Search results for: amblyopia diagnostic criterion
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1677

Search results for: amblyopia diagnostic criterion

1497 A Diagnostic Challenge of Drug Resistant Childhood Tuberculosis in Developing World

Authors: Warda Fatima, Hasnain Javed

Abstract:

The emerging trend of Drug resistance in childhood Tuberculosis is increasing worldwide and now becoming a priority challenge for National TB Control Programs of the world. Childhood TB accounts for 10-15% of total TB burden across the globe and same proportion is quantified in case of drug resistant TB. One third population suffering from MDR TB dies annually because of non-diagnosis and unavailability of appropriate treatment. However, true Childhood MDR TB cannot be estimated due to non-confirmation. Diagnosis of Pediatric TB by sputum Smear Microscopy and Culture inoculation are limited due to paucibacillary nature and difficulties in obtaining adequate sputum specimens. Diagnosis becomes more difficult when it comes to HIV infected child. New molecular advancements for early case detection of TB and MDR TB in adults have not been endorsed in children. Multi centered trials are needed to design better diagnostic approaches and efficient and safer treatments for DR TB in high burden countries. The aim of the present study is to sketch out the current situation of the childhood Drug resistant TB especially in the developing world and to highlight the classic and novel methods that are to be implemented in high-burden resource-limited locations.

Keywords: drug resistant TB, childhood, diagnosis, novel methods

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1496 Lifetime Assessment for Test Strips of POCT Device through Accelerated Degradation Test

Authors: Jinyoung Choi, Sunmook Lee

Abstract:

In general, single parameter, i.e. temperature, as an accelerating parameter is used to assess the accelerated stability of Point-of-Care Testing (POCT) diagnostic devices. However, humidity also plays an important role in deteriorating the strip performance since major components of test strips are proteins such as enzymes. 4 different Temp./Humi. Conditions were used to assess the lifetime of strips. Degradation of test strips were studied through the accelerated stability test and the lifetime was assessed using commercial POCT products. The life distribution of strips, which were obtained by monitoring the failure time of test strip under each stress condition, revealed that the weibull distribution was the most proper distribution describing the life distribution of strips used in the present study. Equal shape parameters were calculated to be 0.9395 and 0.9132 for low and high concentrations, respectively. The lifetime prediction was made by adopting Peck Eq. Model for Stress-Life relationship, and the B10 life was calculated to be 70.09 and 46.65 hrs for low and high concentrations, respectively.

Keywords: accelerated degradation, diagnostic device, lifetime assessment, POCT

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1495 Tolerance of Colonoscopy: Questioning Its Utility in the Elderly

Authors: Faizan Rathore, Naveed Sultan, Humphrey O. Connor

Abstract:

This study was carried out from Jan '12-Dec'12 to assess current practice in Kerry General Hospital against the age-related indicators for colonoscopies. A total of 1474 colonoscopies were performed,1177(79.9%) were diagnostic and 297 (20.1%) were therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal which made up the majority of the total diagnoses, 1330 (90.2%) of colonoscopies occurred without any complications. Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases. Patient discomfort was higher in younger patients as evidenced by 98 cases aged <75 , followed by 11 cases aged 75-80, 2 cases aged 81-85 and 1 case aged >86. Highest percentage of poor tolerance was found in 14 (1.1%) of total patients <75, 1 (0.8%) of total patients aged 75-80, 1(1.7%) of total patients in age group 81-85 and none (0%) in age group >86. We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in the presence of other comorbidities in elderly is questionable.

Keywords: colonoscopy, elderly patients, utility, tolerance

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1494 Novel Nanomagnetic Beads Based- Latex Agglutination Assay for Rapid Diagnosis of Human Schistosomiasis Haematobium

Authors: Ibrahim Aly, Rabab Zalat, Bahaa EL Deen W. El Aswad, Ismail M. Moharm, Basam M. Masoud, Tarek Diab

Abstract:

The objective of the present study was to evaluate the novel nanomagnetic beads based–latex agglutination assay (NMB-LAT) as a simple test for diagnosis of S. haematobium as well as standardize the novel nanomagnetic beads based –ELISA (NMB-ELISA). According to urine examination this study included 85 S. haematobium infected patients, 30 other parasites infected patients and 25 negative control samples. The sensitivity of novel NMB-LAT was 82.4% versus 96.5% and 88.2% for NMB-ELISA and currently used sandwich ELISA respectively. The specificity of NMB-LAT was 83.6% versus 96.3% and 87.3% for NMB-ELISA and currently used sandwich ELISA respectively. In conclusion, the novel NMB-ELISA is a valuable applicable diagnostic technique for diagnosis of human schistosomiasis haematobium. The novel NMB-ELISA assay is a suitable applicable diagnostic method in field survey especially when followed by ELISA as a confirmatory test in query false negative results. Trials are required to increase the sensitivity and specificity of NMB-ELISA assay.

