Search results for: effective outcome

Authors: Bindhu Lal, Karnika Kochal

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Clayey soil contains clay minerals with traces of metal oxides and organic matter, which exhibits properties like low drainage, high plasticity, and shrinkage. To overcome these issues, various soil reinforcement techniques are used to elevate the stiffness, water tightness, and bearing capacity of the soil. Such techniques include cementation, bituminization, freezing, fiber inclusion, geo-synthetics, nailing, etc. Reinforcement of soil with fibers has been a cost-effective solution to soil improvement problems. An experimental study was undertaken involving the inclusion of cotton waste fibers in clayey soil as reinforcement with different fiber contents (1%, 1.5%, 2%, and 2.5% by weight) and analyzing its effects on the unconfined compressive strength of the soil. Two categories of soil were taken, comprising of natural clay and clay mixed with 5% sodium bentonite by weight. The soil specimens were subjected to proctor compaction and unconfined compression tests. The validated outcome shows that fiber inclusion has a strikingly positive impact on the compressive strength and axial strain at failure of the soil. Based on the commendatory results procured, compressive strength was found to be directly proportional to the fiber content, with the effect being more pronounced at lower water content.

Keywords: bentonite clay, clay, cotton fibers, unconfined compressive strength

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Authors: Nureni Asafe Yekini, Olawale Nasiru Lawal, Bola Dada, Gabriel Adeyemi Okunlola

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This study is focused on the strengths and challenges associated with using the online social network as a rapidly evolving medium in marketing tourism services and businesses among the youths in Nigeria. The paper examines the Nigerian tourists’ attitude, mainly towards three aspects: application of Internet for travel and tourism; usage of online social networks in sharing travel and tourism experiences; and trust in electronic-media for marketing tourism businesses and services. The aim of this research is to determine the level of application of internet tools in marketing tourism businesses and services in Nigeria. This study reports an empirical analysis based on data obtained from a survey among 1004 Nigerian tourists. The outcome confirms the research hypothesis and points to crucial importance of introducing online social network site for marketing tourism businesses and services in Nigeria, and increasing the awareness for Nigeria as a tourist destination. Moreover, the paper strongly recommends the use of online social network as a tool for marketing tourism businesses and services, and the need for identifying effective framework for application of ICT tools in marketing tourism businesses and services in Nigeria at large.

Keywords: tourism business, internet, online social networks, tourism services, ICT

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Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: Ali M. Alsagheir

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Effective teaching is concerned to be one of the research fields of teaching, and its fundamental case is to reach the most successful ways that makes teaching fruitful. Undoubtedly, these methods are common factors between all parties who are concerned with the educational process such as instructors, directors, parents, and others. This study had aimed to recognize the cognitions of physical education supervisors and teachers for conceptions of effective teaching according to the interests theory. A questionnaire was used to collect data of the study; the sample contained 230 teachers and supervisors.The results were ended in: that the average of conceptions of effective teaching expressions for the sample of the study decreases at the progress through stages of teaching development in general. The study showed the absence of statistical indicator between teachers and supervisors at the core of both teaching principals and teaching tasks although the results showed that there are statistical indicators at the core of teaching achievements between supervisors and teachers in favor of supervisors. The study ended in to recommendations which can share in increasing the effectiveness of teaching such as: putting clear and specific standards for the effectiveness of teaching in which teacher's performance is based, constructing practical courses that focus on bringing on both supervisors and teachers with skills and strategies of effectiveness teaching, taking care of children achievement as an important factor and a strong indicator on effectiveness of teaching and learning.

Keywords: concerns theory, effective teaching, physical education, supervisors, teachers

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Authors: Restituto I. Rodelas

