geological map (scale 1:50000).

Keywords: remote sensing, petrography, mineralization, alteration detection

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10 Effect of 16 Weeks Walking with Different Dosages on Psychosocial Function Related Quality of Life among 60 to 75 Years Old Men

Authors: Mohammad Ehsani, Elham Karimi, Hashem Koozechian

Abstract:

Aim: The purpose of current semi-experimental study was a survey on effect of 16 week walking on psychosocial function related quality of life among 60 to 75 years old men. Methodology: For this reason, short from of health – related quality of life questionnaire (SF – 36) and Geriatric Depression Scale (GDS) had been distributed to the subjects at 2 times of pre – test and posttest. Statistical sample of current study was 60 to 75 years old men who placed at Kahrizak house and assessed by considering physically and medical background. Also factors of entrance to the intervention like age range, have satisfaction and have intent to participating in walking program, lack of having diabetic, cardiovascular, Parkinsonism diseases and postural, neurological, musculoskeletal disorders, lack of having clinical background like visual disorders or disordering on equilibrium system, lack of motor limitation, foot print disorders, having surgery and mental health had been determined and assessed. Finally after primary studies, 80 persons selected and categorized accidentally to the 3 experimental group (1, 2, 3 sessions per week, 30 min walking with moderate intension at every sessions) and one control group (without physical activity in period of 16 weeks). Data analysed by employing ANOVA, Pearson coefficient and Scheffe Post – Hoc tests at the significance level of p < 0.05. Results: Results showed that psychosocial function of men with 60 to 75 years old increase by influence of 16 week walking and increase of exercise sessions lead to more effectiveness of walking. Also there was no significant difference between psychosocial function of subjects within 1 session and 3 sessions experimental groups (p > 0.05). Conclusion: On the basis of results, we can say that doing regular walking with efficient and standard dosage for elderly people, can increase their quality of life. Furthermore, designing and action operation regular walking program for elderly men on the basis of special, logical and systematic pattern under the supervision of aware coaches have been recommended on the basis of results.

Keywords: walking, quality of life, psychosocial function, elders

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9 Aerodynamic Design Optimization Technique for a Tube Capsule That Uses an Axial Flow Air Compressor and an Aerostatic Bearing

Authors: Ahmed E. Hodaib, Muhammed A. Hashem

Abstract:

High-speed transportation has become a growing concern. To increase high-speed efficiencies and minimize power consumption of a vehicle, we need to eliminate the friction with the ground and minimize the aerodynamic drag acting on the vehicle. Due to the complexity and high power requirements of electromagnetic levitation, we make use of the air in front of the capsule, that produces the majority of the drag, to compress it in two phases and inject a proportion of it through small nozzles to make a high-pressure air cushion to levitate the capsule. The tube is partially-evacuated so that the air pressure is optimized for maximum compressor effectiveness, optimum tube size, and minimum vacuum pump power consumption. The total relative mass flow rate of the tube air is divided into two fractions. One is by-passed to flow over the capsule body, ensuring that no chocked flow takes place. The other fraction is sucked by the compressor where it is diffused to decrease the Mach number (around 0.8) to be suitable for the compressor inlet. The air is then compressed and intercooled, then split. One fraction is expanded through a tail nozzle to contribute to generating thrust. The other is compressed again. Bleed from the two compressors is used to maintain a constant air pressure in an air tank. The air tank is used to supply air for levitation. Dividing the total mass flow rate increases the achievable speed (Kantrowitz limit), and compressing it decreases the blockage of the capsule. As a result, the aerodynamic drag on the capsule decreases. As the tube pressure decreases, the drag decreases and the capsule power requirements decrease, however, the vacuum pump consumes more power. That’s why Design optimization techniques are to be used to get the optimum values for all the design variables given specific design inputs. Aerodynamic shape optimization, Capsule and tube sizing, compressor design, diffuser and nozzle expander design and the effect of the air bearing on the aerodynamics of the capsule are to be considered. The variations of the variables are to be studied for the change of the capsule velocity and air pressure.

