Testing the dimensionality of the quality management construct

© 2014 Taylor & Francis. Numerous empirical studies have conceptualised quality management (QM) as either a multidimensional or unidimensional construct. While few prior studies tested some aspects of the assumed dimensional structure of the construct, no study has been found to have tested the construct's dimensionality using alternative factor analysis models. To gain a better insight into dimensional properties of the QM construct, this paper tests its dimensionality using three confirmatory factor analysis models (oblique factor model, higher-order factor model, and one-factor model) on a subset of data collected in a larger study that investigated the effects of QM on competitive advantage using a sample of 288 hotel managers in Egypt. The results of the three tests indicate that the QM construct is multidimensional. While this study contributes to advancing the QM theory and practice, further studies are needed to investigate the dimensional properties of the construct in greater depth. The results of this study may therefore stimulate research in this area and encourage the much needed debate on the dimensionality of the QM construct

Role of ankle-brachial pressure index as a predictor of coronary artery disease severity in diabetic and non-diabetic patients

PurposeThe aim of the study was to estimate the role of ankle-brachial pressure index (ABI) in predicting severity of coronary artery disease (CAD) in patients with or without diabetes mellitus.MethodsThis study included 120 patients with CAD proved by coronary angiography and ABI was measured for all of them. They were divided into 4 groups; Group (A): Non-diabetic patients without peripheral arterial disease (PAD) (ABI < or =0.9) , Group (B):diabetic patients without PAD (ABI < or =0.9), Group (C):Non-diabetic patients with PAD (ABI>0.9) and Group (D):diabetic patients with PAD (ABI>0.9).ResultsHypertension was more prevalent in group (D) (p value>0.05). Group (C) had the highest mean age and the highest percentage of smokers, after normalization of the effects of the risk factors mean Gensini score, mean number of affected coronary vessels, mean number of coronary artery lesions and the percentage of coronary artery chronic total occlusions (CTO) were significantly higher in groups (C & D) (p>0.001) (Table 1).ConclusionABI had a significant relationship with the degree of CAD severity. Therefore ABI seems to be a reliable independent prognostic marker of CAD severity in patients with or without diabetes mellitus

Root extracts of Saussurea costus as prospective detoxifying food additive against sodium nitrite toxicity in male rats

Financiado para publicación en acceso aberto: Universidade de Vigo/CISUGThe goal of this study was to investigate the effects of three different extracts of Saussurea costus roots (ethanol, methanol, and water) as a food additive in alleviating the harmful effect of sodium nitrite in rat meals. Thirty-five adult male rats were divided into five groups as follows: control, sodium nitrite (NaNO2; 75 mg/kg BW, single oral dose), S. costus 70% ethanol, 70% methanol, and aqueous extracts (300 mg/kg BW), respectively for four weeks followed by a single dose of NaNO2 24h before decapitation. Results showed that the 70% ethanol extract of S. costus has a higher concentration of total phenolic content, total flavonoids, and antioxidant effect than the 70% methanol and water extracts. Rats pretreated with S. costus extracts reduced the harmful effects induced by NaNO2 and improved the hematological parameters, liver, and kidney function biomarkers as well as lipid profile as compared to the NaNO2 group. Furthermore, S. costus improved the histopathological alterations in the liver and kidney induced by NaNO2 and improved meat sensory evaluation. Conclusively, the 70% ethanol extract of S. costus roots is the most effective extract as an antioxidant against the toxicity of sodium nitrite in male rats and might be used safely as a natural additive in the food industry

iRegNet: Non-rigid Registration of MRI to Interventional US for Brain-Shift Compensation using Convolutional Neural Networks

Accurate and safe neurosurgical intervention can be affected by intra-operative tissue deformation, known as brain-shift. In this study, we propose an automatic, fast, and accurate deformable method, called iRegNet, for registering pre-operative magnetic resonance images to intra-operative ultrasound volumes to compensate for brain-shift. iRegNet is a robust end-to-end deep learning approach for the non-linear registration of MRI-iUS images in the context of image-guided neurosurgery. Pre-operative MRI (as moving image) and iUS (as fixed image) are first appended to our convolutional neural network, after which a non-rigid transformation field is estimated. The MRI image is then transformed using the output displacement field to the iUS coordinate system. Extensive experiments have been conducted on two multi-location databases, which are the BITE and the RESECT. Quantitatively, iRegNet reduced the mean landmark errors from pre-registration value of (4.18 ± 1.84 and 5.35 ± 4.19 mm) to the lowest value of (1.47 ± 0.61 and 0.84 ± 0.16 mm) for the BITE and RESECT datasets, respectively. Additional qualitative validation of this study was conducted by two expert neurosurgeons through overlaying MRI-iUS pairs before and after the deformable registration. Experimental findings show that our proposed iRegNet is fast and achieves state-of-the-art accuracies outperforming state-of-the-art approaches. Furthermore, the proposed iRegNet can deliver competitive results, even in the case of non-trained images as proof of its generality and can therefore be valuable in intra-operative neurosurgical guidance

