Search results for: animation-based screening instrument

Authors: Bijan Nahavandi, Navid Jafarinejad, Somayeh Mehrafzad

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Strategy maps represent the way of value creation in in each organization. Nowadays, implementation of strategy is the main concern for all organizations. Strategy map establishment is the start-up point of strategy implementation and this shows the critical importance of this concept. After some years past since emergence of strategy map, there are some shortcomings in its methodology that frequently quoted by many of researchers. One of these shortcomings is the shortage of a mechanism for refinement of objectives candidate for entrance to map. Organizations in practice have obsession and avidity to determine more number of objectives in strategy map. This study wants to represent a step by step approach to help obviate this problem using quality function deployment (QFD) as a helpful tool and fuzzy screening method. Finally, represented approach applies in a practical case and conclusions have been explained.

Keywords: balanced scorecard, fuzzy screening, house of strategic objectives (HoSO), quality function deployment, strategy map

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Authors: Memnun Seven, Mine Bahar, Aygül Akyüz, Hatice Erdoğan

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Background: The workplace has been deemed a suitable location for educating many women at once about cancer screening. Objective: To determine how group education about early diagnostic methods for breast and cervical cancer affects women’s behavior and readiness to receive mammography and Pap smears. Methods: This semi-interventional study was conducted at a textile factory in Istanbul, Turkey. Female workers (n = 125) were included in the study. A participant identification form and knowledge evaluation form developed for this study, along with the trans-theoretical model, were used to collect data. A 45-min interactive group education was given to the participants. Results: Upon contacting participants 3 months after group education, 15.4% (n = 11) stated that they had since received a mammogram and 9.8% (n = 7) a Pap smear. As suggested by the trans-theoretical model, group education increased participants’ readiness to receive cancer screening, along with their knowledge of breast and cervical cancer. Conclusions: Group education positively impacted women’s knowledge of cancer and their readiness to receive mammography and Pap smears. Group education can therefore potentially create awareness of cancer screening tests among women and improve their readiness to receive such tests.

Keywords: cancer screening, educational intervention, participation, women

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Authors: Pritika Ramharack, Mahmoud E. S. Soliman

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The re-emerging Zika virus is an arthropod-borne virus that has been described to have explosive potential as a worldwide pandemic. The initial transmission of the virus was through a mosquito vector, however, evolving modes of transmission has allowed the spread of the disease over continents. The virus already been linked to irreversible chronic central nervous system (CNS) conditions. The concerns of the scientific and clinical community are the consequences of Zika viral mutations, thus suggesting the urgent need for viral inhibitors. There have been large strides in vaccine development against the virus but there are still no FDA-approved drugs available. Rapid rational drug design and discovery research is fundamental in the production of potent inhibitors against the virus that will not just mask the virus, but destroy it completely. In silico drug design allows for this prompt screening of potential leads, thus decreasing the consumption of precious time and resources. This study demonstrates an optimized and proven screening technique in the discovery of two potential small molecule inhibitors of Zika virus Methyltransferase and RNA-dependent RNA polymerase. This in silico “per-residue energy decomposition pharmacophore” virtual screening approach will be critical in aiding scientists in the discovery of not only effective inhibitors of Zika viral targets, but also a wide range of anti-viral agents.

Keywords: NS5 protein inhibitors, per-residue decomposition, pharmacophore model, virtual screening, Zika virus

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Authors: Ratri Werdiningtyas, Yongping Wei, Andrew Western

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The status quo of social-ecological systems is the results of not only natural processes but also the accumulated consequence of policies applied in the past. Often water management objectives are challenging and are only achieved to a limited degree on the ground. In choosing water management approaches, it is important to account for current conditions and important differences due to varied histories. Since the mid-nineteenth century, Victorian water management has evolved through a series of policy regime shifts. The main goal of this research to explore and identify the stages of the evolution of the water policy instruments as practiced in Victoria from 1890-2016. This comparative historical analysis has identified four stages in Victorian policy instrument development. In the first stage, the creation of policy instruments aimed to match the demand and supply of the resource (reserve condition). The second stage begins after natural system alone failed to balance supply and demand. The focus of the policy instrument shifted to an authority perspective in this stage. Later, the increasing number of actors interested in water led to another change in policy instrument. The third stage focused on the significant role of information from different relevant actors. The fourth and current stage is the most advanced, in that it involved the creation of a policy instrument for synergizing the previous three focal factors: reserve, authority, and information. When considering policy in other jurisdiction, these findings suggest that a key priority should be to reflect on the jurisdictions current position among these four evolutionary stages and try to make improve progressively rather than directly adopting approaches from elsewhere without understanding the current position.

