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Coload Effect On Cardiac Output Measurement Using Transthoracic Echocardiography In Preeclamptic Patients Undergoing Cesarean Delivery, Sherine Ali Elsayed Bakrey, Aya Hasan Masoud Abdelhady, Alaa El-Din Mazy Abdou Mazy, Maha Ahmed Abo-Zeid Salim

Mansoura Medical Journal

Background: During cesarean delivery (CD) for preeclamptic patients under spinal anaesthesia (SA), much intravenous fluids are avoided. Through transthoracic echocardiography, study conducted to assess the hypothesis that colloid plus crystalloid coload will maintain the cardiac output (CO) than crystalloid fluid alone. Methods: Thirty-four preeclamptic patients, scheduled for elective CD, under SA, were allocated according to the fluid coloading into two groups; Crystalloid group (group I); in which the patients received Ringer’s acetate or Crystalloid-colloid group (group II); in which the patients received 6% Hydroxyethyl starch and Ringer’s acetate. The primary outcome was CO while, left ventricular end diastolic diameter (LVEDD), …

Opioid-Free Anaesthesia During Prolonged Orthotopic Urinary Bladder Diversion Surgery: A Prospective Randomized Comparative Study, Mohamed A Ghanem, Mostafa Ma Saied, Hanan Adly, May E Badr

Mansoura Medical Journal

Background: Opioid-free anaesthesia is becoming a favored strategy among anesthetists. This study aims to compare continuous epidural fentanyl infusion with intrathecal bolus of bupivacaine-dexmedetomidine, which is a low-cost analgesic technique with efficient intraoperative hemodynamic stability, postoperative analgesia, and fewer opioid induced drawbacks in urinary bladder diversion surgery.

Patient and Methods: Our randomized prospective comparative study involved 34 patients prepared for urinary bladder diversion surgery. Patients were distributed into two equivalent groups; group A received continuous epidural infusion of bupivacaine-fentanyl; and group B received intrathecal bolus bupivacaine-dexmedetomidine.

Results: Intraoperatively, Heart rate showed a significant decrease at 2 h in group B …

Ultrasound-Guided Femoro-Sciatic Nerve Block Versus Hemispinal Anesthesia In Acute Lower Limb Ischemia: A Prospective Randomized Comparative Study, Mostafa Sayed Ahmed Mohammed Elawady, Nehal Alaa El-Dien Abbass Hamza, Mohammed Ahmed Ahmed Sultan, Hazem Elsayed Moawad, Tarek Habeeb Ramadan

Mansoura Medical Journal

Background: Acute lower limb ischemia (ALLI) is a critical condition that requires prompt surgical intervention. The choice of anesthetic technique can have a significant impact on patient outcomes. The Purpose of this study was to compare the safety and efficacy of femoro-sciatic nerve block (FSNB) guided by ultrasound and hemispinal anesthesia (HSA) among patients undergoing surgery for acute lower limb ischemia.

Methods: We prospectively studied 44, ASA Ⅱ-Ⅲ patients whose surgeries were planned for management of acute lower limb ischemia. Eligible patients were randomly allocated into two groups to be given either HSA or ultrasound-guided FSNB. The duration of the …

Audit Of Management Of Diabetic Ketoacidosis In Mansoura Specialized Medical Hospital, Walaa M Abd-El-Fatah, Omnia I State, Basma Z Elmorsy

Mansoura Medical Journal

Background: Egypt is listed among the world's top ten countries regarding the highest number of people with diabetes mellitus (DM). Diabetic ketoacidosis (DKA) is a medical emergency which is associated with significant mortality and morbidity in diabetic patients. It is also a common reason for hospitalization and thus is associated with significantly high costs. However, DKA is a potentially reversible condition provided that an emergency and immediate medical attention, appropriate diagnosis and therapy were provided.

