Qualitative Grades Research Articles

Defining Echocardiographic Degrees of Right Heart Size and Function in Pulmonary Vascular Disease From the PVDOMICS Study

BACKGROUND: Defining qualitative grades of echocardiographic metrics of right heart chamber size and function is critical for screening, clinical assessment, and measurement of therapeutic response in individuals with pulmonary vascular disease (PVD). In a population enriched for PVD, we sought to establish qualitative grades and prognostic value of right heart chamber size and function. METHODS: We investigated 1053 study participants in PVDOMICS (Redefining Pulmonary Hypertension Through the PVD Phenomics Program) to determine clinical and echocardiographic differences associated with increasing pulmonary vascular resistance severity. Right heart chamber size and function were qualitatively assessed using a percentile-based approach above the median values to create a clinical grading system for right heart adaptation. The relationship between echocardiographic categories and all-cause mortality was examined using survival analyses adjusted for potential confounders. RESULTS: A stepwise increase in adverse right heart remodeling was observed with a concomitant decrease in functional parameters by pulmonary vascular resistance strata ( P <0.001 for all). Mild, moderate, and severe categories of right heart chamber size and dysfunction were defined using a percentile-based approach across the spectrum of PVD. During a median follow-up of 2.07 years (interquartile range, 1.23–3.01 years), 130 participants died (11.4%). Progressive pulmonary vascular resistance increase and 2DE evidence of right heart dysfunction inclusive of fractional area change, and right ventricular global longitudinal strain were independently associated with increased all-cause mortality risk in multivariate analysis adjusted for age, disease duration, and male sex. CONCLUSIONS: In this well-characterized sample of adults with diverse etiologies and varying PVD severity, we define categories of abnormal right heart chamber size and function. Further, we demonstrate a stepwise relationship between these categories of abnormal morphology and function and all-cause mortality. Defining grades of right ventricular dysfunction in individuals with known PVD has important clinical implications for monitoring disease progression and response to therapies.

Grey Assessment

The assessment of human activities is an important task, because it helps to correct mistakes and to improve the overall performance of a group. Frequently, however, the individual assessment of the members of a group is performed not with numerical scores, but with qualitative grades (linguistic expressions). This happens either because the existing data are not exact, or for reasons of elasticity (e.g. teacher for students). In such cases the mean performance of the group cannot be assessed by applying the traditional method of calculating the mean value of the individual scores of its members. In this short communication, a method developed recently by the author is presented for evaluating the mean performance of a group in such cases, using grey numbers as tools. The method is illustrated by an example concerning the assessment of the mean performance of a class of students.

NEUTROSOPHIC ASSESSMENT OF STUDENT MATHEMATICAL SKILLS

Formulation of the problem. Assessment is an important component of the teaching process, because it helps the instructor to determine the student mistakes and to improve their performance by adapting suitably his/her teaching methods. In this work we investigate the problem of evaluating the student overall performance, when the teacher is not sure about the accuracy of the grades assigned to them. This happens, either because the teacher had not enough time to assess properly the students’ mathematical skills, or because, in case of a written examination/test, some students did not present clearly or did not justified properly their answers.
 Materials and methods. Fuzzy assessment methods using neutrosophic sets and grey numbers, as well as the calculation of the Grade Point Average (GPA) index are used in this work for the assessment of a student class mean performance, quality performance, and overall performance when the teacher has doubts about the grades assigned to some students. 
 Results. The paper focuses on a classroom application designed for the assessment, with qualitative (linguistic) grades, of mathematical skills of the engineering students of two Departments of the School of Engineering of the Graduate Technological Educational Institute (TEI) of Western Greece (University of Peloponnese) being at their first term of studies. The instructor was the same person for both Departments. The teaching methodology for the first Department (experimental group) involved a combined use of computers and classroom lectures, whereas for the second Department (control group) involved only lectures in the classical way on the board.
 Conclusions. The use of neutrosophic sets provides a useful tool for evaluating the student overall performance when the teacher has doubts about the accuracy of the grades assigned to them. The outcomes of the classroom application demonstrated a superiority of the experimental group. This superiority, however, was significant with respect to its mean and overall performance (neutrosophic assessment), but rather negligible with respect to its quality performance. This gives a strong indication that the use of computers in the teaching process helps more the mediocre and weak students and not so much the good students.