Keywords: policy instrument, policy transformation, socio-ecolgical system, water management

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Authors: Soofia Malik

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The purpose of this study is to develop an instrument to measure undergraduate students’ attitudes toward mathematics (MAT) and to assess the data collected from the instrument for validity and reliability. The instrument is developed using five subscales: anxiety, enjoyment, self-confidence, value, and technology. The technology dimension is added as the fifth subscale of attitude toward mathematics because of the recent trend of incorporating online homework in mathematics courses as well as due to heavy reliance of higher education on using online learning management systems, such as Blackboard and Moodle. The sample consists of 163 (M = 82, F = 81) undergraduates enrolled in College Algebra course in the summer 2017 semester at a university in the USA. The data is analyzed to answer the research question: if and how do undergraduate students’ attitudes toward mathematics load using Principal Components Analysis (PCA)? As a result of PCA, three subscales emerged namely: anxiety/self-confidence scale, enjoyment, and value scale. After deleting the last five items or the last two subscales from the initial MAT scale, the Cronbach’s alpha was recalculated using the scores from 20 items and was found to be α = .95. It is important to note that the reliability of the initial MAT form was α = .93. This means that employing the final MAT survey form would yield consistent results in repeated uses. The final MAT form is, therefore, more reliable as compared to the initial MAT form.

Keywords: college algebra, Cronbach's alpha reliability coefficient, Principal Components Analysis, PCA, technology in mathematics

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Authors: Maria C. Almario, Pam Remer, Jeff Resse, Kathy Moran, Linda Theander Adam

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The identification of victims of human trafficking and consequential service provision is characterized by a significant disconnection between the estimated prevalence of this issue and the number of cases identified. This poses as tremendous problem for human rights advocates as it prevents data collection, information sharing, allocation of resources and opportunities for international dialogues. The current paper introduces the Inclusive Human Trafficking Checklist (IHTC) as a measurement methodology with theoretical underpinnings derived from dialectic theory. The presence of human trafficking in a person’s life is conceptualized as a dynamic and dialectic interaction between vulnerability and exploitation. The current papers explores the operationalization of exploitation and vulnerability, evaluates the metric qualities of the instrument, evaluates whether there are differences in assessment based on the participant’s profession, level of knowledge, and training, and assesses if users of the instrument perceive it as useful. A total of 201 participants were asked to rate three vignettes predetermined by experts to qualify as a either human trafficking case or not. The participants were placed in three conditions: business as usual, utilization of the IHTC with and without training. The results revealed a statistically significant level of agreement between the expert’s diagnostic and the application of the IHTC with an improvement of 40% on identification when compared with the business as usual condition While there was an improvement in identification in the group with training, the difference was found to have a small effect size. Participants who utilized the IHTC showed an increased ability to identify elements of identity-based vulnerabilities as well as elements of fraud, which according to the results, are distinctive variables in cases of human trafficking. In terms of the perceived utility, the results revealed higher mean scores for the groups utilizing the IHTC when compared to the business as usual condition. These findings suggest that the IHTC improves appropriate identification of cases and that it is perceived as a useful instrument. The application of the IHTC as a multidisciplinary instrumentation that can be utilized in legal and human services settings is discussed as a pivotal piece of helping victims restore their sense of dignity, and advocate for legal, physical and psychological reparations. It is noteworthy that this study was conducted with a sample in the United States and later re-tested in Colombia. The implications of the instrument for treatment conceptualization and intervention in human trafficking cases are discussed as opportunities for enhancement of victim well-being, restoration engagement and activism. With the idea that what is personal is also political, we believe that the careful observation and data collection in specific cases can inform new areas of human rights activism.