Aim: auditing the adherence to protocol for the management of DKA in our Mansoura University Hospital (Specialized Medical Hospital) in Egypt from May 2021 to …

Evaluation Of Low Dose Intrathecal Bupivacaine With Dexmedetomidine In Geriatric Patients Undergoing Traumatic Hip Surgery, Rania E. Elbadrawy, Sherine A Bakrey, Reem Abdelraouf Elsharkawy

Mansoura Medical Journal

Abstract: Background: Spinal anesthesia (SA) is typically utilized during surgical treatment of severe hip fractures. Searching for early ambulation and reduction of frequency and severity of hypotension, and after adding dexmedetomidine (DEX), different intrathecal (IT) dosages of 0.5% hyperbaric bupivacaine had been used to determine the lowest dosage that will result in a good block without hemodynamic instability. Methods: At random, 78 patients were divided into three groups. A 7.5 mg of 0.5% hyperbaric bupivacaine was administered in the first group10 mg in the second and 12.5 mg in the third group. Dexmedetomidine (5 μg) was added to each group. …

The Effect Of Ultrasound-Guided Thoracic Retrolaminar Block Versus Erector Spinae Plane Block On Opioid Consumption After Pediatric Open-Heart Surgery: A Randomized Controlled Non-Inferiority Study, Ahmed Abdellatif Elsayed Abdelwahab, Ghada Fathy Elrahmawy, Ibrahim Ibrahim Abdelbaser, Rania Elmohamady Elbadrawy

Mansoura Medical Journal

Background Pain following open cardiac surgery in pediatric patient is crucial for the anesthesiologist Objective to compare a single-shot US-guided bilateral thoracic retrolaminar block (TRLB) and erector spinae plane block (ESPB) as regarding 24 hours postoperative opioid analgesic requirements as primary outcome, while time to first rescue analgesic, the post-operative pain score and rate of block-related complications were secondary outcomes Methods Each study group included 50 patients. TRLB group received 0.4 ml/kg bupivacaine (BPV) 0.25% injected under US guidance bilaterally as the needle touched the lamina of the T4 vertebra; while ESPB group received 0.4 ml/kg BPV 0.25% injected under …

Pathogenic Role Of Angiopoietin-1 And -2 In Community-Acquired Pneumonia Among A Cohort Of Egyptian Children From Rural Areas Of Delta Region, Magdy Mohamed Ebrahim Zedan, Nashwa Khairat Abousamra, Engy Osman Ahmed, Asmaa Salah Ali Gebril

Mansoura Medical Journal

Background: Both an uncontrolled host response and the direct actions of pathogenic agents can be responsible for pneumonia-induced pulmonary hyperpermeability. Two well-known factors that contribute to angiogenesis and regulate inflammation and vascular leakage are angiopoietin-1 (Ang 1) and angiopoietin-2 (Ang 2). Aim: Assessment of Ang 1 and Ang 2 serum levels as indicators of the severity and phenotypes of community-acquired pneumonia (CAP). Subjects and methods: From September 2023 to February 2024, a case-control study was carried out at Mansoura University Children Hospital (MUCH) to assess the serum levels of Ang-1 and Ang-2 as indicators of the severity and phenotypes of …

Is Hyponatremia A Predictor Of Severity And Mortality In Covid 19 Patients?, Manal Mohammed Reda Algharbawy, Mohamed Maher El-Gamal, Eman Ali Ahmed Ali

Mansoura Medical Journal

BACKGROUND: Hyponatremia is one of the commonest water–electrolyte imbalances in the body. It can occur in coincidence with many diseases and its presence can affect the disease outcome.

OBJECTIVE OF THE STUDY: to evaluate the relation between serum sodium level and both COVID disease severity and mortality.