Assessing the Effectiveness of the APOS/ACE Method for Teaching Mathematics to Engineering Students

The present work focuses on a classroom application for evaluating the effectiveness of the APOS/ACE instructional treatment for teaching mathematics to engineering students. Using linguistic (qualitative) grades, the assessment of the mean student performance is realized with the help of grey numbers and the assessment of their quality performance by calculating the Grade Point Average (GPA) index. A neutrosophic assessment method is also applied for evaluating the overall student performance, because the instructor had doubts about the accuracy of the qualitative grades assigned to some students.

Fractional Erbium YAG Laser Resurfacing Versus 20% Trichloroacetic Acid Chemical Peeling in the Treatment of Acne Scars: A Comparative Study.

Acne scarring not only affects the aesthetic appearance of an individual but also has a detrimental effect on mental health and social life. Various treatment modalities are available for acne scars. In this study, fractional erbium-doped yttrium-aluminum-garnet (Er:YAG) laser resurfacing was compared with 20% trichloroacetic acid (TCA) peeling in terms of efficacy and safety. This prospective comparative study included 50 subjects of acne scar who were randomly divided into Groups A and B, 25 patients in each group. Group A was treated with 4 sessions of fractional Er:YAG laser and Group B with 4 session of 20% TCA application as chemical peeling, repeated every 21 days over a period of 3 months. The patients were evaluated for improvement at each visit using Goodman and Baron's qualitative and quantitative acne scar grading. Statistically significant improvement in Goodman and Barron's qualitative acne scar grades was observed in both groups. At the end of therapy, that is, after 12 weeks of therapy, the mean percentage reduction in Goodman and Baron's quantitative acne scar scores was 21.69% ± 16% in Group A and 20.97% ± 8.70% in Group B. In regards of complications, both procedures were well tolerated. We concluded that fractional Er:YAG laser resurfacing and 20% TCA peel application in the treatment of atrophic acne scar are equally efficacious. Both procedures are safe and well tolerated by the patients.

A Hybrid Method for Assessing Student Mathematical Modelling Skills under Fuzzy Conditions

Mathematical modelling (MM) appears today as a valuable tool in mathematics education, which connects mathematics with everyday life situations on the purpose of increasing the student interest on the subject. In this paper a hybrid method is applied for the assessment of student groups’ MM skills with qualitative grades (i.e. under fuzzy conditions). Namely, soft sets are used as tools for a parametric assessment of a group’s performance, the calculation of the GPA index and the Rectangular Fuzzy Assessment Model are applied for evaluating the group’s qualitative performance, grey numbers are used as tools for assessing the group’s mean performance and neutrosophic sets are utilized when the teacher is not sure about the individual grades assigned to some (or all) students of the group.

Putting 3D Printing to Good Use – Additive Manufacturing and the Sustainable Development Goals

Additive Manufacturing (AM), often referred to as 3D printing, is a production technology that creates objects layer by layer and applies to a variety of materials. 
 
 AM is expected to have a high impact on the industry as well as on society. The inherent characteristics of AM make it possible to solve not only particular problems but fundamental global challenges as well, which can be examined by reference to the 17 Sustainable Development Goals (SDGs) of the United Nations. This is the first paper that examines the connection of AM and the 17 SDGs through a literature review.
 
 In this work, it is outlined which SDGs have a high or moderate potential to be fostered by AM. In each section, one of these SDGs with high or moderate potential will be introduced and corresponding studies relevant to the respective SDG are presented. At the end of each section, the potential of AM to contribute to the achievement of the SDG is evaluated, using the qualitative grades “high” or “moderate”. SDGs with low potential will be subsumed in the last subsection.
 
 It is found that six out of 17 SDGs have high potential to be fostered by AM. These are SDG 1 (No poverty), SDG 3 (Good Health and Well-Being), SDG 6 (Clean Water and Sanitation), SDG 7 (Affordable and Clean Energy), SDG 9 (Industry, Innovation, and Infrastructure), and SDG 12 (Responsible Consumption and Production). Furthermore, four SDGs have been identified that have moderate potential to be fostered by AM. These are: SDG 2 (Zero Hunger), SDG 4 (Quality Education), SDG 10 (Reduced Inequalities), and SDG 11 (Sustainable Cities and Communities).