Keywords: exploitation, human trafficking, measurement, vulnerability, screening

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Authors: Ahmad Hashim, Thariq Khan Azizuddin Khan, Zulakbal Abd Karim, Nohazira Abdul Karim

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This research aims to obtain the validity and reliability of a survey instrument to evaluate the values, attitudes, and professionalism of sports science students, from the Faculty of Sports Science and Coaching, Universiti Pendidikan Sultan Idris (UPSI). It is a survey which is divided into two components namely first; moral, self-esteem, proactive, self-reliant and voluntary and second; ethics and professionalism. Development of the survey instrument is based on the Malaysian Education Development Plan, Higher Education Malaysia. There are 50 items prepared based on the five-point Likert scale which were tested at the pilot test level. It involved 212 research subjects selected based on random sampling. In addition, the research method applied is in the form of pre-experimental one group pre-test-post-test. Results of the analysis showed that overall field expert validity is r = .89, while the Cronbach alpha reliability correlation value of outdoor education instrument evaluation survey is r = .85. Next, this survey was tested again for construct validity using the factor analysis method for statistical analysis which would validate each item tested was supposed to be in the right component. From the analysis, results show that Bartlett's test is significant p < .05 and Kaiser-Meyer-Olkin index range is r = .87. The result showed 39 survey items are produced out of 50 items of the survey based on this factor analysis method. Research has shown that the survey instrument developed is valid and reliable to be used for the Faculty of Sports Sciences and Coaching, UPSI.

Keywords: values, attitudes, professionalism, ethics, professionalism

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Authors: Girija Madhavanprabhakaran, Frincy Franacis, Sheeba Elizabeth John

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Introduction: A wide range of prenatal genetic screening is introduced with increasing incidences of congenital anomalies even in low-risk pregnancies and is an emerging standard of care. Being frontline caretakers, the role and responsibilities of nurses and midwives are critical as they are working along with couples to provide evidence-based supportive educative care. The increasing genetic disorders and advances in prenatal genetic screening with limited genetic counselling facilities urge nurses and midwifery nurses with essential competencies to help couples to take informed decision. Objective: This integrative literature review aimed to explore nurse midwives’ knowledge and role in prenatal screening and genetic counselling competency and the challenges faced by them to cater to all pregnant women to empower their autonomy in decision making and ensuring psychological comfort. Method: An electronic search using keywords prenatal screening, genetic counselling, prenatal counselling, nurse midwife, nursing education, genetics, and genomics were done in the PUBMED, SCOPUS and Medline, Google Scholar. Finally, based on inclusion criteria, 8 relevant articles were included. Results: The main review results suggest that nurses and midwives lack essential support, knowledge, or confidence to be able to provide genetic counselling and help the couples ethically to ensure client autonomy and decision making. The majority of nurses and midwives reported inadequate levels of knowledge on genetic screening and their roles in obtaining family history, pedigrees, and providing genetic information for an affected client or high-risk families. The deficiency of well-recognized and influential clinical academic midwives in midwifery practice is also reported. Evidence recommended to update and provide sound educational training to improve nurse-midwife competence and confidence. Conclusion: Overcoming the challenges to achieving informed choices about fetal anomaly screening globally is a major concern. Lack of adequate knowledge and counselling competency, communication insufficiency, need for education and policy are major areas to address. Prenatal nurses' and midwives’ knowledge on prenatal genetic screening and essential counselling competencies can ensure services to the majority of pregnant women around the globe to be better-informed decision-makers and enhances their autonomy, and reduces ethical dilemmas.

Keywords: challenges, genetic counselling, prenatal screening, prenatal counselling

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Authors: Jen-Fu Lee

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From the 1980s, the ministry of education in Taiwan moves the instrument ‘Recorder’ into the 9-year compulsory schooling system. The recorder is widely popularized successfully in Taiwan. The research aims to document the history of how the recorder came into Taiwan, what the process of the recorder moving into the schooling system is; what the meaning for the recorder moving into the schooling system is by searching the papers about the recorder in Taiwan and interviewing the people who had participated the process. The research discovers that the recorder in Taiwan was popularized nongovernmental by Shang-Ren, Wang. Shang-Ren, Wang imported 200 recorders from Japan in 1982 and then founded a publishing house which publishes the books and sheets about the recorder in 1983. The reason of Shang-Ren, Wang committed to popularizing the recorder is to spread the Orff Approach in Taiwan. Except for the technique of playing the recorder, the knowledge of the history of the recorder and the role that it plays in Early Music is not available in school. The recorder only plays a ‘Cheap and Easy’ instrument which is suitable for the schooling system in Taiwan, cannot develop to a professional instrument.