METHODS: Study included 164 patients admitted to hospital with COVID-19. Serum sodium was measured on admission. 65 patients had serum sodium more than 135 mmol/l (either normal serum sodium or mild hypernatremia) while the remaining 99 had hyponatremia. Patients were treated and followed till discharge or death. Study included 3 categories of disease …

Guillain-Barré Syndrome In Adults And Children: Differences In Clinical Features, Mahmoud Moaness Elbialy, Maha H. Khalil, Khaled Fathy, Hossam Egila

Mansoura Medical Journal

Background: Guillain-Barré Syndrome (GBS) is an autoimmune disease (AID) affecting peripheral nervous system (PNS) stimulated by either infectious (such as Campylobacter jejuni, Cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus (HIV), Zika virus and SARS-CoV-2 infection) or noninfectious factors. It may occur at any age, and it is the commonest etiology of acute flaccid paralysis in pediatrics. Patients present with progressive and symmetric muscle weakness with absent or depressed deep tendon reflexes and might also have sensory manifestations such as Paresthesia in the hands and feet, dysautonomia and cranial nerve affection such as facial palsy or bulbar affection Aim: This study assessed …

Temporal Lobe Epilepsy And Obesity In Adults, Mahmoud Fathy Saleh, Mohammed Abbas, Mostafa Mansour, M. Saad

Mansoura Medical Journal

Background: Epilepsy is a common, chronic, and disabling neurologic state. Medial temporal lobe epilepsy (TLE) is the commonest, and best-defined, form of symptomatic localization-related epilepsy. Obesity-induced mitochondrial dysfunction and oxidative stress are thought to participate in the initiation and progression of epilepsy. Obesity is a potentially preventable predisposing factor for drug resistant epilepsy (DRE).

Objective: the aim of this study was to investigate the association of TLE with obesity and the effect of obesity on seizure control.

Methods: This case control study was carried out on 50 patients with TLE and was divided into two groups, …

Neurosymbolic Value-Inspired Ai (Why, What, And How), Amit Sheth, Kaushik Roy

Publications

The rapid progression of Artificial Intelligence (AI) systems, facilitated by the advent of Large Language Models (LLMs), has resulted in their widespread application to provide human assistance across diverse industries. This trend has sparked significant discourse centered around the ever-increasing need for LLM-based AI systems to function among humans as part of human society, sharing human values, especially as these systems are deployed in high-stakes settings (e.g., healthcare, autonomous driving, etc.). Towards this end, neurosymbolic AI systems are attractive due to their potential to enable easy-tounderstand and interpretable interfaces for facilitating valuebased decision-making, by leveraging explicit representations of shared values. …

Causal Event Graph-Guided Language-Based Spatiotemporal Question Answering, Kaushik Roy, Alessandro Oltramari, Yuxin Zi, Chathurangi Shyalika, Vignesh Narayanan, Amit Sheth

Publications

Large Language Models have excelled at encoding and leveraging language patterns in large text-based corpora for various tasks, including spatiotemporal event-based question answering (QA). However, due to encoding a text-based projection of the world, they have also been shown to lack a fullbodied understanding of such events, e.g., a sense of intuitive physics, and cause-and-effect relationships among events. In this work, we propose using causal event graphs (CEGs) to enhance language understanding of spatiotemporal events in language models, using a novel approach that also provides proofs for the model’s capture of the CEGs. A CEG consists of events denoted by …

Exploring Alternative Approaches To Language Modeling For Learning From Data And Knowledge, Yuxin Zi, Kaushik Roy, Vignesh Narayanan, Amit Sheth

Publications

Despite their wide applications to language understanding tasks, large language models (LLMs) still face challenges such as hallucinations - the occasional fabrication of information, and alignment issues - the lack of associations with human-curated world models (e.g., intuitive physics or common-sense knowledge). Additionally, the black-box nature of LLMs makes it highly challenging to train them meaningfully in order to achieve a desired behavior. Specifically, the attempt to adjust LLMs’ concept embedding spaces can be highly intractable, which involves analyzing the implicit impact on LLMs’ numerous parameters and the resulting inductive biases. This paper proposes a novel architecture that wraps powerful …

Causal Neuro-Symbolic Ai: A Synergy Between Causality And Neuro-Symbolic Methods, Utkarshani Jaimini, Cory Henson, Amit Sheth

Publications

Causal Neuro-Symbolic AI combines the benefits of causality with Neuro-Symbolic Artificial Intelligence (NeSyAI). More specifically, it (1) enriches NeSyAI systems with explicit representations of causality, (2) integrates causal knowledge with domain knowledge, and (3) enables the use of NeSyAI techniques for causal AI tasks. The explicit causal representation yields insights that predictive models may fail to analyze from observational data. It can also assist people in decision-making scenarios where discerning the cause of an outcome is necessary to choose among various interventions.

