Search results for: outcome.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 286

Search results for: outcome.

286 Perinatal Outcome in Cases with Bleeding during First and Early Second Trimester

Authors: S. Chhabra, C. Tickoo, P. Kalra

Abstract:

Background: Bleeding during first half of pregnancy mostly originates from placenta, some abort, others are at risk of complications. Objective: Study was done to know perinatal outcome with bleeding up to 20 weeks in singleton pregnancy. Material Methods: Subjects were 1020, equal controls managed over 2 years, 435 had viable pregnancy at admission, 135 excluded, 300 followed for perinatal outcome, 99 (19.52% up to 10 weeks), 201 (39.18% of 11-20 weeks). Results: Hypertensive disorders occurred in 24% cases of bleeding within 10 weeks, 22% 11-20 weeks 14.79% controls, placenta previa 4% in 10 weeks, 0.9% 11-20 weeks, 0.97% controls, prelabor rupture of membranes in 16%, 7.45% controls. 20% up to 10 weeks, 35% 11-20 weeks, 18% controls had fetal growth restriction, 34.34% up to 10 weeks 30.35% of 11-20 weeks 17.17% controls had preterm births, perinatal mortality rate in study was 118.62, in controls 68.16 (Uneventful pregnancy in 13.52% study, 46.11% controls). Conclusion: Once bleeding occurs, one third continue pregnancy, maternal neonatal outcome gets affected with variations in cases of bleeding within first 10 weeks & 11-20 weeks.

Keywords: First, Second trimester, bleeding, Disorders, Perinatal Outcome.

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285 Visual and Clinical Outcome in Patients with Corneal Lacerations

Authors: Avantika Verma

Abstract:

In industrialized nations, corneal lacerations are one of the most common reason for hospitalization. This study was designed to study visual and clinical outcome in patients presenting with full thickness corneal lacerations in Indian population and to ascertain the impact of various preoperative and operative factors influencing prognosis after repair of corneal lacerations. Males in third decade with injuries at work with metallic objects were common. Lens damage, hyphema, vitreous hemorrhage, retinal detachment and endophthalmitis were seen. All the patients underwent primary repair within first 24 hours of presentation. At 3 months, 74.3% had a good visual outcome. About 5.7% of patients had no perception of light.In conclusion, various demographic and preoperative factors like age, time of presentation, vision at presentation, length of corneal wound, involvement of visual axis, associated ocular features like hyphaema, lenticular changes, vitreous haemorrhage and retinal detachment are significant prognostic indicators for final visual outcome.

Keywords: Cornea, laceration, visual outcome, wound repair.

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284 Regret, Choice, and Outcome

Authors: Olimpia Matarazzo, Lucia Abbamonte

Abstract:

In two studies we challenged the well consolidated position in regret literature according to which the necessary condition for the emergence of regret is a bad outcome ensuing from free decisions. Without free choice, and, consequently, personal responsibility, other emotions, such as disappointment, but not regret, are supposed to be elicited. In our opinion, a main source of regret is being obliged by circumstance out of our control to chose an undesired option. We tested the hypothesis that regret resulting from a forced choice is more intense than regret derived from a free choice and that the outcome affects the latter, not the former. Besides, we investigated whether two other variables – the perception of the level of freedom of the choice and the choice justifiability – mediated the relationships between choice and regret, as well as the other four emotions we examined: satisfaction, anger toward oneself, disappointment, anger towards circumstances. The two studies were based on the scenario methodology and implied a 2 x 2 (choice x outcome) between design. In the first study the foreseen short-term effects of the choice were assessed; in the second study the experienced long-term effects of the choice were assessed. In each study 160 students of the Second University of Naples participated. Results largely corroborated our hypotheses. They were discussed in the light of the main theories on regret and decision making.

Keywords: Choice, outcome, regret.