Keywords: diagnosis, iatex agglutination, nanomagnetic beads, sandwich ELISA

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1493 Intracranial Hypotension: A Brief Review of the Pathophysiology and Diagnostic Algorithm

Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

Abstract:

The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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1492 Modeling Anisotropic Damage Algorithms of Metallic Structures

Authors: Bahar Ayhan

Abstract:

The present paper is concerned with the numerical modeling of the inelastic behavior of the anisotropically damaged ductile materials, which are based on a generalized macroscopic theory within the framework of continuum damage mechanics. Kinematic decomposition of the strain rates into elastic, plastic and damage parts is basis for accomplishing the structure of continuum theory. The evolution of the damage strain rate tensor is detailed with the consideration of anisotropic effects. Helmholtz free energy functions are constructed separately for the elastic and inelastic behaviors in order to be able to address the plastic and damage process. Additionally, the constitutive structure, which is based on the standard dissipative material approach, is elaborated with stress tensor, a yield criterion for plasticity and a fracture criterion for damage besides the potential functions of each inelastic phenomenon. The finite element method is used to approximate the linearized variational problem. Stress and strain outcomes are solved by using the numerical integration algorithm based on operator split methodology with a plastic and damage (multiplicator) variable separately. Numerical simulations are proposed in order to demonstrate the efficiency of the formulation by comparing the examples in the literature.

Keywords: anisotropic damage, finite element method, plasticity, coupling

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1491 Verification of Low-Dose Diagnostic X-Ray as a Tool for Relating Vital Internal Organ Structures to External Body Armour Coverage

Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni

Abstract:

Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.

Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage

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1490 Durability of Reinforced Concrete Structure on Very High Aggressive Environment: A Case Study

Authors: Karla Peitl Miller, Leomar Bravin Porto, Kaitto Correa Fraga, Nataniele Eler Mendes

Abstract:

This paper presents the evaluation and study of a real reinforced concrete structure of a fertilizer storage building, constructed on a Vale’s Port at Brazil, which has been recently under refurbishment. Data that will be shared and commented aim to show how wrong choices in project concepts allied to a very high aggressive environment lead to a fast track degradation, incurring on a hazardous condition associated with huge and expensive treatment for repair and guarantee of minimum performance conditions and service life. It will be also shown and discussed all the covered steps since pathological manifestations first signs were observed until the complete revitalization and reparation planning would be drawn. The conclusions of the work easily explicit the importance of professional technical qualification, the importance of minimum requirements for design and structural reforms, and mainly, the importance of good inspection and diagnostic engineering continuous work.

Keywords: durability, reinforced concrete repair, structural inspection, diagnostic engineering

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1489 Performance and Limitations of Likelihood Based Information Criteria and Leave-One-Out Cross-Validation Approximation Methods

Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer

Abstract:

Model assessment, in the Bayesian context, involves evaluation of the goodness-of-fit and the comparison of several alternative candidate models for predictive accuracy and improvements. In posterior predictive checks, the data simulated under the fitted model is compared with the actual data. Predictive model accuracy is estimated using information criteria such as the Akaike information criterion (AIC), the Bayesian information criterion (BIC), the Deviance information criterion (DIC), and the Watanabe-Akaike information criterion (WAIC). The goal of an information criterion is to obtain an unbiased measure of out-of-sample prediction error. Since posterior checks use the data twice; once for model estimation and once for testing, a bias correction which penalises the model complexity is incorporated in these criteria. Cross-validation (CV) is another method used for examining out-of-sample prediction accuracy. Leave-one-out cross-validation (LOO-CV) is the most computationally expensive variant among the other CV methods, as it fits as many models as the number of observations. Importance sampling (IS), truncated importance sampling (TIS) and Pareto-smoothed importance sampling (PSIS) are generally used as approximations to the exact LOO-CV and utilise the existing MCMC results avoiding expensive computational issues. The reciprocals of the predictive densities calculated over posterior draws for each observation are treated as the raw importance weights. These are in turn used to calculate the approximate LOO-CV of the observation as a weighted average of posterior densities. In IS-LOO, the raw weights are directly used. In contrast, the larger weights are replaced by their modified truncated weights in calculating TIS-LOO and PSIS-LOO. Although, information criteria and LOO-CV are unable to reflect the goodness-of-fit in absolute sense, the differences can be used to measure the relative performance of the models of interest. However, the use of these measures is only valid under specific circumstances. This study has developed 11 models using normal, log-normal, gamma, and student’s t distributions to improve the PCR stutter prediction with forensic data. These models are comprised of four with profile-wide variances, four with locus specific variances, and three which are two-component mixture models. The mean stutter ratio in each model is modeled as a locus specific simple linear regression against a feature of the alleles under study known as the longest uninterrupted sequence (LUS). The use of AIC, BIC, DIC, and WAIC in model comparison has some practical limitations. Even though, IS-LOO, TIS-LOO, and PSIS-LOO are considered to be approximations of the exact LOO-CV, the study observed some drastic deviations in the results. However, there are some interesting relationships among the logarithms of pointwise predictive densities (lppd) calculated under WAIC and the LOO approximation methods. The estimated overall lppd is a relative measure that reflects the overall goodness-of-fit of the model. Parallel log-likelihood profiles for the models conditional on equal posterior variances in lppds were observed. This study illustrates the limitations of the information criteria in practical model comparison problems. In addition, the relationships among LOO-CV approximation methods and WAIC with their limitations are discussed. Finally, useful recommendations that may help in practical model comparisons with these methods are provided.