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The higher education has adopted the outcomes-based education from K-12. In this approach, the teacher uses any teaching and learning strategies that enable the students to achieve the learning outcomes. The students may be required to exert more effort and figure things out on their own. Hence, outcomes-based students are assumed to be more responsible and more capable of applying the knowledge learned. Another approach that the higher education in the Philippines is starting to adopt from other countries is blended learning. This combination of classroom and fully online instruction and learning is expected to be more effective. Participating in the online sessions, however, is entirely up to the students. Thus, the effect of blended learning on the performance of students in Statistics may be mediated by outcomes-based education. If there is a significant positive mediating effect, then blended learning can be optimized by integrating outcomes-based education. In this study, the sample will consist of four blended learning Statistics classes at Jose Rizal University in the second semester of AY 2015–2016. Two of these classes will be assigned randomly to the experimental group that will be handled using outcomes-based education. The two classes in the control group will be handled using the traditional lecture approach. Prior to the discussion of the first topic, a pre-test will be administered. The same test will be given as posttest after the last topic is covered. In order to establish equality of the groups’ initial knowledge, single factor ANOVA of the pretest scores will be performed. Single factor ANOVA of the posttest-pretest score differences will also be conducted to compare the performance of the experimental and control groups. When a significant difference is obtained in any of these ANOVAs, post hoc analysis will be done using Tukey's honestly significant difference test (HSD). Mediating effect will be evaluated using correlation and regression analyses. The groups’ initial knowledge are equal when the result of pretest scores ANOVA is not significant. If the result of score differences ANOVA is significant and the post hoc test indicates that the classes in the experimental group have significantly different scores from those in the control group, then outcomes-based education has a positive effect. Let blended learning be the independent variable (IV), outcomes-based education be the mediating variable (MV), and score difference be the dependent variable (DV). There is mediating effect when the following requirements are satisfied: significant correlation of IV to DV, significant correlation of IV to MV, significant relationship of MV to DV when both IV and MV are predictors in a regression model, and the absolute value of the coefficient of IV as sole predictor is larger than that when both IV and MV are predictors. With a positive mediating effect of outcomes-base education on the effect of blended learning on student performance, it will be recommended to integrate outcomes-based education into blended learning. This will yield the best learning results.

Keywords: outcome-based teaching, blended learning, face-to-face, student-centered

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Authors: Mojtaba Ghodsi, Hamidreza Ziaifar, Morteza Mohammadzaheri, Payam Soltani

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In this paper, the performance of a medium power (25 kW/25 kHz) hybrid inverter with a reactive transformer is investigated. To analyze the sensitivity of the inverster, the RSM technique is employed to manifest the effective factors in the inverter to minimize current passing through the Insulated Bipolar Gate Transistors (IGBTs) (current stress). It is revealed that the ratio of the axillary inductor to the effective inductance of resonant inverter (N), is the most effective parameter to minimize the current stress in this type of inverter. In practice, proper selection of N mitigates the current stress over IGBTs by five times. This reduction is very helpful to keep the IGBTs at normal temperatures.

Keywords: analytical analysis, hybrid resonant inverter, reactive transformer, response surface method

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Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun

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Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90, and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of elbow flexion and extension task was investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76%, and 0.82% when using muscle relaxation periods of 60, 90, and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity, and knowing the optimal resting period will make the automation more effective.

Keywords: rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue

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

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

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

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Authors: Habsah Mohamad Sabli, Mohammad Fardillah Wahi

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The main aim of this research study is to better understand and measure students' perceptions towards the effectiveness of mobile learning. This paper reports on the results of a survey of three hundred nineteen students at Polytechnic Mukah Sarawak (PMU) about their perception to the use of mobile technology in education. An analysis of the quantitative survey findings is presented focusing on the ramification for mobile-learning (m-learning) practices in higher learning and teaching environments. In this paper we present our research findings about the level of perception and gender correlations with perceived ease of use and perceived usefulness using M-Learning in learning activities among students in Polytechnic Mukah (PMU). Based on gender respondent, were 150 female (47.0%) and 169 male (53.0%). The survey findings further revealed that perception of students are in moderately high and agree for using m-learning. The perceived ease of use and perceived usefulness is significant with weak correlations between students to adapt m-learning for active learning activities. The outcome of this research can benefit the decision makers of higher institution in Mukah Sarawak regard to way to enhance m-learning and promote effective teaching and learning activities as well as strengthening the quality of learning delivery.

Keywords: M-learning, student attitudes, student perception, mobile technology

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Authors: Olajumoke Elizabeth Olawale-Olakunle

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This research examined effective event development on the sustainability of tourism in Lagos State. The objectives were to ascertain the implication of effective event development on cost, environmental innovations, opportunity for participants, job creation and working conditions. Also, there was a focus on employee participation and the sustainability of the tourism industry. However, the primary data were obtained via the use of structured questionnaire administered to the selected respondents. Simple random sampling was used to select the respondents, using the Yaro Yame formula. The formulated hypothesis was tested using Analysis of Variance (ANOVA) and Non-parametric chi-square. From the tests conducted, the results showed that effective event development has helped to reduce costs, bring about environmental innovations, offer unique opportunity among event participants, create jobs and promote better working conditions, and the influence it has on employee participation affects the sustainability of the tourism industry. Based on these results, it was concluded that effective event development helps to achieve sustainability in the tourism industry by reducing costs, ensuring efficient use of tourism resources and offers a unique opportunity among event participants. It was, therefore, recommended that events should be developed in such a way that it can help to reduce cost and help leverage the financial burdens of participants and stakeholders, thereby, achieving sustainability in the tourism industry.

