How peer assessment could be interactive and effective

In practical courses, students consider teachers’ assessment of various skills to be baseless and unfair. Unfortunately, due to a lack of equipment, only a few students take part in practical skills performance, while the rest of the students remain passive in learning and assessment. In this paper we suggest an original design to use peer assessment as an interactive strategy and examine its efficiency to improve students’ individual skills, teamwork skills and practical performance in an educational technology course. In the study reported on here, a quasi-experimental design was used, which included a sample of 73 female students divided into experimental and control groups. The treatment tools were provided to the experimental group while the assessment tools were applied to both groups before and after the intervention. Data analysis revealed that an interactive peer assessment strategy was effective in improving individual skills, teamwork skills and practical performance. We recommend that this suggested strategy is used widely in practical courses. Keywords: individual skills; interactive peer assessment strategy; peer tutoring; practical performance; teamwork skill

Driving microfluidic flows with three dimensional electrodes.

Most of the structures in submillimeter-scale engineering are created from thin films, making them essentially two-dimensional (2D). Significant work has been done to fabricate 3D structures using self-folding, a deterministic form of self-assembly, and three dimensional lithographic and non-lithographic patterning. The objective of this work is to propose different fabrication and patterning strategies of 3D structures used as pumping electrodes for micro fluidic applications. 3D electrodes drive flows over the whole channel height while 2D electrodes stay near one wall. The first application of the 3D electrodes is mixing chemical or biological samples with reagents for chemical analysis which is one of the most time consuming operations in microfluidic platforms. The mixer used is based on the electrokinetic phenomenon of induced charge electro-osmosis (ICEO). ICEO creates microvortices around polarized posts with gold coated sidewalls, connected to embedded electrodes, by application of alternating current (AC) electric fields. These microvortices around posts help in mixing the two reagents very quickly. These vertical sidewall gold coated posts and embedded electrodes are fabricated using 3D photolithographic patterning and an ion milling fabrication technique. The second application is fast ac electro-osmotic (ACEO) pumps using 3D electrodes. These 3D electrodes dramatically improve the flow rate and frequency range of ACEO pumps over the planar electrodes. A non-photolithographic electrode patterning method is proposed to fabricate such electrodes. The method is based on shadowed evaporation of metal on an insulating substrate. This method is considered to be simple and cost effective compared to others used to create these stepped 3D electrodes. Finally, a self-folding technique is proposed to create out-of plane three dimensional electrodes for ACEO tube pumps. The technique depends on the strain mismatch between two different layered sheets of material. One layer usually has compressive stress, i.e. thermally grown Si02, and the other has relatively tensile stress, i.e. metals. The design is similar to the planar electrodes design in the literature, except as a 3D electrode it interacts with a larger volume of fluid for a more efficient pump

The Effect of Tuberculosis on the Mortality of Cirrhotic Patients: A Population-Based 3-Year Follow-Up Study

[[abstract]]Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis. It is still unknown if TB, like other infectious diseases contributes a poor prognosis in cirrhotic patients. The aim of this study was to investigate the impact of TB on the mortality of cirrhotic patients. National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify 434 cirrhotic patients with new diagnosis of TB between January 1, 2007 and December 31, 2007. The comparison group consisted of 4340 selected cirrhotic patients without TB in the same period by propensity score matching analysis. The 30-day, 90-day, 1-year and 3-year mortalities were 10.1%, 24.2%, 43.1%, and 63% in the TB group, and 7.9%, 15.5%, 31.2%, and 53.4% in the non-TB group. After Cox proportional hazard regression model adjusted by the patients' gender, age, and comorbid disorders, the hazard ratios (HR) in cirrhotic patients with TB for 30-day, 30 to 90-day, 90-day to 1-year, and 1 to 3-year mortalities were 1.33 [95% confidence interval (CI) 0.97-1.83], 1.91 (95% CI 1.45-2.51), 1.46 (95% CI 1.16-1.84), and 1.10 (95% CI 0.88-1.37), compared to the non-TB group. In conclusion, TB is a risk factor for the mortality of cirrhotic patients. The effect focused on the 30-day to 1-year after diagnosis of TB.[[notice]]補正完畢[[journaltype]]國外[[incitationindex]]SCI[[ispeerreviewed]]Y[[booktype]]紙本[[countrycodes]]IN

Effect of Self Care Management on Nursing-Sensitive Patients’ Outcomes after Permanent Pacemaker Implantation