Keywords: cross-validation, importance sampling, information criteria, predictive accuracy

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1488 Future of Nanotechnology in Digital MacDraw

Authors: Pejman Hosseinioun, Abolghasem Ghasempour, Elham Gholami, Hamed Sarbazi

Abstract:

Considering the development in global semiconductor technology, it is anticipated that gadgets such as diodes and resonant transistor tunnels (RTD/RTT), Single electron transistors (SET) and quantum cellular automata (QCA) will substitute CMOS (Complementary Metallic Oxide Semiconductor) gadgets in many applications. Unfortunately, these new technologies cannot disembark the common Boolean logic efficiently and are only appropriate for liminal logic. Therefor there is no doubt that with the development of these new gadgets it is necessary to find new MacDraw technologies which are compatible with them. Resonant transistor tunnels (RTD/RTT) and circuit MacDraw with enhanced computing abilities are candida for accumulating Nano criterion in the future. Quantum cellular automata (QCA) are also advent Nano technological gadgets for electrical circuits. Advantages of these gadgets such as higher speed, smaller dimensions, and lower consumption loss are of great consideration. QCA are basic gadgets in manufacturing gates, fuses and memories. Regarding the complex Nano criterion physical entity, circuit designers can focus on logical and constructional design to decrease complication in MacDraw. Moreover Single electron technology (SET) is another noteworthy gadget considered in Nano technology. This article is a survey in future of Nano technology in digital MacDraw.

Keywords: nano technology, resonant transistor tunnels, quantum cellular automata, semiconductor

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1487 Assessment of Dose: Area Product of Common Radiographic Examinations in Selected Southern Nigerian Hospitals

Authors: Lateef Bamidele

Abstract:

Over the years, radiographic examinations are the most used diagnostic tools in the Nigerian health care system, but most diagnostic examinations carried out do not have records of patient doses. Lack of adequate information on patient doses has been a major hindrance in quantifying the radiological risk associated with radiographic examinations. This study aimed at estimating dose–area product (DAP) of patient examined in X-Ray units in selected hospitals in Southern Nigeria. The standard projections selected are chest posterior-anterior (PA), abdomen anterior-posterior (AP), pelvis AP, pelvis lateral (LAT), skull AP/PA, skull LAT, lumbar spine AP, lumbar spine, LAT. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDs were converted into DAP using the beam area of patients. The results show that the mean DAP ranged from 0.17 to 18.35 Gycm². The results obtained in this study when compared with those of NRPB-HPE were found to be higher. These are an indication of non optimization of operational conditions.

Keywords: dose–area product, radiographic examinations, patient doses, optimization

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1486 Investigation of Emotional Indicators of Schizophrenia Patients on Draw a Person Test in Pakistan

Authors: Shakir Iqbal, Muhammad Aqeel, Asghar Ali Shah, Aftab Hussain

Abstract:

The present study was aimed to investigate and compare the emotional indicators of patients with schizophrenia on Draw a Person test in Pakistan. Draw a Person test was administered on a sample of 400 (Schizophrenia patients=200, Normal=200) age ranged from 20 to 50 years. The data was collected from two provinces of Pakistan (Punjab and Khyber Pakhtun Khwa). The sample was selected by the age levels. According to the Koppitz method of scoring a list of 40 Emotional indicators was selected that were derived from the literature review. It was found that 26 out of 40 emotional indicators (EIs) on Draw a Person test significantly differentiated between patients with schizophrenia and normal (healthy) population. Chi square analysis of the study indicated that 23 EIs were found significant at (p=.001) level, while three EIs were found significant at (P=.05) levels. It was also found that 9 exclusive and 4 frequent EIs on Human Figure Drawings may be significant diagnostic emotional indicators for schizophrenia. It was found that DAP test can be used as a diagnostic tool with the battery of psychological tests such as MCMI-III, MMPI, MSE, HTP for schizophrenia in Pakistan.

Keywords: draw a person test, normal population, Schizophrenia patients, psychological sciences

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1485 Medical Experience: Usability Testing of Displaying Computed Tomography Scans and Magnetic Resonance Imaging in Virtual and Augmented Reality for Accurate Diagnosis

Authors: Alyona Gencheva

Abstract:

The most common way to study diagnostic results is using specialized programs at a stationary workplace. Magnetic Resonance Imaging is presented in a two-dimensional (2D) format, and Computed Tomography sometimes looks like a three-dimensional (3D) model that can be interacted with. The main idea of the research is to compare ways of displaying diagnostic results in virtual reality that can help a surgeon during or before an operation in augmented reality. During the experiment, the medical staff examined liver vessels in the abdominal area and heart boundaries. The search time and detection accuracy were measured on black-and-white and coloured scans. Usability testing in virtual reality shows convenient ways of interaction like hand input, voice activation, displaying risk to the patient, and the required number of scans. The results of the experiment will be used in the new C# program based on Magic Leap technology.