Keywords: tourism, hospitality, industry, development

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Authors: S. O. Uwaifo

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The paper examines the pivotal role of the library in university education through the provision of a wide range of information materials (print and non- print) required for the teaching, learning and research activities of the university. However certain impediments to the effectiveness of Nigerian university libraries, such as financial constraints, high foreign exchange, global disparities in accessing the internet, lack of local area networks, erratic electric power supply, absence of ICT literacy, poor maintenance culture, etc., were identified. Also, the necessity of repositioning Nigerian university libraries for effective information provision and delivery was stressed by pointing out their dividends, such as users’ access to Directory of Open Access Journals (DOAJ), Online Public Access Catalogue (OPAC), Institutional Repositories, Electronic Document Delivery, Social Media Networks, etc. It therefore becomes necessary for the libraries to be repositioned by way of being adequately automated or digitized for effective service delivery, in this age of globalization. Based on the identified barriers by this paper, some recommendations were proffered.

Keywords: repositioning, Nigerian university libraries, effective information provision and delivery, globalization

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Authors: Christophe Spaas, Lies Pottel, Joke De Ceulaer, Johan Abeloos, Philippe Lamoral, Tom De Backer, Calix De Clercq

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We aimed to evaluate the accuracy of an in-house developed low-cost computer-assisted surgery (CAS) protocol for osseous free flap mandibular reconstruction. All patients who underwent primary or secondary mandibular reconstruction with a free (solely or composite) osseous flap, either a fibula free flap or iliac crest free flap, between January 2014 and December 2017 were evaluated. The low-cost protocol consisted out of a virtual surgical planning, a prebend custom reconstruction plate and an individualized free flap positioning guide. The accuracy of the protocol was evaluated through comparison of the postoperative outcome with the 3D virtual planning, based on measurement of the following parameters: intercondylar distance, mandibular angle (axial and sagittal), inner angular distance, anterior-posterior distance, length of the fibular/iliac crest segments and osteotomy angles. A statistical analysis of the obtained values was done. Virtual 3D surgical planning and cutting guide design were performed with Proplan CMF® software (Materialise, Leuven, Belgium) and IPS Gate (KLS Martin, Tuttlingen, Germany). Segmentation of the DICOM data as well as outcome analysis were done with BrainLab iPlan® Software (Brainlab AG, Feldkirchen, Germany). A cost analysis of the protocol was done. Twenty-two patients (11 fibula /11 iliac crest) were included and analyzed. Based on voxel-based registration on the cranial base, 3D virtual planning landmark parameters did not significantly differ from those measured on the actual treatment outcome (p-values >0.05). A cost evaluation of the in-house developed CAS protocol revealed a 1750 euro cost reduction in comparison with a standard CAS protocol with a patient-specific reconstruction plate. Our results indicate that an accurate transfer of the planning with our in-house developed low-cost CAS protocol is feasible at a significant lower cost.

Keywords: CAD/CAM, computer-assisted surgery, low-cost, mandibular reconstruction

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Authors: Yazan Khalid Abed-Allah Migdadi

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The aim of this study is identifying the effective operations competitive advantages of mobile phone service providers across countries. All Arab countries in the Middle East region were surveyed except Syria, and 27 out of 31 service providers were surveyed. Data collected from corporations’ annual reports, websites and other professional institutions published sources. Multiple linear regression analysis test was used to identify the relationship between operations competitive advantages and market share. The effective operations competitive advantages were; diversity of offers and service accessibility

Keywords: competitive advantage, mobile telecommunication operations, Middle East, service provider

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Authors: Chao Jen-Chih, Hsu Kuo-Wei