Keywords: tube-capsule, hyperloop, aerodynamic design optimization, air compressor, air bearing

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8 Natural and Synthetic Antioxidant in Beef Meatball

Authors: Abul Hashem

Abstract:

The experiment was conducted to find out the effect of different levels of Moringa oleifiera leaf extract and synthetic antioxidant (Beta Hydroxyl Anisole) on fresh and preserved beef meatballs. For this purpose, ground beef samples were divided into five treatment groups. They are treated as control, synthetic antioxidant, 0.1%, 0.2% and 0.3% Moringa oleifera leaf extract as T1, T2, T3, T4 and T5, respectively. Five kinds of meatballs were made and biscuit crushed and egg albumin was mixed with beef meatballs and cooking was practiced properly. Proximate analysis, sensory tests (color, flavor, tenderness, juiciness, overall acceptability), cooking loss, pH value, free fatty acids (FFA), thiobarbituric acid values (TBARS), peroxide value(POV) and microbiological examination were determined in order to evaluate the effect of Moringa oleifiera leaf extract as natural antioxidant & antimicrobial activities in comparing to BHA (Beta Hydroxyl Anisole) at first day before freezing and for maintaining meatballs qualities on the shelf life of beef meat balls stored for 60 days under frozen condition. Freezing temperature was -20˚C. Days of intervals of experiment were on 0, 15th, 30th, and 60th days. Dry matter content of all the treatment groups differ significantly (p<0.05). On the contrary, DM content increased significantly (p<0.05) with the advancement of different days of intervals. CP content of all the treatments were increased significantly (p<0.05) among the different treatment groups. EE content at different treatment levels differ significantly (p<0.05). Ash content at different treatment levels was also differ significantly (p<0.05). FFA values, TBARS, POV were decreased significantly (p<0.05) at different treatment levels. Color, odor, tenderness, juiciness, overall acceptability, raw PH, cooked pH were increased at different treatment levels significantly (p<0.05). The cooking loss (%) at different treatment levels were differ significantly (p<0.05). TVC (logCFU/g), TCC (logCFU/g) and TYMC (logCFU/g) was decreased significantly (p<0.05) at different treatment levels comparison to control. Considering CP, tenderness, juiciness, overall acceptability, cooking loss, FFA, POV, TBARS and microbial parameters it can be concluded that Moringa oleifera leaf extract at 0.1%, 0.2% and 0.3% can be used instead of 0.1% synthetic antioxidant BHA in beef meatballs.

Keywords: antioxidant, beef meatball, BHA, moringa leaf extract, quality

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7 Moderating Effect of Owner's Influence on the Relationship between the Probability of Client Failure and Going Concern Opinion Issuance

Authors: Mohammad Noor Hisham Osman, Ahmed Razman Abdul Latiff, Zaidi Mat Daud, Zulkarnain Muhamad Sori

Abstract:

The problem that Malaysian auditors do not issue going concern opinion (GC opinion) to seriously financially distressed companies is still a pressing issue. Policy makers, particularly the Financial Statement Review Committee (FSRC) of Malaysian Institute of Accountant, have raised this issue as early as in 2009. Similar problem happened in the US, UK, and many developing countries. It is important for auditors to issue GC opinion properly because such opinion is one signal about the viability of a company much needed by stakeholders. There are at least two unanswered questions or research gaps in the literature on determinants of GC opinion. Firstly, is client’s probability of failure associated with GC opinion issuance? Secondly, to what extent influential owners (management, family, and institution) moderate the association between client probability of failure and GC opinion issuance. The objective of this study is, therefore, twofold; (1) To examine the extent of the relationship between the probability of client failure and the issuance of GC opinion and (2) To examine the level of management, family, and institutional ownerships moderate the association between client probability of failure and the issuance of GC opinion. This study is quantitative in nature, and the sources of data are secondary (mainly company’s annual reports). A total of four hypotheses have been developed and tested on data accumulated from annual reports of seriously financially distressed Malaysian public listed companies. Data from 2006 to 2012 on a sample of 644 observations have been analyzed using panel logistic regression. It is found that certainty (rather than probability) of client failure affects the issuance of GC opinion. In addition, it is found that only the level of family ownership does positively moderate the relationship between client probability of failure and GC opinion issuance. This study is a contribution to auditing literature as its findings can enhance our understanding about audit quality; particularly on the variables that are associated with the issuance of GC opinion. The findings of this study shed light on the roles family owners in GC opinion issuance process, and this would open ways for the researcher to suggest measures that can be used to tackle the problem of auditors do not want to issue GC opinion to financially distressed clients. The measures to be suggested can be useful to policy makers in formulating future promulgations.