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283 Marital Interactions in Predicting Treatment Outcome in Panic Disorder with Agoraphobia

Authors: Ghassan El-Baalbaki, Claude Bélanger, Michel Perreault, Steffany J. Fredman, Donald H. Baucom

Abstract:

This study had two goals. First, it investigated marital interaction variables as predictors of treatment outcome in panic disorder with agoraphobia (PDA) in sixty-five couples with one spouse suffering from PDA. Second, it analyzed the impact of PDA improvement, following therapy, on marital interaction patterns of both spouses. The partners were observed during a problem-solving task, before and after treatment. Negative behaviors at the outset of therapy, both in the PDA and the NPDA partners, predicted less improvement at post-test. It also appears that improvement in some PDA symptoms following therapy is linked to increase in the dominant behavior of the NPDA spouse and to an improvement in terms of his intrusiveness.

Keywords: Communication and problem-solving skills, Emotional overinvolvement, Marital relationship, Panic disorder withagoraphobia, Treatment outcome.

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282 Maternal Health Outcome and Economic Growth in Sub-Saharan Africa: A Dynamic Panel Analysis

Authors: Okwan Frank

Abstract:

Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Keywords: Economic growth, maternal mortality, pool mean group, Sub-Saharan Africa.

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281 The Application of Bayesian Heuristic for Scheduling in Real-Time Private Clouds

Authors: Sahar Sohrabi

Abstract:

The emergence of Cloud data centers has revolutionized the IT industry. Private Clouds in specific provide Cloud services for certain group of customers/businesses. In a real-time private Cloud each task that is given to the system has a deadline that desirably should not be violated. Scheduling tasks in a real-time private CLoud determine the way available resources in the system are shared among incoming tasks. The aim of the scheduling policy is to optimize the system outcome which for a real-time private Cloud can include: energy consumption, deadline violation, execution time and the number of host switches. Different scheduling policies can be used for scheduling. Each lead to a sub-optimal outcome in a certain settings of the system. A Bayesian Scheduling strategy is proposed for scheduling to further improve the system outcome. The Bayesian strategy showed to outperform all selected policies. It also has the flexibility in dealing with complex pattern of incoming task and has the ability to adapt.

Keywords: Bayesian, cloud computing, real-time private cloud, scheduling.

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280 Decision Trees for Predicting Risk of Mortality using Routinely Collected Data

Authors: Tessy Badriyah, Jim S. Briggs, Dave R. Prytherch

Abstract:

It is well known that Logistic Regression is the gold standard method for predicting clinical outcome, especially predicting risk of mortality. In this paper, the Decision Tree method has been proposed to solve specific problems that commonly use Logistic Regression as a solution. The Biochemistry and Haematology Outcome Model (BHOM) dataset obtained from Portsmouth NHS Hospital from 1 January to 31 December 2001 was divided into four subsets. One subset of training data was used to generate a model, and the model obtained was then applied to three testing datasets. The performance of each model from both methods was then compared using calibration (the χ2 test or chi-test) and discrimination (area under ROC curve or c-index). The experiment presented that both methods have reasonable results in the case of the c-index. However, in some cases the calibration value (χ2) obtained quite a high result. After conducting experiments and investigating the advantages and disadvantages of each method, we can conclude that Decision Trees can be seen as a worthy alternative to Logistic Regression in the area of Data Mining.

Keywords: Decision Trees, Logistic Regression, clinical outcome, risk of mortality.

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279 Effect of Teaching Games for Understanding Approach on Students- Cognitive Learning Outcome

Authors: Malathi Balakrishnan, Shabeshan Rengasamy, Mohd Salleh Aman

Abstract:

The study investigated the effects of Teaching Games for Understanding approach on students ‘cognitive learning outcome. The study was a quasi-experimental non-equivalent pretest-posttest control group design whereby 10 year old primary school students (n=72) were randomly assigned to an experimental and a control group. The experimental group students were exposed with TGfU approach and the control group with the Traditional Skill approach of handball game. Game Performance Assessment Instrument (GPAI) was used to measure students' tactical understanding and decision making in 3 versus 3 handball game situations. Analysis of covariance (ANCOVA) was used to analyze the data. The results reveal that there was a significant difference between the TGfU approach group and the traditional skill approach group students on post test score (F (1, 69) = 248.83, p < .05). The findings of this study suggested the importance of TGfU approach to improve primary students’ tactical understanding and decision making in handball game.