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Climate change and natural disasters take effect on urban development. It has been discussed urban renewals can prevent natural disasters. Integrating green infrastructure and urban renewals may have great effect on adapting the impact of climate change. To highlight the economic value of green infrastructure development on urban renewals, some strategies need to be carry on to reduce environmental impact. A number of urban renewals studies has been conducted on right transfer, financial risk, urban renewal policy, and public participation. Little research has been devoted on the subject of the economic value of green infrastructure development on urban renewals. The purpose of this study is to investigate the affecting factors on the economic value of green infrastructure development on urban renewals. This study will present the benefits of green infrastructure development and summarize the critical factors of green infrastructure develop on urban renewals for real essence and non-real essence on economic value from literature. Our results indicate that factors of housing price, land value, floor area incentive, and facilitation of the construction industry affect the outcome of real essence economic value. Factors of enhancement of urban disaster prevention, improvement of urban environment and landscape, crime reduction, climate control, pollution reduction, biological diversity, health impacts, and leisure space affects the outcome of non-real essence economic value.

Keywords: economic value, green infrastructure, urban renewals, urban development

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Authors: Alexander Zibenberg, Rima’a Da’As

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According to the author’s knowledge, individuals are naturally inclined to classify people as leaders and followers. Individuals utilize cognitive structures or prototypes specifying the traits and abilities that characterize the effective leader (implicit leadership theories) and effective follower in an organization (implicit followership theories). Thus, the present study offers insights into understanding how teachers' personal values (self-enhancement and self-transcendence) explain the preference for styles of effective leader (i.e., principal) and assumptions about the traits and behaviors that characterize effective followers (i.e., student). Beyond the direct effect on perceptions of effective types of leader and follower, the present study argues that values may also interact with organizational and personal contexts in influencing perceptions. Thus authors suggest that teachers' managerial position may moderate the relationships between personal values and perception of the effective leader and follower. Specifically, two key questions are addressed in the present research: (1) Is there a relationship between personal values and perceptions of the effective leader and effective follower? and (2) Are these relationships stable or could they change across different contexts? Two hundred fifty-five Israeli teachers participated in this study, completing questionnaires – about the effective student and effective principal. Results of structural equations modeling (SEM) with maximum likelihood estimation showed: first: the model fit the data well. Second: researchers found a positive relationship between self-enhancement and anti-prototype of the effective principal and anti-prototype of the effective student. The relationship between self-transcendence value and both perceptions were found significant as well. Self-transcendence positively related to the way the teacher perceives the prototype of the effective principal and effective student. Besides, authors found that teachers' managerial position moderates these relationships. The article contributes to the literature both on perceptions and on personal values. Although several earlier studies explored issues of implicit leadership theories and implicit followership theories, personality characteristics (values) have garnered less attention in this matter. This study shows that personal values which are deeply rooted, abstract motivations that guide justify or explain attitudes, norms, opinions and actions explain differences in perception of the effective leader and follower. The results advance the theoretical understanding of the relationship between personal values and individuals’ perceptions in organizations. An additional contribution of this study is the application of the teacher's managerial position to explain a potential boundary condition of the translation of personal values into outcomes. The findings suggest that through the management process in the organization, teachers acquire knowledge and skills which augment their ability (beyond their personal values) to predict perceptions of ideal types of principal and student. The study elucidates the unique role of personal values in understanding an organizational thinking in organization. It seems that personal values might explain the differences in individual preferences of the organizational paradigm (mechanistic vs organic).

Keywords: implicit leadership theories, implicit followership theories, organizational paradigms, personal values

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Authors: Ahmed Mostafa, Mohamed Mahmoud, Nesreen H. Hafez, Mohamed Fahim

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This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

Keywords: ductal carcinoma in situ, surgical treatment, radiotherapy, breast conserving therapy, hormonal treatment

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Authors: Sergei P. Efimov

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The anomalous magnetic moment of the electron is calculated by introducing the effective mass of the virtual part of the electron structure. In this case, the anomalous moment is inversely proportional to the effective mass Meff, which is shown to be a linear combination of the neutron, proton, and electrostatic electron field masses. The spin of a rotating structure is assumed to be equal to 3/2, while the spin of a 'bare' electron is equal to unity, the resultant spin being 1/2. A simple analysis gives the coefficients for a linear combination of proton and electron masses, the approximation precision giving here nine significant digits after the decimal point. The summand proportional to α² adds four more digits. Thus, the conception of the effective mass Meff leads to the formula for the total magnetic moment of the electron, which is accurate to fourteen digits. Association with the virtual beta-decay reaction and possible reasons for simplicity of the derived formula are discussed.