Ontolog Summit 2024 Talk Report: Healthcare Assistance Challenges-Driven Neurosymbolic Ai, Kaushik Roy

Publications

Although Artificial Intelligence technology has proven effective in providing healthcare assistance by analyzing health data, it still falls short in supporting decision-making. This deficiency largely stems from the predominance of opaque neural networks, particularly in mental health care AI applications, which raise concerns about their unpredictable and unverifiable nature. This skepticism hinders the transition from information support to decision support. This presentation will explore neurosymbolic approaches that combine neural networks with symbolic control and verification mechanisms. These approaches aim to unlock AI’s full potential by enhancing information analysis and decision-making support for healthcare assistance1.

Neurosymbolic Customized And Compact Copilots, Kaushik Roy, Megha Chakraborty, Yuxin Zi, Manas Gaur, Amit Sheth

Publications

Large Language Models (LLMs) are credible with open-domain interactions such as question answering, summarization, and explanation generation [1]. LLM reasoning is based on parametrized knowledge, and as a consequence, the models often produce absurdities and inconsistencies in outputs (e.g., hallucinations and confirmation biases) [2]. In essence, they are fundamentally hard to control to prevent off-the-rails behaviors, are hard to fine-tune, customize for tailored needs, prompt effectively (due to the “tug-of-war” between external and parametric memory), and extremely resource-hungry due to the enormous size of their extensive parametric configurations [3,4]. Thus, significant challenges arise when these models are required to perform …

Analysis Of Bankruptcy Prediction Of Shipping Industry - Machine Learning Approach, Minsu Kwon

Plymouth Business School Theses

The Korean shipping industry's vulnerability to economic crises, such as the 2016 bankruptcy of Hanjin Shipping, highlights the need for robust bankruptcy prediction methods, particularly for small and medium-sized enterprises (SMEs). This research aims to identify key risk factors for predicting bankruptcy in shipping companies from Korean industry by leveraging financial, non-financial, and economic data through advanced machine learning models, including Extreme Gradient Boosting (XGBoost) and Long Short-Term Memory (LSTM) networks. A comprehensive literature review and interviews with industry practitioners were conducted to refine the variables used in the models. These models predict bankruptcy across 1, 3, and 5-year horizons, …

How Do Followers Experience Shared Leadership As A Lived Experience?Understanding The Relationality, Processes And Practices Informing Such Collaboration., Sybille Erika Schiffmann

Plymouth Business School Theses

How do followers experience shared leadership as a lived experience? Understanding the relationality, processes and practices informing such collaboration. Within shared leadership research culture, the aspiration is to explore “leadership as a dynamic interactive influence process”’ at the group level, supporting goal achievement (Pearce and Conger, 2003, P.1). However, the motivation of much research has focused on performance improvement, whereby discrete leadership variables are examined, using reductionist methods, to determine relevant linkages to team effectiveness (Denis et al., 2012. See also Fairhurst et.al, 2020). In expanding understanding of shared leadership from a follower perspective, enabling a fuller appreciation of how …

2024 January, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for January of 2024.

From Crisis To Resilience: Pandemic Perspectives On College Student Experiences, Motivation And Self-Regulated Learning, Diana Botnaru, Anna C. Brady, Dragos Amarie, April Garrity, Erica Hillsnipe, Caroline Hopkinson, Cynthia Lynes, Eryn Michelle Maher