Keywords: recorder, Taiwan, Shang-Ren, Wang, compulsory schooling system

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Authors: Osifeko Olalekan Remigious, Adesanya Adebisi Joseph, Omolade Akinmade Olatunde

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The focus of this study was to determine the factors associated with the use of substances for sport performance of youth in Lagos state sport. Questionnaire was the instrument used for the study. Descriptive research method was used. The estimated population for the study was 2000 sport men and women. The sample size was 200 respondents for purposive sampling techniques were used. The instrument was validated in it content and constructs value. The instrument was administered with the assistance of the coaches. Same 200 copies administered were returned. The data obtained was analysed using simple percentage and chi-square (x2) for stated hypothesis at 0.05 level of significance. The finding reveal that sport injuries exercise induced and anaphylaxis and asthma and feeling of loss of efficacy associated with alcohol used on sport performance among the users of substances. Alcohol users are recommended to partake in sport like swimming, basketball and volleyball because they have space of time for resting while at play. Government should be fully in charge of the health of sport men and women.

Keywords: implications, Lagos state, substances, sports performance, youth

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Authors: I. Sani, A. Abdulhamid, F. Bello, Isah M. Fakai

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Phytochemicals are active secondary plant metabolites responsible for most of the claimed medicinal activities of plants. Eucalyptus camaldulensis is one of those plants that possess these phytochemicals and claimed to possess medicinal activities on various ailments. The phytochemicals constituents of various parts of this plant were investigated using standard methods of phytochemicals screening in both aqueous and ethanolic extracts. Qualitative screening revealed that tannins, saponins, glycosides, steroids and anthraquinones were present in aqueous extract of all the parts of the plant, whereas alkaloids, flavonoids and terpenoids were absent. On the other hand, tannins and steroids were present in the ethanolic extract of all the parts of the plant, while saponins, alkaloids, flavonoids and terpenoids were present only in some parts of the plant. However, glycosides and anthraquinone were absent in all the ethanolic extracts. The quantitative screening revealed large amount of saponins in both aqueous and ethanolic extracts across the various parts of the plant. Whereas small amount of tannins, alkaloids and flavonoids were found only in the ethanolic extract of some parts of the plant. The presence of these phytochemicals in Eucalyptus camaldulensis could therefore justify the applications of the plant in management and curing of various ailments as claimed traditionally.

Keywords: Eucalyptus camaldulensis, phytochemical Screening, aqueous extract, ethanolic extract

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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Authors: Rashad Al-Hindi

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The study aimed at investigating and screening of some contaminants in some honey-based products. Sixty-nine 'honey paste' samples marketed in Jeddah, Saudi Arabia, were subjected to physicochemical studies and screening of aflatoxins and pesticide residues. The physicochemical parameters studied were mainly: moisture content, total sugars, total ash, total nitrogen, fibres, total acidity as citric acid and pH. These parameters were investigated using standard methods of analysis. Mycotoxins (aflatoxins) and pesticide residues were by an enzyme-linked immunosorbent assay (ELISA) according to official methods. Results revealed that mean values of the examined criteria were: 15.44±0.36%; 74±4.30%; 0.40±0.062%; 0.22±0.05%; 6.93±1.30%; 2.53±0.161 mmol/kg; 4.10±0.158, respectively. Overall results proved that all tested honey pastes samples were free from mycotoxins (aflatoxins) and pesticide residues. Therefore, we conclude that 'honey pastes' marketed in Jeddah city, Saudi Arabia were safe for human consumption.

Keywords: aflatoxins, honey mixtures, pesticide residues, physicochemical

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Authors: Marie-Helena Docherty, Sion Edryd Williams