Context: Nursing is striving to build a knowledge base that supports professional practice and improves the quality of care.Aim: This study aimed to evaluate the effect of self-care management guidelines on nursing-sensitive patients' outcomes after permanent pacemaker implantation.Methods: A quasi-experimental design was utilized in this study. A purposive sample of 50 patients was admitted to the cardiac catheterization unit at Ain Shams University Hospital after permanent pacemaker implantation during their follow-up visit. They are divided into two matched groups, study and control groups. Their mean age ±SD was 45.37±5.76, and 48.75±4.27 successively. Patient socio-demographic characteristic and medical data sheet, self-care management level assessment scale, and nursing-sensitive outcomes measuring scale were utilized to achieve the study aim.Results: The study results revealed positive outcomes for patients of the study group compared to the controls and their pre-implementation level of self-care guidelines.Conclusion: The study concludes that implementing self-care management guidelines positively enhances all dimensions of nursing-sensitive patients' outcomes, recommending that it be applied in all cardiac catheterization units and should be updated periodically to enhance self-care management for those patients based on nursing-sensitive outcomes classification

Medical Image Classification using Deep Learning Techniques and Uncertainty Quantification

The emergence of medical image analysis using deep learning techniques has introduced multiple challenges in terms of developing robust and trustworthy systems for automated grading and diagnosis. Several works have been presented to improve classification performance. However, these methods lack the diversity of capturing different levels of contextual information among image regions, strategies to present diversity in learning by using ensemble-based techniques, or uncertainty measures for predictions generated from automated systems. Consequently, the presented methods provide sub-optimal results which is not enough for clinical practice. To enhance classification performance and introduce trustworthiness, deep learning techniques and uncertainty quantification methods are required to provide diversity in contextual learning and the initial stage of explainability, respectively. This thesis aims to explore and develop novel deep learning techniques escorted by uncertainty quantification for developing actionable automated grading and diagnosis systems. More specifically, the thesis provides the following three main contributions. First, it introduces a novel entropy-based elastic ensemble of Deep Convolutional Neural Networks (DCNNs) architecture termed as 3E-Net for classifying grades of invasive breast carcinoma microscopic images. 3E-Net is based on a patch-wise network for feature extraction and image-wise networks for final image classification and uses an elastic ensemble based on Shannon Entropy as an uncertainty quantification method for measuring the level of randomness in image predictions. As the second contribution, the thesis presents a novel multi-level context and uncertainty-aware deep learning architecture named MCUa for the classification of breast cancer microscopic images. MCUa consists of multiple feature extractors and multi-level context-aware models in a dynamic ensemble fashion to learn the spatial dependencies among image patches and enhance the learning diversity. Also, the architecture uses Monte Carlo (MC) dropout for measuring the uncertainty of image predictions and deciding whether an input image is accurate based on the generated uncertainty score. The third contribution of the thesis introduces a novel model agnostic method (AUQantO) that establishes an actionable strategy for optimising uncertainty quantification for deep learning architectures. AUQantO method works on optimising a hyperparameter threshold, which is compared against uncertainty scores from Shannon entropy and MC-dropout. The optimal threshold is achieved based on single- and multi-objective functions which are optimised using multiple optimisation methods. A comprehensive set of experiments have been conducted using multiple medical imaging datasets and multiple novel evaluation metrics to prove the effectiveness of our three contributions to clinical practice. First, 3E-Net versions achieved an accuracy of 96.15% and 99.50% on invasive breast carcinoma dataset. The second contribution, MCUa, achieved an accuracy of 98.11% on Breast cancer histology images dataset. Lastly, AUQantO showed significant improvements in performance of the state-of-the-art deep learning models with an average accuracy improvement of 1.76% and 2.02% on Breast cancer histology images dataset and an average accuracy improvement of 5.67% and 4.24% on Skin cancer dataset using two uncertainty quantification techniques. AUQantO demonstrated the ability to generate the optimal number of excluded images in a particular dataset

Reliable quantification of the potential for equations based on spot urine samples to estimate population salt intake: protocol for a systematic review and meta-analysis.