Keywords: anomalous magnetic moment of electron, comparison with quantum electrodynamics. effective mass, fifteen significant figures, proton and neutron masses

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Authors: Supunmali Ahangama, Danny Chiang Choon Poo

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Health analytics (HA) is used in healthcare systems for effective decision-making, management, and planning of healthcare and related activities. However, user resistance, the unique position of medical data content, and structure (including heterogeneous and unstructured data) and impromptu HA projects have held up the progress in HA applications. Notably, the accuracy of outcomes depends on the skills and the domain knowledge of the data analyst working on the healthcare data. The success of HA depends on having a sound process model, effective project management and availability of supporting tools. Thus, to overcome these challenges through an effective process model, we propose an HA process model with features from the rational unified process (RUP) model and agile methodology.

Keywords: agile methodology, health analytics, unified process model, UML

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Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

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Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

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Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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Authors: O. Nkwonta, B. Dzwairo, F. Otieno, J. Adeyemo

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The effective management of water resources is of great importance to ensure the supply of water resources to support changing water requirements over a selected planning horizon and in a sustainable and cost-effective way. Essentially, the purpose of the water resources planning process is to balance the available water resources in a system with the water requirements and losses to which the system is subjected. In such situations, water resources yield and planning model can be used to solve those difficulties. It has an advantage over other models by managing model runs, developing a representative system network, modelling incremental sub-catchments, creating a variety of standard system features, special modelling features, and run result output options.

Keywords: complex, water resources, planning, cost effective, management

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Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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Authors: Tarun Jain, Lovnish Gupta, Soumen Basu

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Organic pollutants like phenols and organic dyes present in industrial waste water are posing a hazardous threat to aquatic ecosystem. Several measures have been adopted for the neutralization and photodecomposition of these harmful organic moieties, among these semiconductor photocatalysis has been provided a major thrust after the discovery of Honda-Fujishema effect. Present study demonstrates the adsorption of TiO2- P25 in nano size (~36 nm) on cement balls for effective photodegradation of Alizarin and penta chlorophenol (PCP) under UV light illumination. Triton-X was used as a stabilizer for effective adsorption of TiO2 on cement balls (TCB) followed by calcination at ~300oC for 4 h. The TCB’s were dispersed randomly in a self designed reactor for phototcatalytic performance as shown in scheme 1. The change in concentration of alizarin and PCP was observed under UV-Vis spectroscopy, PCP was detoxified within 40 min while alizarin photodecomposed within 15 min of UV light irradiation. Taking into consideration the go green slogan and future prospective this technique can be also utilized under visible light and on mass scale because this is an effective tool for environmental remediation and waste water treatment.

Keywords: organic pollutants, TiO2 cement balls, photodegradation, UV light irradiation

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Authors: Noritaka Shigei, Kazuto Matsumoto, Yoshiki Nakashima, Hiromi Miyajima

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Although Mobile Wireless Sensor Networks (MWSNs), which consist of mobile sensor nodes (MSNs), can cover a wide range of observation region by using a small number of sensor nodes, they need to construct a network to collect the sensing data on the base station by moving the MSNs. As an effective method, the network construction method based on Virtual Rails (VRs), which is referred to as VR method, has been proposed. In this paper, we propose two types of effective techniques for the VR method. They can prolong the operation time of the network, which is limited by the battery capabilities of MSNs and the energy consumption of MSNs. The first technique, an effective arrangement of VRs, almost equalizes the number of MSNs belonging to each VR. The second technique, an adaptive movement method of MSNs, takes into account the residual energy of battery. In the simulation, we demonstrate that each technique can improve the network lifetime and the combination of both techniques is the most effective.

Keywords: mobile sensor node, relay of sensing data, residual energy, virtual rail, wireless sensor network

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Authors: Roopali Kulkarni, Yuliya Khrypko

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A major problem in educational digital game design is that game developers are often focused on maintaining the fun and playability of an educational game, whereas educators are more concerned with the learning aspect of the game rather than its entertaining characteristics. There is a clear need to understand what key aspects of digital learning games make them an effective learning medium in tertiary education. Through a systematic literature review and content analysis, this paper identifies, evaluates, and summarizes twenty-three key attributes of digital games used in tertiary education and presents a summary digital game-based learning (DGBL) model for designing and evaluating an educational digital game of any genre that promotes effective learning in tertiary education. The proposed solution overcomes limitations of previously designed models for digital game evaluation, such as a small number of game attributes considered or applicability to a specific genre of digital games. The proposed DGBL model can be used to assist game designers and educators with creating effective and engaging educational digital games for the tertiary education curriculum.