Keywords: augmented reality, computed tomography, magic leap, magnetic resonance imaging, usability testing, VTE risk

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1484 Improving Diagnostic Accuracy of Ankle Syndesmosis Injuries: A Comparison of Traditional Radiographic Measurements and Computed Tomography-Based Measurements

Authors: Yasar Samet Gokceoglu, Ayse Nur Incesu, Furkan Okatar, Berk Nimetoglu, Serkan Bayram, Turgut Akgul

Abstract:

Ankle syndesmosis injuries pose a significant challenge in orthopedic practice due to their potential for prolonged recovery and chronic ankle dysfunction. Accurate diagnosis and management of these injuries are essential for achieving optimal patient outcomes. The use of radiological methods, such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), plays a vital role in the accurate diagnosis of syndesmosis injuries in the context of ankle fractures. Treatment options for ankle syndesmosis injuries vary, with surgical interventions such as screw fixation and suture-button implantation being commonly employed. The choice of treatment is influenced by the severity of the injury and the presence of associated fractures. Additionally, the mechanism of injury, such as pure syndesmosis injury or specific fracture types, can impact the stability and management of syndesmosis injuries. Ankle fractures with syndesmosis injury present a complex clinical scenario, requiring accurate diagnosis, appropriate reduction, and tailored management strategies. The interplay between the mechanism of injury, associated fractures, and treatment modalities significantly influences the outcomes of these challenging injuries. The long-term outcomes and patient satisfaction following ankle fractures with syndesmosis injury are crucial considerations in the field of orthopedics. Patient-reported outcome measures, such as the Foot and Ankle Outcome Score (FAOS), provide essential information about functional recovery and quality of life after these injuries. When diagnosing syndesmosis injuries, standard measurements, such as the medial clear space, tibiofibular overlap, tibiofibular clear space, anterior tibiofibular ratio (ATFR), and the anterior-posterior tibiofibular ratio (APTF), are assessed through radiographs and computed tomography (CT) scans. These parameters are critical in evaluating the presence and severity of syndesmosis injuries, enabling clinicians to choose the most appropriate treatment approach. Despite advancements in diagnostic imaging, challenges remain in accurately diagnosing and treating ankle syndesmosis injuries. Traditional diagnostic parameters, while beneficial, may not capture the full extent of the injury or provide sufficient information to guide therapeutic decisions. This gap highlights the need for exploring additional diagnostic parameters that could enhance the accuracy of syndesmosis injury diagnoses and inform treatment strategies more effectively. The primary goal of this research is to evaluate the usefulness of traditional radiographic measurements in comparison to new CT-based measurements for diagnosing ankle syndesmosis injuries. Specifically, this study aims to assess the accuracy of conventional parameters, including medial clear space, tibiofibular overlap, tibiofibular clear space, ATFR, and APTF, in contrast with the recently proposed CT-based measurements such as the delta and gamma angles. Moreover, the study intends to explore the relationship between these diagnostic parameters and functional outcomes, as measured by the Foot and Ankle Outcome Score (FAOS). Establishing a correlation between specific diagnostic measurements and FAOS scores will enable us to identify the most reliable predictors of functional recovery following syndesmosis injuries. This comparative analysis will provide valuable insights into the accuracy and dependability of CT-based measurements in diagnosing ankle syndesmosis injuries and their potential impact on predicting patient outcomes. The results of this study could greatly influence clinical practices by refining diagnostic criteria and optimizing treatment planning for patients with ankle syndesmosis injuries.

Keywords: ankle syndesmosis injury, diagnostic accuracy, computed tomography, radiographic measurements, Tibiofibular syndesmosis distance

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1483 Enhancement of X-Rays Images Intensity Using Pixel Values Adjustments Technique

Authors: Yousif Mohamed Y. Abdallah, Razan Manofely, Rajab M. Ben Yousef

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X-Ray images are very popular as a first tool for diagnosis. Automating the process of analysis of such images is important in order to help physician procedures. In this practice, teeth segmentation from the radiographic images and feature extraction are essential steps. The main objective of this study was to study correction preprocessing of x-rays images using local adaptive filters in order to evaluate contrast enhancement pattern in different x-rays images such as grey color and to evaluate the usage of new nonlinear approach for contrast enhancement of soft tissues in x-rays images. The data analyzed by using MatLab program to enhance the contrast within the soft tissues, the gray levels in both enhanced and unenhanced images and noise variance. The main techniques of enhancement used in this study were contrast enhancement filtering and deblurring images using the blind deconvolution algorithm. In this paper, prominent constraints are firstly preservation of image's overall look; secondly, preservation of the diagnostic content in the image and thirdly detection of small low contrast details in diagnostic content of the image.

Keywords: enhancement, x-rays, pixel intensity values, MatLab

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1482 Effect of the Binary and Ternary Exchanges on Crystallinity and Textural Properties of X Zeolites

Authors: H. Hammoudi, S. Bendenia, K. Marouf-Khelifa, R. Marouf, J. Schott, A. Khelifa

Abstract:

The ionic exchange of the NaX zeolite by Cu2+ and/or Zn2+ cations is progressively driven while following the development of some of its characteristic: crystallinity by XR diffraction, profile of isotherms, RI criterion, isosteric adsorption heat and microporous volume using both the Dubinin–Radushkevich (DR) equation and the t-plot through the Lippens–de Boer method which also makes it possible to determine the external surface area. Results show that the cationic exchange process, in the case of Cu2+ introduced at higher degree, is accompanied by crystalline degradation for Cu(x)X, in contrast to Zn2+-exchanged zeolite X. This degradation occurs without significant presence of mesopores, because the RI criterion values were found to be much lower than 2.2. A comparison between the binary and ternary exchanges shows that the curves of CuZn(x)X are clearly below those of Zn(x)X and Cu(x)X, whatever the examined parameter. On the other hand, the curves relating to CuZn(x)X tend towards those of Cu(x)X. This would again confirm the sensitivity of the crystalline structure of CuZn(x)X with respect to the introduction of Cu2+ cations. An original result is the distortion of the zeolitic framework of X zeolites at middle exchange degree, when Cu2+ competes with another divalent cation, such as Zn2+, for the occupancy of sites distributed within zeolitic cavities. In other words, the ternary exchange accentuates the crystalline degradation of X zeolites. An unexpected result also is the no correlation between crystal damage and the external surface area.

Keywords: adsorption, crystallinity, ion exchange, zeolite

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1481 Understanding Surface Failures in Thick Asphalt Pavement: A 3-D Finite Element Model Analysis

Authors: Hana Gebremariam Liliso

Abstract:

This study investigates the factors contributing to the deterioration of thick asphalt pavements, such as rutting and cracking. We focus on the combined influence of traffic loads and pavement structure. This study uses a three-dimensional finite element model with a Mohr-Coulomb failure criterion to analyze the stress levels near the pavement's surface under realistic conditions. Our model considers various factors, including tire-pavement contact stresses, asphalt properties, moving loads, and dynamic analysis. This research suggests that cracking tends to occur between dual tires. Some key discoveries include the risk of cracking increases as temperatures rise; surface cracking at high temperatures is associated with distortional deformation; using a uniform contact stress distribution underestimates the risk of failure compared to realistic three-dimensional tire contact stress, particularly at high temperatures; the risk of failure is higher near the surface when there is a negative temperature gradient in the asphalt layer; and debonding beneath the surface layer leads to increased shear stress and premature failure around the interface.

Keywords: asphalt pavement, surface failure, 3d finite element model, multiaxial stress states, Mohr-Coulomb failure criterion

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1480 Different Types of Amyloidosis Revealed with Positive Cardiac Scintigraphy with Tc-99M DPD-SPECT

Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

Abstract:

Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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1479 Analytical Solutions for Tunnel Collapse Mechanisms in Circular Cross-Section Tunnels under Seepage and Seismic Forces

Authors: Zhenyu Yang, Qiunan Chen, Xiaocheng Huang

Abstract:

Reliable prediction of tunnel collapse remains a prominent challenge in the field of civil engineering. In this study, leveraging the nonlinear Hoek-Brown failure criterion and the upper-bound theorem, an analytical solution for the collapse surface of shallowly buried circular tunnels was derived, taking into account the coupled effects of surface loads and pore water pressures. Initially, surface loads and pore water pressures were introduced as external force factors, equating the energy dissipation rate to the external force, yielding our objective function. Subsequently, the variational method was employed for optimization, and the outcomes were juxtaposed with previous research findings. Furthermore, we utilized the deduced equation set to systematically analyze the influence of various rock mass parameters on collapse shape and extent. To validate our analytical solutions, a comparison with prior studies was executed. The corroboration underscored the efficacy of our proposed methodology, offering invaluable insights for collapse risk assessment in practical engineering applications.

Keywords: tunnel roof stability, analytical solution, hoek–brown failure criterion, limit analysis

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1478 Fast Prototyping of Precise, Flexible, Multiplexed, Printed Electrochemical Enzyme-Linked Immunosorbent Assay System for Point-of-Care Biomarker Quantification

Authors: Zahrasadat Hosseini, Jie Yuan

Abstract:

Point-of-care (POC) diagnostic devices based on lab-on-a-chip (LOC) technology have the potential to revolutionize medical diagnostics. However, the development of an ideal microfluidic system based on LOC technology for diagnostics purposes requires overcoming several obstacles, such as improving sensitivity, selectivity, portability, cost-effectiveness, and prototyping methods. While numerous studies have introduced technologies and systems that advance these criteria, existing systems still have limitations. Electrochemical enzyme-linked immunosorbent assay (e-ELISA) in a LOC device offers numerous advantages, including enhanced sensitivity, decreased turnaround time, minimized sample and analyte consumption, reduced cost, disposability, and suitability for miniaturization, integration, and multiplexing. In this study, we present a novel design and fabrication method for a microfluidic diagnostic platform that integrates screen-printed electrochemical carbon/silver chloride electrodes on flexible printed circuit boards with flexible, multilayer, polydimethylsiloxane (PDMS) microfluidic networks to accurately manipulate and pre-immobilize analytes for performing electrochemical enzyme-linked immunosorbent assay (e-ELISA) for multiplexed quantification of blood serum biomarkers. We further demonstrate fast, cost-effective prototyping, as well as accurate and reliable detection performance of this device for quantification of interleukin-6-spiked samples through electrochemical analytics methods. We anticipate that our invention represents a significant step towards the development of user-friendly, portable, medical-grade, POC diagnostic devices.