Keywords: Constructivism, learning outcome, tactical understanding, and Teaching Game for Understanding (TGfU)

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278 Model Canvas and Process for Educational Game Design in Outcome-Based Education

Authors: Ratima Damkham, Natasha Dejdumrong, Priyakorn Pusawiro

Abstract:

This paper explored the solution in game design to help game designers in the educational game designing using digital educational game model canvas (DEGMC) and digital educational game form (DEGF) based on Outcome-based Education program. DEGMC and DEGF can help designers develop an overview of the game while designing and planning their own game. The way to clearly assess players’ ability from learning outcomes and support their game learning design is by using the tools. Designers can balance educational content and entertainment in designing a game by using the strategies of the Business Model Canvas and design the gameplay and players’ ability assessment from learning outcomes they need by referring to the Constructive Alignment. Furthermore, they can use their design plan in this research to write their Game Design Document (GDD). The success of the research was evaluated by four experts’ perspectives in the education and computer field. From the experiments, the canvas and form helped the game designers model their game according to the learning outcomes and analysis of their own game elements. This method can be a path to research an educational game design in the future.

Keywords: Constructive alignment, constructivist theory, educational game, outcome-based education.

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277 Design of a Constant Chord Single-Rotating Propeller using Lock and Goldstein Techniques

Authors: Samrand Rashahmadi, Morteza Abbaszadeh, Sana Hoseyni, Raziyeh Alizadeh

Abstract:

Design of a constant chord propeller is presented in this paper in order to reduce propeller-s design procedure-s costs. The design process was based on Lock and Goldstein-s techniques of propeller design and analysis. In order to calculate optimum chord of propeller, chord of a referential element is generalized as whole blades chord. The design outcome which named CS-X-1 is modeled & analyzed by CFD methods using K-ε: R.N.G turbulence model. Convergence of results of two codes proved that outcome results of design process are reliable. Design result is a two-blade propeller with a total diameter of 1.1 meter, radial velocity of 3000 R.P.M, efficiency above .75 and power coefficient near 1.05.

Keywords: Single rotating propeller, Design, C.F.D. test, constant chord

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276 The Influence of Project-Based Learning and Outcome-Based Education: Interior Design Tertiary Students in Focus

Authors: Omneya Messallam

Abstract:

Technology has been developed dramatically in most of the educational disciplines. For instance, digital rendering subject, which is being taught in both Interior and Architecture fields, is witnessing almost annually updated software versions. A lot of students and educators argued that there will be no need for manual rendering techniques to be learned. Therefore, the Interior Design Visual Presentation 1 course (ID133) has been chosen from the first level of the Interior Design (ID) undergraduate program, as it has been taught for six years continually. This time frame will facilitate sound observation and critical analysis of the use of appropriate teaching methodologies. Furthermore, the researcher believes in the high value of the manual rendering techniques. The course objectives are: to define the basic visual rendering principles, to recall theories and uses of various types of colours and hatches, to raise the learners’ awareness of the value of studying manual render techniques, and to prepare them to present their work professionally. The students are female Arab learners aged between 17 and 20. At the outset of the course, the majority of them demonstrated negative attitude, lacking both motivation and confidence in manual rendering skills. This paper is a reflective appraisal of deploying two student-centred teaching pedagogies which are: Project-based learning (PBL) and Outcome-based education (OBE) on ID133 students. This research aims of developing some teaching strategies to enhance the quality of teaching in this given course over an academic semester. The outcome of this research emphasized the positive influence of applying such educational methods on improving the quality of students’ manual rendering skills in terms of: materials, textiles, textures, lighting, and shade and shadow. Furthermore, it greatly motivated the students and raised the awareness of the importance of learning the manual rendering techniques.

Keywords: Manual renders, outcome-based education, project-based learning, personal competences, and visual presentation.