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The prevalence of diabetes mellitus is increasing worldwide. In Sub-Saharan Africa, type 2 diabetes represents over 90% of all types of diabetes with the number of diabetic patients expected to rise. This represents a huge economic burden in an area already contending with high rates of other significant diseases, including the highest worldwide prevalence of HIV. Diabetic complications considerably impact on morbidity and mortality. The epidemiological data for the region quotes high rates of retinopathy (7-63%), neuropathy (27-66%) and microalbuminuria (10-83%). It is therefore imperative that diabetic screening programmes are established. It is recognised that in many parts of the developing world the implementation and management of such programmes is limited by a lack of available resources. The International Diabetes Federation produced guidelines in 2012 taking these limitations into account suggesting that all diabetic patients should have access to basic screening. These guidelines are consistent with the national diabetic guidelines produced by the Lesotho Medical Council. However, diabetic care in Lesotho is delivered at the local level, with variable levels of quality. A cross sectional study was performed in the outpatient department of Maluti Hospital in Mapoteng, Lesotho, a busy rural hospital in the Berea district. Demographic data on gender, age and modality of treatment were collected over a six-week time period. Information regarding 3 basic screening parameters was obtained. These parameters included eye screening (defined as a documented ophthalmology review within the last 12 months), foot screening (defined as a documented foot health assessment by any health care professional within the last 12 months) and secondary prevention (defined as a documented blood pressure and lipid profile reading within the last 12 months). These parameters were selected on the basis of the absolute minimum level of resources in Maluti Hospital. Renal screening was excluded, as the hospital does not have access to reliable renal profile checks or urinalysis. There is however a fully functioning on-site ophthalmology department run by a senior ophthalmologist with the ability to provide retinal photography, retinal surgery and photocoagulation therapy. Data was collected on 183 type 2 diabetics. 112 patients were male and 71 were female. The average age was 43 years. 4 patients were diet controlled, 140 patients were on oral hypoglycaemic agents (metformin and/or glibenclamide), and 39 patients were on a combination of insulin and oral hypoglycaemics. In the preceding 12 months, 5 patients had undergone eye screening (3%), 24 patients had undergone foot screening (13%), and 31 patients had lipid profile testing (17%). All patients had a documented blood pressure reading (100%). Our results show that screening is poorly performed in the basic indicators suggested by the IDF and the Lesotho Medical Council. On the basis of these results, a screening programme was developed using the mnemonic SaFE; secondary prevention, foot and eye care. This is simple, memorable and transferable between healthcare professionals. In the future, the expectation would be to expand upon this current programme to include renal screening, and to further develop screening pertaining to secondary prevention.

Keywords: Africa, complications, rural, screening

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Authors: Masoud Ghaemi, Mohammadjafar Hedayati, Faezeh Yousefzadeh, Hoseinali Heydarzadeh

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Careful monitoring in the earth dams to measure deformation caused by settlement and movement has always been a concern for engineers in the field. In order to measure settlement and deformation of earth dams, usually, the precision instruments of settlement set and combined Inclinometer that is commonly referred to IS instrument will be used. In some dams, because the thickness of alluvium is high and there is no possibility of alluvium removal (technically and economically and in terms of performance), there is no possibility of placing the end of IS instrument (precision instruments of Inclinometer-settlement set) in the rock foundation. Inevitably, have to accept installing pipes in the weak and deformable alluvial foundation that leads to errors in the calculation of the actual settlement (absolute settlement) in different parts of the dam body. The purpose of this paper is to present new and refine criteria for predicting settlement and deformation in earth dams. The study is based on conditions in three dams with a deformation quite alluvial (Agh Chai, Narmashir and Gilan-e Gharb) to provide settlement criteria affected by the alluvial foundation. To achieve this goal, the settlement of dams was simulated by using the finite difference method with FLAC3D software, and then the modeling results were compared with the reading IS instrument. In the end, the caliber of the model and validate the results, by using regression analysis techniques and scrutinized modeling parameters with real situations and then by using MATLAB software and CURVE FITTING toolbox, new criteria for the settlement based on elasticity modulus, cohesion, friction angle, the density of earth dam and the alluvial foundation was obtained. The results of these studies show that, by using the new criteria measures, the amount of settlement and deformation for the dams with alluvial foundation can be corrected after instrument readings, and the error rate in reading IS instrument can be greatly reduced.

Keywords: earth-fill dam, foundation, settlement, finite difference, MATLAB, curve fitting

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Authors: Shubham Dwivedi, Raghavender Medishetti, Rita Rani, Aarti Sevilimedu, Pushkar Kulkarni, Yogeeswari Perumal

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Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder of early onset, characterized by impaired sociability, cognitive function and stereotypies. There is a significant urge to develop and establish new animal models with ASD-like characteristics for better understanding of underlying mechanisms. The aim of the present study was to develop a cost and time effective zebrafish model with quantifiable parameters to facilitate mechanistic studies as well as high-throughput screening of new molecules for autism. Zebrafish embryos were treated with valproic acid and a battery of behavioral tests (anxiety, inattentive behavior, irritability and social impairment) was performed on larvae at 7th day post fertilization, followed by study of molecular markers of autism. This model shows a significant behavioural impairment in valproic acid treated larvae in comparison to control which was again supported by alteration in few marker genes and proteins of autism. The model also shows a rescue of behavioural despair with positive control drugs. The model shows robust parameters to study behavior, molecular mechanism and drug screening approach in a single frame. Thus we postulate that our 7 days zebrafish larval model for autism can help in high throughput screening of new molecules on autism.