Keywords: lab-on-a-chip, point-of-care diagnostics, electrochemical ELISA, biomarker quantification, fast prototyping

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1477 Fast Prototyping of Precise, Flexible, Multiplexed, Printed Electrochemical Enzyme-Linked Immunosorbent Assay Platform for Point-of-Care Biomarker Quantification

Authors: Zahrasadat Hosseini, Jie Yuan

Abstract:

Point-of-care (POC) diagnostic devices based on lab-on-a-chip (LOC) technology have the potential to revolutionize medical diagnostics. However, the development of an ideal microfluidic system based on LOC technology for diagnostics purposes requires overcoming several obstacles, such as improving sensitivity, selectivity, portability, cost-effectiveness, and prototyping methods. While numerous studies have introduced technologies and systems that advance these criteria, existing systems still have limitations. Electrochemical enzyme-linked immunosorbent assay (e-ELISA) in a LOC device offers numerous advantages, including enhanced sensitivity, decreased turnaround time, minimized sample and analyte consumption, reduced cost, disposability, and suitability for miniaturization, integration, and multiplexing. In this study, we present a novel design and fabrication method for a microfluidic diagnostic platform that integrates screen-printed electrochemical carbon/silver chloride electrodes on flexible printed circuit boards with flexible, multilayer, polydimethylsiloxane (PDMS) microfluidic networks to accurately manipulate and pre-immobilize analytes for performing electrochemical enzyme-linked immunosorbent assay (e-ELISA) for multiplexed quantification of blood serum biomarkers. We further demonstrate fast, cost-effective prototyping, as well as accurate and reliable detection performance of this device for quantification of interleukin-6-spiked samples through electrochemical analytics methods. We anticipate that our invention represents a significant step towards the development of user-friendly, portable, medical-grade POC diagnostic devices.

Keywords: lab-on-a-chip, point-of-care diagnostics, electrochemical ELISA, biomarker quantification, fast prototyping

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1476 A Comparison of Convolutional Neural Network Architectures for the Classification of Alzheimer’s Disease Patients Using MRI Scans

Authors: Tomas Premoli, Sareh Rowlands

Abstract:

In this study, we investigate the impact of various convolutional neural network (CNN) architectures on the accuracy of diagnosing Alzheimer’s disease (AD) using patient MRI scans. Alzheimer’s disease is a debilitating neurodegenerative disorder that affects millions worldwide. Early, accurate, and non-invasive diagnostic methods are required for providing optimal care and symptom management. Deep learning techniques, particularly CNNs, have shown great promise in enhancing this diagnostic process. We aim to contribute to the ongoing research in this field by comparing the effectiveness of different CNN architectures and providing insights for future studies. Our methodology involved preprocessing MRI data, implementing multiple CNN architectures, and evaluating the performance of each model. We employed intensity normalization, linear registration, and skull stripping for our preprocessing. The selected architectures included VGG, ResNet, and DenseNet models, all implemented using the Keras library. We employed transfer learning and trained models from scratch to compare their effectiveness. Our findings demonstrated significant differences in performance among the tested architectures, with DenseNet201 achieving the highest accuracy of 86.4%. Transfer learning proved to be helpful in improving model performance. We also identified potential areas for future research, such as experimenting with other architectures, optimizing hyperparameters, and employing fine-tuning strategies. By providing a comprehensive analysis of the selected CNN architectures, we offer a solid foundation for future research in Alzheimer’s disease diagnosis using deep learning techniques. Our study highlights the potential of CNNs as a valuable diagnostic tool and emphasizes the importance of ongoing research to develop more accurate and effective models.

Keywords: Alzheimer’s disease, convolutional neural networks, deep learning, medical imaging, MRI

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1475 Predictive Value of Hepatitis B Core-Related Antigen (HBcrAg) during Natural History of Hepatitis B Virus Infection

Authors: Yanhua Zhao, Yu Gou, Shu Feng, Dongdong Li, Chuanmin Tao

Abstract:

The natural history of HBV infection could experience immune tolerant (IT), immune clearance (IC), HBeAg-negative inactive/quienscent carrier (ENQ), and HBeAg-negative hepatitis (ENH). As current biomarkers for discriminating these four phases have some weaknesses, additional serological indicators are needed. Hepatits B core-related antigen (HBcrAg) encoded with precore/core gene contains denatured HBeAg, HBV core antigen (HBcAg) and a 22KDa precore protein (p22cr), which was demonstrated to have a close association with natural history of hepatitis B infection, but no specific cutoff values and diagnostic parameters to evaluate the diagnostic efficacy. This study aimed to clarify the distribution of HBcrAg levels and evaluate its diagnostic performance during the natural history of infection from a Western Chinese perspective. 294 samples collected from treatment-naïve chronic hepatitis B (CHB) patients in different phases (IT=64; IC=72; ENQ=100, and ENH=58). We detected the HBcrAg values and analyzed the relationship between HBcrAg and HBV DNA. HBsAg and other clinical parameters were quantitatively tested. HBcrAg levels of four phases were 9.30 log U/mL, 8.80 log U/mL, 3.00 log U/mL, and 5.10 logU/mL, respectively (p < 0.0001). Receiver operating characteristic curve analysis demonstrated that the area under curves (AUCs) of HBcrAg and quantitative HBsAg at cutoff values of 9.25 log U/mL and 4.355 log IU/mL for distinguishing IT from IC phases were 0.704 and 0.694, with sensitivity 76.39% and 59.72%, specificity 53.13% and 79.69%, respectively. AUCs of HBcrAg and quantitative HBsAg at cutoff values of 4.15 log U/mlmL and 2.395 log IU/mlmL for discriminating between ENQ and ENH phases were 0.931 and 0.653, with sensitivity 87.93% and 84%, specificity 91.38% and 39%, respectively. Therefore, HBcrAg levels varied significantly among four natural phases of HBV infection. It had higher predictive performance than quantitative HBsAg for distinguishing between ENQ-patients and ENH-patients and similar performance with HBsAg for the discrimination between IT and IC phases, which indicated that HBcrAg could be a potential serological marker for CHB.