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275 Fuzzy Logic Approach to Robust Regression Models of Uncertain Medical Categories

Authors: Arkady Bolotin

Abstract:

Dichotomization of the outcome by a single cut-off point is an important part of various medical studies. Usually the relationship between the resulted dichotomized dependent variable and explanatory variables is analyzed with linear regression, probit regression or logistic regression. However, in many real-life situations, a certain cut-off point dividing the outcome into two groups is unknown and can be specified only approximately, i.e. surrounded by some (small) uncertainty. It means that in order to have any practical meaning the regression model must be robust to this uncertainty. In this paper, we show that neither the beta in the linear regression model, nor its significance level is robust to the small variations in the dichotomization cut-off point. As an alternative robust approach to the problem of uncertain medical categories, we propose to use the linear regression model with the fuzzy membership function as a dependent variable. This fuzzy membership function denotes to what degree the value of the underlying (continuous) outcome falls below or above the dichotomization cut-off point. In the paper, we demonstrate that the linear regression model of the fuzzy dependent variable can be insensitive against the uncertainty in the cut-off point location. In the paper we present the modeling results from the real study of low hemoglobin levels in infants. We systematically test the robustness of the binomial regression model and the linear regression model with the fuzzy dependent variable by changing the boundary for the category Anemia and show that the behavior of the latter model persists over a quite wide interval.

Keywords: Categorization, Uncertain medical categories, Binomial regression model, Fuzzy dependent variable, Robustness.

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274 Critical Factors Affecting the Implementation of Total Quality Management in the Construction Industry in U.A.E

Authors: Firas Mohamad Al-Sabek

Abstract:

The purpose of the paper is to examine the most critical and important factor which will affect the implementation of Total Quality Management (TQM) in the construction industry in the United Arab Emirates. It also examines the most effected Project outcome from implementing TQM. A framework was also proposed depending on the literature studies. The method used in this paper is a quantitative study. A survey with a sample of 60 respondents was created and distributed in a construction company in Abu Dhabi, which includes 15 questions to examine the most critical factor that will affect the implementation of TQM in addition to the most effected project outcome from implementing TQM. The survey showed that management commitment is the most important factor in implementing TQM in a construction company. Also it showed that Project cost is most effected outcome from the implementation of TQM. Management commitment is very important for implementing TQM in any company. If the management loose interest in quality then everyone in the organization will do so. The success of TQM will depend mostly on the top of the pyramid. Also cost is reduced and money is saved when the project team implement TQM. While if no quality measures are present within the team, the project will suffer a commercial failure. Based on literature, more factors can be examined and added to the model. In addition, more construction companies could be surveyed in order to obtain more accurate results. Also this study could be conducted outside the United Arab Emirates for further enchantment.

Keywords: Construction project, total quality management, management commitment, cost, theoretical framework.

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273 Antecedent and Outcome of New Product Development in the Leather Industry, Bangkok and Vicinity, Thailand

Authors: Bundit Pungnirund

Abstract:

The purposes of this research were to develop and to monitor the antecedent factors which directly affected the success rate of new product development. This was a case study of the leather industry in Bangkok, Thailand. A total of 350 leather factories were used as a sample group. The findings revealed that the new product development model was harmonized with the empirical data at the acceptable level, the statistic values are: χ2=6.45, df= 7, p-value = .48856; RMSEA = .000; RMR = .0029; AGFI = .98; GFI = 1.00. The independent variable that directly influenced the dependent variable at the highest level was marketing outcome which had a influence coefficient at 0.32 and the independent variables that indirectly influenced the dependent variables at the highest level was a clear organization policy which had a influence coefficient at 0.17, whereas, all independent variables can predict the model at 48 percent.

Keywords: Antecedent, New Product Development, Leather Industry.

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272 Digital Individual Benefit Statement: The Use of a Triangulation Methodology to Design a Digital Platform for Switzerland

Authors: Catherine Equey Balzli

Abstract:

Old age retirement pensions are an important concern among the Swiss but estimating one’s income after retirement is difficult due to the Swiss insurance system’s complexity. This project’s aim is to prepare for developing a digital platform that will allow individuals to plan for retirement in a simplified manner. The main objective of the platform will be to give individuals the tools to check that their savings and retirement benefits will allow them to continue the lifestyle to which they are accustomed once they are retired. The research results from qualitative (focus group) and quantitative (survey) methodologies, recommend the scope and functionalities for a digital platform to be developed. A main outcome is the need to limit the platform’s scope to old-age pension only (excluding survivors’ or disability pensions, for instance). Furthermore, an outcome regarding the functionalities is the proposition of scenarios such as early retirement, changes to income, or modifications to personal status. The development of the digital platform will be a subsequent project.