Keywords: autism, zebrafish, valproic acid, neurodevelopment, behavioral assay

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Authors: A. Zurraini, Syed Alwi Sar, H. Helmy, H. Nazeefah

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Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ’s reliability and validity. Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach’s alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). The result showed that the overall Cronbach’s alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach’s alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). Pearson correlation coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong, positive correlation between the two variables, r = 0.992, N=160, P <0.001. The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Keywords: Early Dementia Questionnaire (EDQ), screening, primary care, construct validity

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Authors: Afentoula Mavrodi, Andreas Georgiou, Georgios Tsiotras, Vassilis Aletras

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Placing a monetary value on a quality-adjusted-life-year (QALY) is of utmost importance in economic evaluation. Identifying the population’s preferences is critical in order to understand some of the reasons driving variations in the assigned monetary value. Yet, evidence of the motives behind value assignment to a QALY by the general public is limited. Developing an instrument that would capture the population’s motives could be proven valuable to policy-makers, to guide them in allocating different values to a QALY based on users’ motivations. The aim of this study was to identify the most relevant motives and develop an appropriate instrument to assess them. To design the instrument, we employed: a) the EQ-5D-3L tool to assess participants’ current health status, and b) the Willingness-to-Pay (WTP) approach, within the Contingent Valuation (CV) Method framework, to elicit the monetary value. Advancing the open-ended approach adopted to assess solely protest bidders’ motives; a variety of follow-up item-specific statements were designed (deductive approach), aiming to evaluate motives of both protest bidders and participants willing to pay for the hypothetical treatment under consideration. The initial design of the survey instrument was the outcome of an extensive literature review. This instrument was revised based on 15 semi-structured interviews that took place in September 2018 and a pilot study held during two months (October-November) in 2018. Individuals with different educational, occupational and economical backgrounds and adequate verbal skills were recruited to complete the semi-structured interviews. The follow-up motivation statements of both protest bidders and those willing to pay were revised and rephrased after the semi-structured interviews. In total 4 statements for protest bidders and 3 statements for those willing to pay for the treatment were chosen to be included in the survey tool. Using the CATI (Computer Assisted Telephone Interview) method, a randomly selected sample of 97 persons living in Thessaloniki, Greece, completed the questionnaire on two occasions over a period of 4 weeks. Based on pilot study results, a test-retest reliability assessment was performed using the intra-class correlation coefficient (ICC). All statements formulated for protest bidders showed acceptable reliability (ICC values of 0.84 (95% CI: 0.67, 0.92) and above). Similarly, all statements for those willing to pay for the treatment showed high reliability (ICC values of 0.86 (95% CI: 0.78, 0.91) and above). Overall, the instrument designed in this study was reliable with regards to the item-specific statements assessing participants’ motivation. Validation of the instrument will take place in a future study. For a holistic WTP per QALY instrument, participants’ motivation must be addressed broadly. The instrument developed in this study captured a variety of motives and provided insight with regards to the method through which the latter are evaluated. Last but not least, it extended motive assessment to all study participants and not only protest bidders.

Keywords: contingent valuation method, instrument, motives, quality-adjusted life-year, willingness-to-pay

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Authors: Ahmed Al Ansari, Khalid Al Khalifa

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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

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Authors: Zhen Ye, Maryam Zaroudi, Elizabeth Aisenbrey, Nicolynn E. Davis, Peng Gao

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Nanoparticles have been used as drug delivery systems in the treatment of life-threatening diseases for decades, but traditional formulation development methods are time consuming and labor intensive. Millipore Sigma has developed a platform¬¬– NanoFabTxTM¬¬– for rapid and reproducible formulation development and screening to ensure consistentnanoparticle characteristics. Reproducible and precise control of the development process for a range of nanoparticle formulations accelerates the introduction of novel formulations to the clinic.