BACKGROUND: Methods based on spot urine samples (a single sample at one time-point) have been identified as a possible alternative approach to 24-hour urine samples for determining mean population salt intake. OBJECTIVE: The aim of this study is to identify a reliable method for estimating mean population salt intake from spot urine samples. This will be done by comparing the performance of existing equations against one other and against estimates derived from 24-hour urine samples. The effects of factors such as ethnicity, sex, age, body mass index, antihypertensive drug use, health status, and timing of spot urine collection will be explored. The capacity of spot urine samples to measure change in salt intake over time will also be determined. Finally, we aim to develop a novel equation (or equations) that performs better than existing equations to estimate mean population salt intake. METHODS: A systematic review and meta-analysis of individual participant data will be conducted. A search has been conducted to identify human studies that report salt (or sodium) excretion based upon 24-hour urine samples and spot urine samples. There were no restrictions on language, study sample size, or characteristics of the study population. MEDLINE via OvidSP (1946-present), Premedline via OvidSP, EMBASE, Global Health via OvidSP (1910-present), and the Cochrane Library were searched, and two reviewers identified eligible studies. The authors of these studies will be invited to contribute data according to a standard format. Individual participant records will be compiled and a series of analyses will be completed to: (1) compare existing equations for estimating 24-hour salt intake from spot urine samples with 24-hour urine samples, and assess the degree of bias according to key demographic and clinical characteristics; (2) assess the reliability of using spot urine samples to measure population changes in salt intake overtime; and (3) develop a novel equation that performs better than existing equations to estimate mean population salt intake. RESULTS: The search strategy identified 538 records; 100 records were obtained for review in full text and 73 have been confirmed as eligible. In addition, 68 abstracts were identified, some of which may contain data eligible for inclusion. Individual participant data will be requested from the authors of eligible studies. CONCLUSIONS: Many equations for estimating salt intake from spot urine samples have been developed and validated, although most have been studied in very specific settings. This meta-analysis of individual participant data will enable a much broader understanding of the capacity for spot urine samples to estimate population salt intake

Human Norovirus prevalence in Africa:a review of studies from 1990 to 2013

OBJECTIVES: To assess the contribution of Human Norovirus to diarrheal diseases in Africa.   METHODS: We conducted a systematic review of the PubMed and EMBASE databases for published articles of Human Norovirus in Africa between 1990 and 2013. Data were extracted from selected studies and analysed.   RESULTS: A total of 208 eligible studies were identified, of which 55 (from 19 countries) met the inclusion criteria. Many cases were of sporadic gastroenteritis (70.9%) in children (82%), 65.4% of which were seen in an outpatient setting. Over half (59.4%) of affected children were under 5 years of age. The pooled prevalence rate of Human NoV was 11% (95% CI 8-14%) and the meta-analysis indicated significant heterogeneity between the studies. However, the conditional negative binomial regression could not clearly find the factors affecting the Human NoV prevalence rates reported. A close relationship was found between Human Norovirus strains from environmental and clinical samples.   CONCLUSION: Unreported sporadic gastroenteritis cases of Human Norovirus are common in Africa. Most are community-associated infections. Possible environmental transmission routes have been documented. Combined environmental and clinical studies are required for targeted actions to control transmission of Human Norovirus in Africa. Systematic surveillance of Human Norovirus is needed to measure the burden of Norovirus-induced gastroenteritis in Africa and support any requirements for vaccine development. This article is protected by copyright. All rights reserved

Validation of a method to elute viruses from different types of face masks

Due to the SARS-CoV-2 pandemic, it is crucial to study the efficiency of face masks in retaining viruses for the upcoming years. The first objective of this study was to validate a method to elute viruses from polyester and cotton face masks. We observed that deionized water followed by 3% beef glycine (pH 9.5 or pH 7.2) was significantly more efficient (p < 0.05) in eluting the bacteriophage phiX174 virus from polyester (4.73% ± 0.25% to 28.67% ± 1.89%), polyester/cotton (3% ± 0.33%), and cotton (1.7% ± 0.21%) face masks than 3% beef glycine only (pH 9.5 or pH 7.2) as a single eluent (3.4% ± 0.16% to 21.33% ± 0.94% for polyester, 1.91% ± 0.08% for polyester/cotton, and 1.47% ± 0.12% for cotton face masks). Also, deionized water was significantly less efficient as a single eluent for eluting bacteriophage phiX174 from all the studied face mask types. The polyethylene glycol (PEG) precipitation method was substantially more efficient (p < 0.05) as a second step concentration method for the viruses in the eluates than the organic flocculation (OF) method. Higher viral loads were eluted from polyester face masks than cotton ones. We also found varying viral loads in the eluate solutions from different commercial polyester face masks, with the highest percentage seen for the N95 face mask. The second objective was to apply the validated method to study the effect of autoclaving on the different face mask materials. Results of the study did not show any significant differences in the viral loads eluted from the studied face masks before and after one and five autoclaving cycles. Moreover, a scanning electron microscope (SEM) analysis revealed no changes in the yarns, elongation, tensile strength, and contact angle measurements of the polyester or cotton materials after one or five autoclaving cycles