Keywords: Benefit statement, digital platform, retirement financial planning, social insurances.

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271 The Effect of Facial Expressions on Students in Virtual Educational Environments

Authors: G. Theonas, D. Hobbs, D. Rigas

Abstract:

The scope of this research was to study the relation between the facial expressions of three lecturers in a real academic lecture theatre and the reactions of the students to those expressions. The first experiment aimed to investigate the effectiveness of a virtual lecturer-s expressions on the students- learning outcome in a virtual pedagogical environment. The second experiment studied the effectiveness of a single facial expression, i.e. the smile, on the students- performance. Both experiments involved virtual lectures, with virtual lecturers teaching real students. The results suggest that the students performed better by 86%, in the lectures where the lecturer performed facial expressions compared to the results of the lectures that did not use facial expressions. However, when simple or basic information was used, the facial expressions of the virtual lecturer had no substantial effect on the students- learning outcome. Finally, the appropriate use of smiles increased the interest of the students and consequently their performance.

Keywords: emotion, facial expression, smile, virtual educational environment, virtual learning, virtual lecturer.

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270 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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269 Moving Beyond the Limits of Disability Inclusion: Using the Concept of Belonging Through Friendship to Improve the Outcome of the Social Model of Disability

Authors: Luke S. Carlos A. Thompson

Abstract:

The medical model of disability, though beneficial for the medical professional, is often exclusionary, restrictive and dehumanizing when applied to the lived experience of disability. As a result, a critique of this model was constructed called the social model of disability. Much of the language used to articulate the purpose behind the social model of disability can be summed up within the word inclusion. However, this essay asserts that inclusiveness is an incomplete aspiration. The social model, as it currently stands, does not aid in creating a society where those with impairments actually belong. Rather, the social model aids in lessening the visibility, or negative consequence of, difference. Therefore, the social model does not invite society to welcome those with physical and intellectual impairments. It simply aids society in ignoring the existence of impairment by removing explicit forms of exclusion. Rather than simple inclusion, then, this essay uses John Swinton’s concept of friendship and Jean Vanier’s understanding of belonging to better articulate the intended outcome of the social model—a society where everyone can belong.

Keywords: Belong, community, disability, exclusion, friendship, inclusion.

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268 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

Abstract:

Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, Burns, FLAMES, scoring systems, outcome.

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267 Improvement in Power Transformer Intelligent Dissolved Gas Analysis Method

Authors: S. Qaedi, S. Seyedtabaii

Abstract:

Non-Destructive evaluation of in-service power transformer condition is necessary for avoiding catastrophic failures. Dissolved Gas Analysis (DGA) is one of the important methods. Traditional, statistical and intelligent DGA approaches have been adopted for accurate classification of incipient fault sources. Unfortunately, there are not often enough faulty patterns required for sufficient training of intelligent systems. By bootstrapping the shortcoming is expected to be alleviated and algorithms with better classification success rates to be obtained. In this paper the performance of an artificial neural network, K-Nearest Neighbour and support vector machine methods using bootstrapped data are detailed and shown that while the success rate of the ANN algorithms improves remarkably, the outcome of the others do not benefit so much from the provided enlarged data space. For assessment, two databases are employed: IEC TC10 and a dataset collected from reported data in papers. High average test success rate well exhibits the remarkable outcome.

Keywords: Dissolved gas analysis, Transformer incipient fault, Artificial Neural Network, Support Vector Machine (SVM), KNearest Neighbor (KNN)

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266 Exploring Management of the Fuzzy Front End of Innovation in a Product Driven Startup Company

Authors: Dmitry K. Shaytan, Georgy D. Laptev

Abstract:

In our research we aimed to test a managerial approach for the fuzzy front end (FFE) of innovation by creating controlled experiment/ business case in a breakthrough innovation development. The experiment was in the sport industry and covered all aspects of the customer discovery stage from ideation to prototyping followed by patent application. In the paper we describe and analyze mile stones, tasks, management challenges, decisions made to create the break through innovation, evaluate overall managerial efficiency that was at the considered FFE stage. We set managerial outcome of the FFE stage as a valid product concept in hand. In our paper we introduce hypothetical construct “Q-factor” that helps us in the experiment to distinguish quality of FFE outcomes. The experiment simulated for entrepreneur the FFE of innovation and put on his shoulders responsibility for the outcome of valid product concept. While developing managerial approach to reach the outcome there was a decision to look on product concept from the cognitive psychology and cognitive science point of view. This view helped us to develop the profile of a person whose projection (mental representation) of a new product could optimize for a manager or entrepreneur FFE activities. In the experiment this profile was tested to develop breakthrough innovation for swimmers. Following the managerial approach the product concept was created to help swimmers to feel/sense water. The working prototype was developed to estimate the product concept validity and value added effect for customers. Based on feedback from coachers and swimmers there were strong positive effect that gave high value for customers, and for the experiment – the valid product concept being developed by proposed managerial approach for the FFE. In conclusions there is a suggestion of managerial approach that was derived from experiment.

Keywords: Concept development, concept testing, customer discovery, entrepreneurship, entrepreneurial management, idea generation, idea screening, startup management.

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265 Effect of Open-Ended Laboratory toward Learners Performance in Environmental Engineering Course: Case Study of Civil Engineering at Universiti Malaysia Sabah

Authors: N. Bolong, J. Makinda, I. Saad

Abstract:

Laboratory activities have produced benefits in student learning. With current drives of new technology resources and evolving era of education methods, renewal status of learning and teaching in laboratory methods are in progress, for both learners and the educators. To enhance learning outcomes in laboratory works particularly in engineering practices and testing, learning via handson by instruction may not sufficient. This paper describes and compares techniques and implementation of traditional (expository) with open-ended laboratory (problem-based) for two consecutive cohorts studying environmental laboratory course in civil engineering program. The transition of traditional to problem-based findings and effect were investigated in terms of course assessment student feedback survey, course outcome learning measurement and student performance grades. It was proved that students have demonstrated better performance in their grades and 12% increase in the course outcome (CO) in problem-based open-ended laboratory style than traditional method; although in perception, students has responded less favorable in their feedback.

Keywords: Engineering education, open-ended laboratory, environmental engineering lab.

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264 A Study on the Relation among Primary Care Professionals Serving the Disadvantaged Community, Socioeconomic Status, and Adverse Health Outcome

Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, Jr., James Tyus, Dexter Samuels

Abstract:

During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Keywords: Disadvantaged Community, K-means Cluster Analysis, PLS Path Modeling, Primary care.

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263 Design Systems and the Need for a Usability Method: Assessing the Fitness of Components and Interaction Patterns in Design Systems Using Atmosphere Methodology

Authors: P. Johansson, S. Mardh

Abstract:

The present study proposes a usability test method, Atmosphere, to assess the fitness of components and interaction patterns of design systems. The method covers the user’s perception of the components of the system, the efficiency of the logic of the interaction patterns, perceived ease of use as well as the user’s understanding of the intended outcome of interactions. These aspects are assessed by combining measures of first impression, visual affordance and expectancy. The method was applied to a design system developed for the design of an electronic health record system. The study was conducted involving 15 healthcare personnel. It could be concluded that the Atmosphere method provides tangible data that enable human-computer interaction practitioners to analyze and categorize components and patterns based on perceived usability, success rate of identifying interactive components and success rate of understanding components and interaction patterns intended outcome.

Keywords: atomic design, atmosphere methodology, design system, expectancy testing, first impression testing, usability testing, visual affordance testing

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262 Clique and Clan Analysis of Patient-Sharing Physician Collaborations

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

Abstract:

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

Keywords: Clique, clan, electronic health records, physician collaboration.

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261 Nurse’s Role in Early Detection of Breast Cancer through Mammography and Genetic Screening and Its Impact on Patient's Outcome

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

Abstract:

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

Keywords: Early detection, Genetic Screening, Mammography.