Keywords: Bio platform, Formulation development, NanoFabTxTM, Drug delivery

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Authors: Stelios A. Mitilineos, Nicolas-Alexander Tatlas, Georgia Korompili, Lampros Kokkalas, Stelios M. Potirakis

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Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is a widespread chronic disease that mostly remains undetected, mainly due to the fact that it is diagnosed via polysomnography which is a time and resource-intensive procedure. Screening the disease’s symptoms at home could be used as an alternative approach in order to alert individuals that potentially suffer from OSAHS without compromising their everyday routine. Since snoring is usually linked to OSAHS, developing a snore detector is appealing as an enabling technology for screening OSAHS at home using ubiquitous equipment like commodity microphones (included in, e.g., smartphones). In this context, this study developed a snore detection tool and herein present the approach and selection of specific sound features that discriminate snoring vs. environmental sounds, as well as the performance of the proposed tool. Furthermore, a Real-Time Snore Detector (RTSD) is built upon the snore detection tool and employed in whole-night sleep sound recordings resulting to a large dataset of snoring sound excerpts that are made freely available to the public. The RTSD may be used either as a stand-alone tool that offers insight to an individual’s sleep quality or as an independent component of OSAHS screening applications in future developments.

Keywords: obstructive sleep apnea hypopnea syndrome, apnea screening, snoring detection, machine learning, neural networks

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Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Since about two decades, the Algerian government created a new instrument in the field of its fiscal policy, which is the FRR (Fonds de Régulation des Recettes). The FRR is a sovereign fund, which the initial role was saving the surplus generated by the fixation of a referential oil price to establish the state budget in the aim equilibrium between budgetary incomes and public expenditures. After a while, the government turns to use this instrument in boosting the public investment more than keeping for funding a deficit budget in periods of crisis. This lead to ask some justified questions about the efficiency of this sovereign fund and its real role.

Keywords: FRR sovereign fund, public expenditures, public investment, efficiency

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Authors: Rebecca Lynn

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The successful inclusion of students with disabilities depends upon many factors, including the collaboration between general and special education teachers for meeting student learning goals as outlined in the Individualized Education Plan (IEP). However, Individualized Education Plans do not provide sufficient information on accommodations and modifications for the variety of general education contexts and content areas in which a student may participate. In addition, general and special education teachers lack observation skills and tools for gathering essential information about the strengths and needs of students with disabilities in relation to general education instruction and classrooms. More research and tools are needed for planning adaptations that increase access to content in general education classrooms. This paper will discuss the outcomes of a qualitative field-based study of a structured observation instrument used for gathering information on student strengths and needs in relation to social, academic and regulatory expectations during instruction in general education classrooms. The study explores the following questions: To what extent does the observation structure and instrument increase collaborative planning of adaptations in general education classrooms for students with disabilities? To what extent does the observation structure and instrument change pedagogical practices and collaboration in general education classrooms for fostering successful inclusion? A hypothesis of this study was that use of the instrument in the context of lessons and in collaborative debriefing would increase awareness and use of meaningful adaptations, and lead to universal design in the planning of instruction. A finding of the study is a shift from viewing students with disabilities as passive participants to a more pedagogical inclusion as teachers developed skills in observation and created content/context-specific adaptations for students with disabilities in the general education classroom.

Keywords: adaptations, collaboration, inclusion, observations

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Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Mary Kiviiri Nakawuka, Mary Namugalu, Andrew Otiti

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BACKGROUND Cervical cancer is the fourth most common cancer in women and seventh overall among all cancers worldwide. It accounts for about 7.5% of all female-cancer deaths with 85% occurring in low and middle-income countries and the first most common female cancer in women aged 15 to 44 years in Uganda with an annual number of new cases at 3,915 and 2,275 annual number of cervical cancer deaths in 2012 (ICO INFORMATION CENTRE ON HPV AND CANCER, 2017).Despite the available free cervical cancer screening services whose uptake has been documented to improve the chances of successful treatment of pre-cancers and cancers among women of reproductive age, there is a low uptake of these services thus we sought to examine the uptake of cervical cancer services and associated factors among women of reproductive age (25-49) attending the ART clinic of KISWA HCII in Kampala, Uganda METHODS The research was carried out in the ART clinic of KISWA HCII among 385 participants. An analytical, cross-sectional study with quantitative methods of data collection was used. The study adopted a non-probability convenience sampling method to select participants. Quantitative data was collected through structured questionnaires. RESULTS 72.2% of the participants were found to have been screened for cervical cancer. 36 % of the screened women had a positive HPV or VIA result ,59.2% of the screened women had a negative HPV or VIA result and 4.8% had an invalid HPV test result. Only 39.5% of the participants had adequate overall knowledge about cervical cancer, more than a third of the participants (50%) had moderate or low knowledge and minority of them (10.5%) had no knowledge. There was no significant association between the uptake of cervical cancer screening services among participants and their socio-demographic characteristics. CONCLUSIONS Although majority of the women surveyed had been screened for cervical cancer, a comparatively large number of participants had inadequate knowledge about cervical cancer and therefore there is still need to continue teaching about cervical cancer and this may include education campaigns, improvements to the accessibility and convenience of the screening services.