Keywords: DGBL model, digital games, educational games, game-based learning, tertiary education

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Authors: Neha Singh

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Background: Nowadays, the nanoparticle is gaining unexceptional attention in targeted drug delivery. But before proceeding to this episode of accomplishment, the journey and closure of these nanoparticles inside the cells should be disentangle. Being foreign for the cells, nanoparticles will easily getcleared off without any effective outcome. As the cancer cells withhold these nanoparticles for a longer period of time, more will be the drug’s effect. Chlorpromazine is a cationic amphiphilic drug which is believed to inhibit clathrin-coated pit formation by a reversible translocation of clathrin and its adapter proteins from the plasma membrane to intracellular vesicles. Chlorpromazine has a role in increasing the retention of nanoparticles in cancer cells. The mechanism of action how this small molecule increases the retention of nanoparticles is still uncovered. Method: Polymeric nanoparticle (PLGA) with Cyanine3.5 dye were synthesized by solvent evaporation method and characterized for size and zeta potential. FTIR was also done. Pulse and chase studies with and without inhibitor were done to check the retention of nanoparticle using fluorescence microscopy. Mean fluorescence intensity was measured by ImageJ software. Results: Increased retention of nanoparticle with inhibitor was observed in both pulse and chase studies. Conclusion: Our results demonstrate that by repurposing these small molecule inhibitor, we can increase the retention of nanoparticle at the targeted site.

Keywords: nanoparticle, endocytosis, clathrin inhibitor, cancer cell

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Authors: Sahar Navabakhsh, Rokia Raslan, Yair Schwartz

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Decision-making on regeneration of housing estates, whether to refurbish or re-build, has been mostly triggered by economic factors. To enable sustainable growth, it is vital that environmental and social impacts of different scenarios are also taken into account. The methodology used to include all the three sustainable development pillars is called Life Cycle Sustainability Assessment (LCSA), which comprises of Life Cycle Assessment (LCA) for the assessment of environmental impacts of buildings. Current practice of LCA is regularly conducted post design stage and by sustainability experts. Not only is undertaking an LCA at this stage less effective, but issues such as the limited scope for the definition and assessment of environmental impacts, the implication of changes in the system boundary and the alteration of each of the variable metrics, employment of different Life Cycle Impact Assessment Methods and use of various inventory data for Life Cycle Inventory Analysis can result in considerably contrasting results. Given the niche nature and scarce specialist domain of LCA of buildings, the majority of the stakeholders do not contribute to the generation or interpretation of the impact assessment, and the results can be generated and interpreted subjectively due to the mentioned uncertainties. For an effective and democratic assessment of environmental impacts, different stakeholders, and in particular the community and design team should collaborate in the process of data collection, assessment and analysis. This paper examines and evaluates a participatory approach to LCSA through the analysis of a case study of a housing estate in South West London. The study has been conducted throughout tier-based collaborative methods to collect and share data through surveys and co-design workshops with the community members and the design team as the main stakeholders. The assessment of lifecycle impacts is conducted throughout the process and has influenced the decision-making on the design of the Community Plan. The evaluation concludes better assessment transparency and outcome, alongside other socio-economic benefits of identifying and engaging the most contributive stakeholders in the process of conducting LCSA.

Keywords: life cycle assessment, participatory LCA, life cycle sustainability assessment, participatory processes, decision-making, housing estate regeneration

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Authors: Petr Daniel Kovarik, Matt Kennedy, James Adams, Ajay Wilson, Andy Burns, Charles Kelly, Malcolm Jackson, Rahul Patil, Shahid Iqbal