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260 Pre-Malignant Breast Lesions, Methods of Treatment and Outcome

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

Abstract:

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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259 Incidence, Occurrence, Classification and Outcome of Small Animal Fractures: A Retrospective Study (2005-2010)

Authors: L. M. Ben Ali

Abstract:

A retrospective study was undertaken to record the occurrence and pattern of fractures in small animals (dogs and cats) from year 2005 to 2010. A total of 650 cases were presented in small animal surgery unit out of which of 116 (dogs and cats) were presented with history of fractures of different bones. A total of 17.8% (116/650) cases were of fractures which constituted dogs 67% while cats were 23%. The majority of animals were intact. Trauma in the form of road side accident was the principal cause of fractures in dogs whereas as in cats it was fall from height. The ages of the fractured dog ranged from 4 months to 12 years whereas in cat it was from 4 weeks to 10 years. The femoral fractures represented 37.5% and 25% respectively in dogs and cats. Diaphysis, distal metaphyseal and supracondylar fractures were the most affected sites in dog and cats. Tibial fracture in dogs and cats represented 21.5% and 10% while humoral fractures were 7.9% and 14% in dogs and cats respectively. Humoral condyler fractures were most commonly seen in puppies aged 4 to 6 months. Fractured radius-ulna incidence was 19% and 14% in dogs and cats respectively. Other fractures recorded were of lumbar vertebrae, mandible and metacarpals etc. The management comprised of external and internal fixation in both the species. The most common internal fixation technique employed was Intramedullary fixation in long followed by other methods like stack or cross pinning, wiring etc as per findings in the cases. The cast bandage was used majorly as mean for external coaptation. The paper discusses the outcome of the case as per the technique employed.

Keywords: Animal, Fracture, Incidence, Occurrence.

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258 Sperm Identification Using Elliptic Model and Tail Detection

Authors: Vahid Reza Nafisi, Mohammad Hasan Moradi, Mohammad Hosain Nasr-Esfahani

Abstract:

The conventional assessment of human semen is a highly subjective assessment, with considerable intra- and interlaboratory variability. Computer-Assisted Sperm Analysis (CASA) systems provide a rapid and automated assessment of the sperm characteristics, together with improved standardization and quality control. However, the outcome of CASA systems is sensitive to the method of experimentation. While conventional CASA systems use digital microscopes with phase-contrast accessories, producing higher contrast images, we have used raw semen samples (no staining materials) and a regular light microscope, with a digital camera directly attached to its eyepiece, to insure cost benefits and simple assembling of the system. However, since the accurate finding of sperms in the semen image is the first step in the examination and analysis of the semen, any error in this step can affect the outcome of the analysis. This article introduces and explains an algorithm for finding sperms in low contrast images: First, an image enhancement algorithm is applied to remove extra particles from the image. Then, the foreground particles (including sperms and round cells) are segmented form the background. Finally, based on certain features and criteria, sperms are separated from other cells.

Keywords: Computer-Assisted Sperm Analysis (CASA), Sperm identification, Tail detection, Elliptic shape model.

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257 Specific Biomarker Level and Function Outcome Changes in Treatment of Patients with Frozen Shoulder Using Dextrose Prolotherapy Injection

Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

Abstract:

Frozen shoulder (FS) is an insidious, painful condition caused by an inflammatory condition that causes fibrosis of the glenohumeral joint capsule, which causes progressive stiffness and restriction of the active and passive range of motion (ROM) of the shoulder. The studies of FS are still limited. This single-blinded randomized controlled trial involved participants with FS. The study participants were divided into two groups. The Prolotherapy group was the study group, and the Normal Saline (NS) group was the control group. Both groups were given injections at weeks 0, 2, 4, and 6. Matrix Metalloproteinase-1 (MMP-1) and Tissue Inhibitor Metalloproteinase-1 (TIMP-1) were measured at week six and week 12 after the last injection. The Disabilities of The Arm, Shoulder, and Hand (DASH) Score and ROM were measured at weeks 0, 2, 4, and 6 before and after injection and week 12. Comparative analysis was performed using repeated measures Paired T-Test, and data processing to assess correlation was using ANOVA. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolotherapy injection patients in each measurement week (p < 0.05). While the measurement of ROM, each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p < 0.05). Dextrose prolotherapy injection results significantly improved the functional outcome of the shoulder joint and ROM. They did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1, in tissue repair. This study suggests an alternative to injection prolotherapy in FS patients; it has minimal adverse effects and is efficient in time and cost.

Keywords: Frozen Shoulder, ROM, DASH Score, prolotherapy, MMP-1, TIMP-1.

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