Keywords: chronic hepatitis B, hepatitis B core-related antigen, hepatitis B surface antigens, hepatitis B virus

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1474 Experimental Study and Numerical Modelling of Failure of Rocks Typical for Kuzbass Coal Basin

Authors: Mikhail O. Eremin

Abstract:

Present work is devoted to experimental study and numerical modelling of failure of rocks typical for Kuzbass coal basin (Russia). The main goal was to define strength and deformation characteristics of rocks on the base of uniaxial compression and three-point bending loadings and then to build a mathematical model of failure process for both types of loading. Depending on particular physical-mechanical characteristics typical rocks of Kuzbass coal basin (sandstones, siltstones, mudstones, etc. of different series – Kolchuginsk, Tarbagansk, Balohonsk) manifest brittle and quasi-brittle character of failure. The strength characteristics for both tension and compression are found. Other characteristics are also found from the experiment or taken from literature reviews. On the base of obtained characteristics and structure (obtained from microscopy) the mathematical and structural models are built and numerical modelling of failure under different types of loading is carried out. Effective characteristics obtained from modelling and character of failure correspond to experiment and thus, the mathematical model was verified. An Instron 1185 machine was used to carry out the experiments. Mathematical model includes fundamental conservation laws of solid mechanics – mass, impulse, energy. Each rock has a sufficiently anisotropic structure, however, each crystallite might be considered as isotropic and then a whole rock model has a quasi-isotropic structure. This idea gives an opportunity to use the Hooke’s law inside of each crystallite and thus explicitly accounting for the anisotropy of rocks and the stress-strain state at loading. Inelastic behavior is described in frameworks of two different models: von Mises yield criterion and modified Drucker-Prager yield criterion. The damage accumulation theory is also implemented in order to describe a failure process. Obtained effective characteristics of rocks are used then for modelling of rock mass evolution when mining is carried out both by an open-pit or underground opening.

Keywords: damage accumulation, Drucker-Prager yield criterion, failure, mathematical modelling, three-point bending, uniaxial compression

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1473 Investigating the Relationship and Interaction between Auditory Processing Disorder and Auditory Attention

Authors: Amirreza Razzaghipour Sorkhab

Abstract:

The exploration of the connection between cognition and Auditory Processing Disorder (APD) holds significant value. Individuals with APD experience challenges in processing auditory information through the central auditory nervous system's varied pathways. Understanding the importance of auditory attention in individuals with APD, as well as the primary diagnostic tools such as language and auditory attention tests, highlights the critical need for assessing their auditory attention abilities. While not all children with Auditory Processing Disorder (APD) show deficits in auditory attention, there are often deficiencies in cognitive and attentional performance. The link between various types of attention deficits and APD suggests impairments in sustained and divided auditory attention. Research into the origins of APD should also encompass higher-level processes, such as auditory attention. It is evident that investigating the interaction between APD and auditory and cognitive functions holds significant value. Furthermore, it was demonstrated that APD tests may be influenced by cognitive factors, but despite signs of auditory attention interaction with auditory processing skills and the influence of cognitive factors on tests for this disorder, auditory attention measures are not typically included in APD diagnostic protocols. Therefore, incorporating attention assessment tests into the battery of tests for individuals with auditory processing disorder will be beneficial for obtaining useful insights into their attentional abilities.

Keywords: auditory processing disorder, auditory attention, central auditory processing disorder, top-down pathway

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1472 Rapid Inventory of Terrestrial Ferns and Lycopods in Center for Ecological Development and Recreation (Cedar), Impalutao, Impasug-Ong Bukidnon, Philippines

Authors: Diobein Flores, Venus Buagas, Virgie Darunday

Abstract:

The study inventoried the species composition of terrestrial ferns and lycopods in Center for Ecological Development and Recreation (CEDAR) Impalutao, Impasug-ong, Bukidnon. Specifically, it aimed to determine and describe the species composition, and diagnostic characters of the ferns and lycopods in the study site. Transect walk method was employed in the inventory of the species. Each species were classified, identified and described according to its diagnostic characters. Results of the study revealed a total of 20 species of ferns and lycopods. Of these, 18 species were ferns and 2 species were lycopods. Eleven (11) families and fifteen (15) genera for ferns and one (1) family and one (1) genera for lycopods. Psomiocarpa apifolia is Philippine endemic and said to be vulnerable or threatened. Taxonomic characters based on habit, rhizome, leaf arrangement and orientation, stem structure and circinate vernation were used to identify the terrestrial pteridophtyes into families, genera and species. The species collected and assessment in CEDAR should be further investigated and monitor their conservation status.