Keywords: audit quality, auditing, auditor characteristics, going concern opinion, Malaysia

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6 Properties of Sustainable Artificial Lightweight Aggregate

Authors: Wasan Ismail Khalil, Hisham Khalid Ahmed, Zainab Ali

Abstract:

Structural Lightweight Aggregate Concrete (SLWAC) has been developed in recent years because it reduces the dead load, cost, thermal conductivity and coefficient of thermal expansion of the structure. So SLWAC has the advantage of being a relatively green building material. Lightweight Aggregate (LWA) is either occurs as natural material such as pumice, scoria, etc. or as artificial material produced from different raw materials such as expanded shale, clay, slate, etc. The use of SLWAC in Iraq is limited due to the lack in natural LWA. The existence of Iraqi clay deposit with different types and characteristics leads to the idea of producing artificial expanded clay aggregate. The main aim in this work is to present of the properties of artificial LWA produced in the laboratory. Available local bentonite clay which occurs in the Western region of Iraq was used as raw material to produce the LWA. Sodium silicate as liquid industrial waste material from glass plant was mixed with bentonite clay in mix proportion 1:1 by weight. The manufacturing method of the lightweight aggregate including, preparation and mixing of clay and sodium silicate, burning of the mixture in the furnace at the temperature between 750-800˚C for two hours, and finally gradually cooling process. The produced LWA was then crushed to small pieces then screened on standard sieve series and prepared with grading which conforms to the specifications of LWA. The maximum aggregate size used in this investigation is 10 mm. The chemical composition and the physical properties of the produced LWA are investigated. The results indicate that the specific gravity of the produced LWA is 1.5 with the density of 543kg/m3 and water absorption of 20.7% which is in conformity with the international standard of LWA. Many trail mixes were carried out in order to produce LWAC containing the artificial LWA produced in this research. The selected mix proportion is 1:1.5:2 (cement: sand: aggregate) by weight with water to cement ratio of 0.45. The experimental results show that LWAC has oven dry density of 1720 kg/m3, water absorption of 8.5%, the thermal conductivity of 0.723 W/m.K and compressive strength of 23 N/mm2. The SLWAC produced in this research can be used in the construction of different thermal insulated buildings and masonry units. It can be concluded that the SLWA produced in this study contributes to sustainable development by, using industrial waste materials, conserving energy, enhancing the thermal and structural efficiency of concrete.

Keywords: expanded clay, lightweight aggregate, structural lightweight aggregate concrete, sustainable

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5 Formulation of Value Added Beff Meatballs with the Addition of Pomegranate (Punica granatum) Extract as a Source of Natural Antioxident

Authors: M. A. Hashem, I. Jahan

Abstract:

The experiment was conducted to find out the effect of different levels of Pomegranate (Punica granatum) extract and synthetic antioxidant BHA (Beta Hydroxyl Anisole) on fresh and preserved beef meatballs in order to make functional food. For this purpose, ground beef samples were divided into five treatment groups. They were treated as control group, 0.1% synthetic antioxidant group, 0.1%, 0.2% and 0.3% pomegranate extract group as T1, T2, T3, T4 and T5 respectively. Proximate analysis, sensory tests (color, flavor, tenderness, juiciness, overall acceptability), cooking loss, pH value, free fatty acids (FFA), thiobarbituric acid values (TBARS), peroxide value (POV) and microbiological examination were determined in order to evaluate the effect of pomegranate extract as natural antioxidant and antimicrobial activities compared to BHA (Beta Hydroxyl Anisole) at first day before freezing and for maintaining meatballs qualities on the shelf life of beef meat balls stored for 60 days under frozen condition. Freezing temperature was -20˚C. Days of intervals of experiment were on 0, 15th, 30th and 60th days. Dry matter content of all the treatment groups differ significantly (p<0.05). On the contrary, DM content increased significantly (p<0.05) with the advancement of different days of intervals. CP content of all the treatments were increased significantly (p<0.05) among the different treatment groups. EE and Ash content were decreased significantly (p<0.05) at different treatment levels. FFA values, TBARS, POV were decreased significantly (p<0.05) at different treatment levels. Color, odor, tenderness, juiciness, overall acceptability decreased significantly (p<0.05) at different days of intervals. Raw PH, cooked pH were increased at different treatment levels significantly (p<0.05). The cooking loss (%) at different treatment levels were differ significantly (p<0.05). TVC (logCFU/g), TCC (logCFU/g) and TYMC (logCFU/g) was decreased significantly (p<0.05) at different treatment levels and at different days of intervals comparison to control. Considering CP, tenderness, juiciness, overall acceptability, cooking loss, FFA, POV, TBARS value and microbial analysis it can be concluded that pomegranate extract at 0.1%, 0.2% and 0.3% can be used instead of synthetic antioxidant BHA in beef meatballs. On the basis of sensory evaluation, nutrient quality, physicochemical properties, biochemical analysis and microbial analysis 0.3% Pomegranate extract can be recommended for formulation of value added beef meatball enriched with natural antioxidant.