Explainability of deep neural networks for MRI analysis of brain tumors

Purpose Artificial intelligence (AI), in particular deep neural networks, has achieved remarkable results for medical image analysis in several applications. Yet the lack of explainability of deep neural models is considered the principal restriction before applying these methods in clinical practice. Methods In this study, we propose a NeuroXAI framework for explainable AI of deep learning networks to increase the trust of medical experts. NeuroXAI implements seven state-of-the-art explanation methods providing visualization maps to help make deep learning models transparent. Results NeuroXAI has been applied to two applications of the most widely investigated problems in brain imaging analysis, i.e., image classification and segmentation using magnetic resonance (MR) modality. Visual attention maps of multiple XAI methods have been generated and compared for both applications. Another experiment demonstrated that NeuroXAI can provide information flow visualization on internal layers of a segmentation CNN. Conclusion Due to its open architecture, ease of implementation, and scalability to new XAI methods, NeuroXAI could be utilized to assist radiologists and medical professionals in the detection and diagnosis of brain tumors in the clinical routine of cancer patients. The code of NeuroXAI is publicly accessible at https://github.com/razeineldin/NeuroXAI

An extremely rare complete bilateral duplication of Inferior vena cava in a male cadaver: anatomy, embryology and clinical relevance

The study presented an extremely rare case of real complete bilateral duplication of inferior vena cava (IVC) in a male cadaver which has never been reported before. Both IVC had approximately the same diameter. The right IVC drained into the right atrium; the left IVC continued as hemiazygos vein and drained into the superior vena cava. Three anastomotic venous channels, a cranial preaortic, a middle and a caudal retroaortic, joined both vessels. Multiple variations in the way of drainage of posterior intercostal veins, on both sides, were also present. The present report invalidates an old classification defining the two vessels when joined at the level of the renal veins as complete bilateral duplication of IVC. Although the presence of combination of venous variations is extremely rare, awareness of such variations is essential for clinical and surgical procedures to avoid misdiagnosis and surgical complications

Chemical shark repellent: Myth or fact? The effect of a shark necromone on shark feeding behaviour

a b s t r a c t Since 1942, the search for an effective chemical shark repellent has been ongoing research concern in the United States. A long-standing anecdote that sharks avoid areas containing decomposing shark tissue has initiated new interest in identifying trace chemical alarm signals produced during decomposition (necromones). A commercially-sourced shark necromone produced from putrefied shark tissue was evaluated over a five-year period in South Bimini, Bahamas. Competitively-feeding populations of Caribbean reef sharks (Carcharhinus perezi) and blacknose sharks (Carcharhinus acronotus) were exposed to necromones using pressurized aerosol canisters at the surface. Shark density estimations were made at the initial, 1 min and 5 min intervals after preliminary exposure along with continuous exposure of feeding stimulus. In both species, an unambiguous halt in feeding behavior was observed within 1 min after exposure of the necromone. For aerosol delivery, a 150 mL dose of the necromone from a single aerosol canister is able to halt all feeding activity in a combined population of C. perezi and C. acronotus. Shark necromones induced a spectacular alarm response in interacting sharks resulting in a temporary evacuation of an area containing feeding stimuli. Additionally, sharks were not deterred by alternative treatment presentations of 10% weight percent (w/w) aqueous urea, 10% w/w oleic acid in ethanol, or water buffered to pH 8.5. Habituation to the necromone was not observed for repeated tests at the same location. In all experiments, the presence of a shark necromone did not produce a similar aversion response for teleosts as observed in C. perezi or C. acronotus; however, anecdotal observations demonstrate that teleosts increased their feeding rate in the presence of the necromone. Experimental controls using denatured ethanol or water confirmed that feeding sharks were not deterred by bubbles, sound, or the solvents used to extract the necromones. Comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry indicates that the necromone is a complex solution rich in amino acids and putrefaction products. Experiments demonstrate that the key chemical component responsible for the alarm response is within these amino acids and/or putrefaction products, but further experimentation is needed to more accurately identify the active ingredient. Shark necromones hold particular promise for use in shark bycatch reduction and conservation. The existence of a putative chemical shark repellent has been confirmed

Pre-formulation and systematic evaluation of amino acid assisted permeability of insulin across in vitro buccal cell layers

The aim of this work was to investigate alternative safe and effective permeation enhancers for buccal peptide delivery. Basic amino acids improved insulin solubility in water while 200 and 400 µg/mL lysine significantly increased insulin solubility in HBSS. Permeability data showed a significant improvement in insulin permeation especially for 10 µg/mL of lysine (p < 0.05) and 10 µg/mL histidine (p < 0.001), 100 µg/mL of glutamic acid (p < 0.05) and 200 µg/mL of glutamic acid and aspartic acid (p < 0.001) without affecting cell integrity; in contrast to sodium deoxycholate which enhanced insulin permeability but was toxic to the cells. It was hypothesized that both amino acids and insulin were ionised at buccal cavity pH and able to form stable ion pairs which penetrated the cells as one entity; while possibly triggering amino acid nutrient transporters on cell surfaces. Evidence of these transport mechanisms was seen with reduction of insulin transport at suboptimal temperatures as well as with basal-to-apical vectoral transport, and confocal imaging of transcellular insulin transport. These results obtained for insulin is the first indication of a possible amino acid mediated transport of insulin via formation of insulin-amino acid neutral complexes by the ion pairing mechanism