Keywords: alpha taxonomy, conservation, habit, taxonomic characters

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1471 Dielectric Response Analysis Measurement for Diagnostic Oil-Paper Insulation System on Aged Inter Bus Transformer 3x10 MVA

Authors: Eki Farlen, Akas

Abstract:

Condition assessment of oil-paper-insulated power transformers, particularly of water content, is becoming increasingly important for aged transformers. As insulation ages, it can produce water, which reduces its dielectric strength, accelerates the cellulose ageing process, and causes gas bubbles to form at high temperatures. This paper mainly assesses the life condition of oil-paper insulation system of Inter Bus Transformer (IBT) 30 MVA, 150/30 kV in PT PLN-Substation Jelok that has been operating for 41 years, since 1974. Valuable information about the condition of high voltage insulation may be obtained by measuring its dielectric response. This paper describes in detail the interpretation of Dielectric Response Analysis (DIRANA) measurements and the test result compared to other insulation tests to get deep information for diagnostic, such as Tan delta test, oil characteristic test and Dissolve Gas Analysis (DGA) test. This paper mainly discusses the parameter relationship between moisture content, water content, acidity, oil conductivity and dissipation factor. The result and analysis show that IBT 30 MVA Jelok phase U and W had just been ageing due to high acidity level (>0.2 mgKOH/g) which cause high moisture in cellulose/paper (%) are in wet category about 4.7% and 5% and water content in oil (ppm) about 3.13 ppm and 3.33 ppm at temperature 20°C. High acidity level can make oxidation process and produce water in paper and particle which can decrease the value of Interfacial Tension (IFT) below 22 mN/m (poor category) for both phase U and W. Even if paper insulation of transformer are in wet condition, dissipation factor and capacitance at the same frequency (50 Hz) from both measurement DIRANA test and Tangent delta test give the same result (almost), the results are 0.69% and 0.71% (<1%), it may be acceptable and should not be investigated. The DGA results show that TDCG are in level one (1) condition and there are no found a Key Gases, it means that transformers had no failure during operation like arching, partial discharge and thermal in oil or cellulose.

Keywords: diagnostic, inter-bus transformer, oil-paper insulation, moisture, dissipation factor

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1470 Retrospective Analysis Demonstrates No Difference in Percutaneous Native Renal Biopsy Adequacy Between Nephrologists and Radiologists in University Hospital Crosshouse

Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey

Abstract:

Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.

Keywords: biopsy, medical imaging, nephrology, radiology

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1469 Endoscopic Depiction and Treatment Evaluation of Spirocerca lupi in Dogs

Authors: ELdessouky Sheta, Sayed Elzomor, Haithem Farghali, Kawkab A. Ahmed, Naglaa A. Abd Elkader

Abstract:

The present investigation has been dealt with Spirocerca (S.) lupi infested mongrel dogs. This parasitic disease is highly infective to human beings and carnivores. The diagnosis march has been comprised the lateral contrast thoracic radiographs, fecal examination, blood profile, endoscopic examination and histopathological sections of deep seated pinch biopsies. These infested dogs have been put under an adopted treatment with Ivermectin injection combined with oral prednisolone. The obtained results reveal an absence of the pessimistic recognitions particularly after 3 weeks from the onset of treatment. Endoscopically the presented esophageal nodules are marked out in the distal third of infested dogs' esophagus as masses assigned into the esophageal lumen and fundus of stomach. The endoscopic outlook of Spirocerca lupi lesions has been considered an integral procedure of the diagnostic march and for evaluation of treatment follow up. The diagnostic procedures and the recommended treatment are the vet's guidance to care for Spirocerca lupi in dogs, hoping in future to prevent this disease from being spread among human beings and other carnivores.

Keywords: endoscopy, esophagus, stomach spirocercosis, dogs

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1468 The Leadership Criterion: Challenges in Pursuing Excellence in the Jordanian Public Sector

Authors: Shaker Aladwan, Paul Forrester

Abstract:

This paper explores the challenges that face leaders when implementing business excellence programmes in the Jordanian public sector. The study adopted a content analysis approach to analyse the excellence assessment reports that have been produced by the King Abdullah II Centre for Excellence (KACE). The sample comprises ten public organisations which have participated in the King Abdullah Award for Excellence (KAA) more than once and acknowledge in their reports that they have failed to achieve satisfactory results. The key challenges to the implementation of leadership criteria in the public sector in Jordan were found to be poor strategic planning, lack of employee empowerment, weaknesses in benchmarking performance, a lack of financial resources, poor integration and coordination, and poor measurement system: This study proposes a conceptual model for the as assessment of challenges that face managers when seeking to implement excellence in leadership in the Jordanian public sector. Theoretically, this paper fills context gaps in the excellence literature in general and organisational excellence in the public sector in particular. Leadership challenges in the public sector are generally widely studied, but it is important to gain a better understanding of how these challenges can be overcome. In comparison to many existing studies, this research has provided specific and detailed insights these organisational excellence challenges in the public sector and provides a conceptual model for use by other researchers into the future.

Keywords: leadership criterion, organisational excellence, challenges, quality awards, public sector, Jordan

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