Keywords: antioxidant, pomegranate, BHA, value added meat products

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4 A Study on Computational Fluid Dynamics (CFD)-Based Design Optimization Techniques Using Multi-Objective Evolutionary Algorithms (MOEA)

Authors: Ahmed E. Hodaib, Mohamed A. Hashem

Abstract:

In engineering applications, a design has to be as fully perfect as possible in some defined case. The designer has to overcome many challenges in order to reach the optimal solution to a specific problem. This process is called optimization. Generally, there is always a function called “objective function” that is required to be maximized or minimized by choosing input parameters called “degrees of freedom” within an allowed domain called “search space” and computing the values of the objective function for these input values. It becomes more complex when we have more than one objective for our design. As an example for Multi-Objective Optimization Problem (MOP): A structural design that aims to minimize weight and maximize strength. In such case, the Pareto Optimal Frontier (POF) is used, which is a curve plotting two objective functions for the best cases. At this point, a designer should make a decision to choose the point on the curve. Engineers use algorithms or iterative methods for optimization. In this paper, we will discuss the Evolutionary Algorithms (EA) which are widely used with Multi-objective Optimization Problems due to their robustness, simplicity, suitability to be coupled and to be parallelized. Evolutionary algorithms are developed to guarantee the convergence to an optimal solution. An EA uses mechanisms inspired by Darwinian evolution principles. Technically, they belong to the family of trial and error problem solvers and can be considered global optimization methods with a stochastic optimization character. The optimization is initialized by picking random solutions from the search space and then the solution progresses towards the optimal point by using operators such as Selection, Combination, Cross-over and/or Mutation. These operators are applied to the old solutions “parents” so that new sets of design variables called “children” appear. The process is repeated until the optimal solution to the problem is reached. Reliable and robust computational fluid dynamics solvers are nowadays commonly utilized in the design and analyses of various engineering systems, such as aircraft, turbo-machinery, and auto-motives. Coupling of Computational Fluid Dynamics “CFD” and Multi-Objective Evolutionary Algorithms “MOEA” has become substantial in aerospace engineering applications, such as in aerodynamic shape optimization and advanced turbo-machinery design.

Keywords: mathematical optimization, multi-objective evolutionary algorithms "MOEA", computational fluid dynamics "CFD", aerodynamic shape optimization

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3 Growth and Bone Health in Children following Liver Transplantation

Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

Abstract:

Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

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2 Genetic Diversity Analysis in Ecological Populations of Persian Walnut

Authors: Masoud Sheidai, Fahimeh Koohdar, Hashem Sharifi

Abstract:

Juglans regia (L.) commonly known as Persian walnut of the genus Juglans L. (Juglandaceae) is one of the most important cultivated plant species due to its high-quality wood and edible nuts. The genetic diversity analysis is essential for conservation and management of tree species. Persian walnut is native from South-Eastern Europe to North-Western China through Tibet, Nepal, Northern India, Pakistan, and Iran. The species like Persian walnut, which has a wide range of geographical distribution, should harbor extensive genetic variability to adapt to environmental fluctuations they face. We aimed to study the population genetic structure of seven Persian walnut populations including three wild and four cultivated populations by using ISSR (Inter simple sequence repeats) and SRAP (Sequence related amplified polymorphism) molecular markers. We also aimed to compare the genetic variability revealed by ISSR neutral multilocus marker and rDNA ITS sequences. The studied populations differed in morphological features as the samples in each population were clustered together and were separate from the other populations. Three wild populations studied were placed close to each other. The mantel test after 5000 times permutation performed between geographical distance and morphological distance in Persian walnut populations produced significant correlation (r = 0.48, P = 0.002). Therefore, as the populations become farther apart, they become more divergent in morphological features. ISSR analysis produced 47 bands/ loci, while we obtained 15 SRAP bands. Gst and other differentiation statistics determined for these loci revealed that most of the ISSR and SRAP loci have very good discrimination power and can differentiate the studied populations. AMOVA performed for these loci produced a significant difference (< 0.05) supporting the above-said result. AMOVA produced significant genetic difference based on ISSR data among the studied populations (PhiPT = 0.52, P = 0.001). AMOVA revealed that 53% of the total variability is due to among population genetic difference, while 47% is due to within population genetic variability. The results showed that both multilocus molecular markers and ITS sequences can differentiate Persian walnut populations. The studied populations differed genetically and showed isolation by distance (IBD). ITS sequence based MP and Bayesian phylogenetic trees revealed that Iranian walnut cultivars form a distinct clade separated from the cultivars studied from elsewhere. Almost all clades obtained have high bootstrap value. The results indicated that a combination of multilpcus and sequencing molecular markers can be used in genetic differentiation of Persian walnut.

Keywords: genetic diversity, population, molecular markers, genetic difference

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1 Factors Associated with Hand Functional Disability in People with Rheumatoid Arthritis: A Systematic Review and Best-Evidence Synthesis

Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

Abstract:

Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

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