Keywords: cervical cancer uptake, cervical cancer screening, women of reproductive age., cervical cancer knowledge

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Authors: Fernanda M. Bastos, Teógenes A. da Silva

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Extrapolation chambers were designed to be used as primary standard dosimeter for measuring absorbed dose in a medium in beta radiation and low energy x-rays. The International Organization for Standardization established series of reference x-radiation for calibrating and determining the energy dependence of dosimeters that are to be reproduced in metrology laboratories. Standardization of the low energy x-ray beams with tube potential lower than 30 kV may be affected by the instrument used for dosimetry. In this work, parameters of a 23392 model PTW extrapolation chamber were determined aiming its use in low energy x-ray beams as a reference instrument.

Keywords: extrapolation chamber, low energy x-rays, x-ray dosimetry, X-ray metrology

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Authors: V. Shapaval, N. K. Afseth, D. Tzimorotas, A. Kohler

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Globally there is a dramatic increase in the demand for food, energy, materials and clean water since natural resources are limited. As a result, industries are looking for ways to reduce rest materials and to improve resource efficiency. Microorganisms have a high potential to be used as bio factories for the production of primary and secondary metabolites that represent high-value bio-products (enzymes, polyunsaturated fatty acids, bio-plastics, glucans, etc.). In order to find good microbial producers, to design suitable substrates from food rest materials and to optimize fermentation conditions, rapid analytical techniques for quantifying target bio products in microbial cells are needed. In the EU project FUST (R4SME, Fp7), we have developed a fully automated high-throughput FUST system based on micro-cultivation and FTIR spectroscopy that facilitates the screening of microorganisms, substrates and fermentation conditions for the optimization of the production of different high-value metabolites (single cell oils, bio plastics). The automated system allows the preparation of 100 samples per hour. Currently, The FUST system is in use for screening of filamentous fungi in order to find oleaginous strains with the ability to produce polyunsaturated fatty acids, and the optimization of cheap substrates, derived from food rest materials, and the optimization of fermentation conditions for the high yield of single cell oil.

Keywords: FTIR spectroscopy, FUST system, screening, biotechnology

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Authors: Yagya Raj Pandeya, Joonwhoan Lee

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The dynamic behavior of music and video makes it difficult to evaluate musical instrument playing in a video by computer system. Any television or film video clip with music information are rich sources for analyzing musical instruments using modern machine learning technologies. In this research, we integrate the audio and video information sources using convolutional neural network (CNN) and pass network learned features through recurrent neural network (RNN) to preserve the dynamic behaviors of audio and video. We use different pre-trained CNN for music and video feature extraction and then fine tune each model. The music network use 2D convolutional network and video network use 3D convolution (C3D). Finally, we concatenate each music and video feature by preserving the time varying features. The long short term memory (LSTM) network is used for long-term dynamic feature characterization and then use late fusion with generalized mean. The proposed network performs better performance to recognize the musical instrument using audio-video multimodal neural network.

Keywords: multimodal, 3D convolution, music-video feature extraction, generalized mean

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Authors: Shu-Min Tsao, Chung-Ming Lo, Shao-Chun Chen

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Most diabetes patients tend to suffer from its complication of retina diseases. Therefore, early detection and early treatment are important. In clinical examinations, using color fundus image was the most convenient and available examination method. According to the exudates appeared in the retinal image, the status of retina can be confirmed. However, the routine screening of diabetic retinopathy by color fundus images would bring time-consuming tasks to physicians. This study thus proposed a computer-aided exudate diagnosis for the screening of diabetic retinopathy. After removing vessels and optic disc in the retinal image, six quantitative features including region number, region area, and gray-scale values etc… were extracted from the remaining regions for classification. As results, all six features were evaluated to be statistically significant (p-value < 0.001). The accuracy of classifying the retinal images into normal and diabetic retinopathy achieved 82%. Based on this system, the clinical workload could be reduced. The examination procedure may also be improved to be more efficient.

Keywords: computer-aided diagnosis, diabetic retinopathy, exudate, image processing

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Authors: Wafa Al Jabri

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Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.

Keywords: premarital screening, success, effectiveness, and genetic blood disorders

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