International Journal for the Scholarship of Teaching & Learning

The short-term effects during the transition to emergency remote teaching at the onset of the COVID-19 pandemic on college students are well-studied. The present study investigated the ongoing impact of the COVID-19 pandemic on students enrolled in undergraduate classes (e.g., pandemic experiences and their impact on basic psychological needs, metacognitive learning strategies, and motivation regulation). The survey was administered at a 4-year university in the Southeastern United States during fall 2022. The majority of participants (N = 590) were women (82%), white (56.6%), not Hispanic or Latinx (93.4%), and health profession majors (58.1%). Results indicated that mental health, academic, and …

A Little Transparency Goes A Long Way: Tilt Enhances Student Perceptions Of An Interdisciplinary Research Symposium, Joshua A. Woods, Megan E. Doran, Jesse Wilcox

International Journal for the Scholarship of Teaching & Learning

Transparency in learning and teaching (TILT) has been a growing topic of interest in higher education. This study aimed to examine how a simple TILT manipulation could impact a well-established, popular, interdisciplinary semester- long research symposium that involves scores of undergraduates. TILTing the instructions for this symposium had a significant effect on all three TILT components (i.e., purpose, task, and criteria). Underclassmen benefited equally to upperclassmen in terms of understanding the importance and ways to be successful. Furthermore, although both majors and nonmajors benefited from the TILTed instructions, students studying a course outside their major benefited significantly more than students …

Exploring Integrated Active Learning Practices In An Accelerated Fully Online Graduate-Level Course At A Hispanic Serving Institution, P. Ming-Tsan Lu, Seokmin Kang

Teaching and Learning Faculty Publications

The purpose of the study aimed to explore integrated active learning (IAL) practices in a graduate-level fully online, accelerated course at an HSI, with a focus on students’ perceptions, and to evaluate the implementation of integrated active learning based on student feedback and reflections. Course instructors started implementing IAL practices for the same course in 2022. Data from before and after IAL implementation in terms of course syllabi and course designs on Blackboard, the LMS used in the HSI, were collected. To investigate students’ perceptions, survey methods were also conducted. Findings revealed that graduate students overwhelmingly preferred IAL over traditional …

Virtual Reality & Pilot Training: Existing Technologies, Challenges & Opportunities, Tim Marron, Niall Dungan, Brian Mac Namee, Anna Donnla O'Hagan

Journal of Aviation/Aerospace Education & Research

The introduction of virtual reality (VR) to flying training has recently gained much attention, with numerous VR companies, such as Loft Dynamics and VRpilot, looking to enhance the training process. Such a considerable change to how pilots are trained is a subject that warrants careful consideration. Examining the effect that VR has on learning in other areas gives us an idea of how VR can be suitably applied to flying training. Some of the benefits offered by VR include increased safety, decreased costs, and increased environmental sustainability. Nevertheless, some challenges ahead for developers to consider are negative transfer of learning, …

Career Choice Motivation For Professional Pilots, Brett Watts, Tamilla Curtis, Scott Ambrose

Journal of Aviation/Aerospace Education & Research

This study identified key motivational factors of current flight training students to better understand how individuals are motivated to pursue a career in aviation. The theoretical framework used in this study was based upon self-determination theory, as originally introduced by Deci and Ryan (2000).The research approach for this study was a semi-structured interview process where students were asked eight foundational career motivation source questions and their responses were organized into career choice motivation categories. Results showed most participants became motivated to pursue a piloting career at a very young age. This early motivation was largely due to influence from third …

Addressing The Target Outcomes, Functional Objectives And Functional Skills Of Aspiring Aviators In Individualized Education Plans And Section 504 Plans, Gary C. Booker

Journal of Aviation/Aerospace Education & Research

The Federal Aviation Administration (FAA) has very specific requirements for individuals with Attention Deficit Hyperactivity Disorder (ADHD) that center around the executive function abilities of individuals without the aid of ADHD medications, which are forbidden for use by the FAA. These abilities are evaluated by the FAA's medical examination process, which involve a background investigation into a person's history. K-12 Administrators and educators can assist young aspiring pilots with ADHD by placing aviation-specific functional educational goals in their Individualized Educational Plans (IEPs) and Section 504 Plans.