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Introduction: Osteoradionecrosis (ORN) is a recognised toxicity of radiotherapy (RT) for head and neck cancer (HNC). Existing literature lacks any generally accepted definition and staging system for this toxicity. Objective: The objective is to analyse the outcome of the surgical and nonsurgical treatments of ORN. Material and Method: Data on 2303 patients treated for HNC with radical or adjuvant RT or RT-chemotherapy from January 2010 - December 2021 were retrospectively analysed. Median follow-up to the whole group of patients was 37 months (range 0–148 months). Results: ORN developed in 185 patients (8.1%). The location of ORN was as follows; mandible=170, maxilla=10, and extra oral cavity=5. Multiple ORNs developed in 7 patients. 5 patients with extra oral cavity ORN were excluded from treatment analysis as the management is different. In 180 patients with oral cavity ORN, median follow-up was 59 months (range 5–148 months). ORN healed in 106 patients, treatment failed in 74 patients (improving=10, stable=43, and deteriorating=21). Median healing time was 14 months (range 3-86 months). Notani staging is available in 158 patients with jaw ORN with no previous surgery to the mandible (Notani class I=56, Notani class II=27, and Notani class III=76). 28 ORN (mandible=27, maxilla=1; Notani class I=23, Notani II=3, Notani III=1) healed spontaneously with a median healing time 7 months (range 3–46 months). In 20 patients, ORN developed after dental extraction, in 1 patient in the neomandible after radical surgery as a part of the primary treatment. In 7 patients, ORN developed and spontaneously healed in irradiated bone with no previous surgical/dental intervention. Radical resection of the ORN (segmentectomy, hemi-mandibulectomy with fibula flap) was performed in 43 patients (all mandible; Notani II=1, Notani III=39, Notani class was not established in 3 patients as ORN developed in the neomandible). 27 patients healed (63%); 15 patients failed (improving=2, stable=5, deteriorating=8). The median time from resection to healing was 6 months (range 2–30 months). 109 patients (mandible=100, maxilla=9; Notani I=3, Notani II=23, Notani III=35, Notani class was not established in 9 patients as ORN developed in the maxilla/neomandible) were treated conservatively using a combination of debridement, antibiotics and Pentoclo. 50 patients healed (46%) with a median healing time 14 months (range 3–70 months), 59 patients are recorded with persistent ORN (improving=8, stable=38, deteriorating=13). Out of 109 patients treated conservatively, 13 patients were treated with Pentoclo only (all mandible; Notani I=6, Notani II=3, Notani III=3, 1 patient with neomandible). In total, 8 patients healed (61.5%), treatment failed in 5 patients (stable=4, deteriorating=1). Median healing time was 14 months (range 4–24 months). Extra orally (n=5), 3 cases of ORN were in the auditory canal and 2 in mastoid. ORN healed in one patient (auditory canal after 32 months. Treatment failed in 4 patients (improving=3, stable=1). Conclusion: The outcome of the treatment of ORN remains in general, poor. Every effort should therefore be made to minimise the risk of development of this devastating toxicity.

Keywords: head and neck cancer, radiotherapy, osteoradionecrosis, treatment outcome

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Authors: Shazali Abdulahi

Abstract:

Project planning is the first phase in project life cycle which relates to the use of schedules such as Gantt charts to plan and subsequently report the project progress within the project environment. Likewise, project execution is the third phase in project lifecycle, is the phase where the work of the project must get done correctly and it’s the longest phase in the project lifecycle therefore, they must be effectively communicated, now today Communication has become the crucial element of every organization. During construction project delivery, information needs to be accurately and timely communicating among project stakeholders in order to realize the project objective. Effective communication among stakeholders during construction project delivery is one of the major factors that impact construction project delivery. Therefore, the aim of the research work is to examine the critical factors influencing effective communication among stakeholders on construction project delivery from the perspective of construction professionals (Architects, Builders, Quantity surveyors, and Civil engineers). A quantitative approach was adopted. This entailed the used of structured questionnaire to one (108) construction professionals in public and private organization within dutse metropolis. Frequency, mean, ranking and multiple linear regression using SPSS vision 25 software were used to analyses the data. The results show that Leadership, Trust, Communication tools, Communication skills, Stakeholders involvement, Cultural differences, and Communication technology were the most critical factors influencing effective communication among stakeholders on construction project delivery. The hypothesis revealed that, effective communication among stakeholders has significant effects on construction project delivery. This research work will profit the construction stakeholders in construction industry, by providing adequate knowledge regarding the factors influencing effective communication among stakeholders, so that necessary steps to be taken to improve project performance. Also, it will provide knowledge about the appropriate strategies to employ in order to improve communication among stakeholders.

Keywords: effetive communication, ineffective communication, stakeholders, project delivery

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