Interpersonal Skills In A Sociotechnical System: A Training Gap In Flight Decks, Kimberly Perkins, Sourojit Ghosh, Crystal Hall

Journal of Aviation/Aerospace Education & Research

This research analyzed the perceptions of interpersonal skills on established aviation safety models, Crew Resource Management (CRM), and Threat and Error Management (TEM) using feedback from industry pilots. The flight deck is a sociotechnical system where much research has focused on the technical aspect, whereas we spotlight its socio aspect. The aviation industry must invest in training pilots on interpersonal skills to enhance safety through increased efficacy of safety models integrated throughout existing training programs. A 34-question survey was disseminated across both commercial and business aviation pilots (N=822). We explored three research questions regarding pilots’ perceived training on interpersonal skills …

Assessing Past Airworthiness Directives And How Safety Management Systems May Benefit Aviation Product Design And Manufacturing, Damon Lercel, Manoj Patankar, Richard Steckel

Journal of Aviation/Aerospace Education & Research

The European Union Aviation Safety Agency (EASA) continues to promulgate Safety Management Systems (SMS) across aviation organizations when it recently issued SMS requirements for EASA certificated Part 145 maintenance, repair and overhaul (MRO) organizations and Part 21 Design & Manufacturing (D&M) organizations. Currently, the Federal Aviation Administration (FAA) has no such rule in place for these U.S.-based organizations, which may challenge those doing business in countries where EASA policies apply. Given that a majority of the United States’ D&M and MRO population is made up of smaller organizations, it is likely a U.S. SMS regulation will require justification of the …

'I’M A Pilot First, Female Second': Why Flight Deck Gender Imbalance Persists And The Case For Allyship, Kimberly Perkins, Rachael H. Merola, Sourojit Ghosh, Cecilia Aragon

Journal of Aviation/Aerospace Education & Research

Why is there greater gender parity for long-haul truck drivers, astronauts, and paleontologists than for women airline captains? This study uses a mixed-methods approach to examine the underlying causes of the gender imbalance in the United States aviation industry, in which only 3.6% of airline captains are women. Two polls and one survey gather data from professional pilots (N=1093) on their experience with stereotyping, gender bias, and allyship. Direct comments were analyzed to shed light on the results of the survey. Results suggest that, contrary to prevailing perceptions, the persistent gender imbalance in the flight deck can largely be attributed …

Integrated Organizational Machine Learning For Aviation Flight Data, Michael J. Pritchard, Austin T. Walden, Paul J. Thomas

Journal of Aviation/Aerospace Education & Research

Increased availability of data and computing power has allowed organizations to apply machine learning techniques to various fleet monitoring activities. Additionally, our ability to acquire aircraft data has increased due to the miniaturization of small form factor computing machines. Aircraft data collection processes contain many data features in the form of multivariate time series (continuous, discrete, categorical, etc.) which can be used to train machine learning models. Yet, three major challenges still face many flight organizations: 1) integration and automation of data collection frameworks, 2) data cleanup and preparation, and 3) developing an embedded machine learning framework. Data cleanup and …

High-Flying Results: A Case Study In A Pilot Development Mentor Program, Catherine G. Cordova, Barron Parsons-Daisley, Emma Fox Captain

Journal of Aviation/Aerospace Education & Research

Consistently considered one of the world’s most stressful occupations, the job of an airline pilot requires increasingly specific skills and responsibilities, especially amidst the global pandemic (Cullen, et al., 2020; Sew, et al., 2022). Given the severity and implications of their decisions and actions, airline pilots must continuously undergo training and practices to ensure proper procedure. In 2020, the Federal Aviation Administration (FAA) augmented qualifications by enacting Pilot Professional Development requirements (85 FR 10923), including mentoring for newly hired pilots in command (PIC’s). In complement with 85 FR 10923, CFR 121-N ensures “techniques for reinforcing the highest standards of technical …