Correlation between lumbar spinal canal magnetic resonance imaging grading systems and parameters in lumbar spinal canal compromise

BackgroundThere is a need to assess how commonly used classification systems of intervertebral disc degeneration reflect the compromise of neural elements. This study aims to explore the relationship between lumbar discs degenerative diseases using the Pfirrmann and the Combined Task Forces (CTF) of the North American Spine Society (NASS) grading systems as well as qualitative and quantitative grades of lumbar spinal stenosis. This retrospective cohort study included adult patients undergoing non-contrast MR imaging of lumbosacral spine. The radiological assessment included the Pfirrmann grading system, Van Rijn classification, Combined Task Force (CTF) classification, measurement of the cross-sectional area of the dural sac, mid-sagittal antero-posterior diameter of the thecal sac, the degree of dural sac compression at disc level, lateral recesses heights, and intervertebral foramina diameters. The degree of stenosis of the spinal canal and intervertebral foramina was assessed.ResultsOne hundred patients were included in the study. At all levels, Pfirrmann grades had a moderate, significant, positive correlation with the severity of stenosis of the central and lateral spinal canals as well as foraminal stenosis. The grades of lumbar spinal canal and foraminal stenosis had a significant positive correlation with degree of disc displacement as assessed by CTF classification and had a significant negative correlation with the quantitative lumbar spinal canal and foraminal measures.ConclusionsThere is a good correlation between Pfirrmann classification, CTF classification of NASS, qualitative grading and quantitative measures of lumbar spinal canal that reflects the severity of lumbar spinal canal stenosis and nerve root compression.

Hemodynamic Analysis for Olfactory Perceptual Degradation Assessment Using Generalized Type-2 Fuzzy Regression

Olfactory perceptual degradation (OPD) refers to the inability of people to recognize the variation in concentration levels of olfactory stimuli. This article attempts to assess the degree of OPD of subjects from their hemodynamic response to olfactory stimuli. This is done in two phases. In the first (training) phase, a regression model is developed to assess the degree of concentration levels of an olfactory stimulus by a subject from her hemodynamic response to the stimulus. In the second (test) phase, the model is employed to predict the possible concentration level experienced by the subject in [0, 100] scale. The difference between the model-predicted response and the oral response (the center value of the qualitative grades) of the subject about her perceived concentration level is regarded as the quantitative measure of the degree of subject’s olfactory degradation. The novelty of the present research lies in the design of a general type-2 fuzzy regression model, which is capable of handling uncertainty due to the presence of intrasession and intersession variations in the brain responses to olfactory stimuli. The attractive feature of the article lies in adaptive tuning of secondary membership functions to reduce model prediction error in an evolutionary optimization setting. The effect of such adaptation in secondary measures is utilized to adjust the corresponding primary memberships in order to reduce the uncertainty involved in the regression process. The proposed regression model has good prediction accuracy and high time efficiency as evident from average percentage success rate (PSR) and runtime complexity analysis, respectively. The Friedman test undertaken also confirms the superior performance of the proposed technique with other competitive techniques at 95% confidence level.

Comparative evaluation of Ziehl- Neelsen staining and kinyoun’s staining in the diagnosis of clinically suspected cases of tuberculosis

: Tuberculosis commonly affects lungs but can also be ex­tra-pulmonary. The increasing prevalence of extra-pulmonary manifestation of tuberculosis is a cause for concern. Microbiological diagnosis is essence for the effective treatment of mycobacterium tuberculosis. The smear detection tests differentiate infectious from non-infectious cases. Both Ziehl-Neelsen (Z-N) and kinyoun stain (KC) methods are over 100 years old; these are most economical in terms of processing time, needed equipment and personnel. The objective of research was to evaluate the two smear microscopy methods for the detection of tubercle bacilli in the sputum and Fine needle aspiration cytology (FNAC) material by comparing the sensitivity, specificity and validities of kinyoun’s method against Z-N staining.A prospective and comparative study was carried using 500 sputum samples and 100 FNAC material received in the department. All the 600 samples were subjected to two methods:Z-N stain and Kinyoun’s cold stain. They were compared for sensitivity and specificity in terms of qualitative results and grades of smear as recommended by RNTCP. : The smear positivity rate was 18% and 20.16% in Ziehl-Neelsen stain and Kinyoun’s cold stain respectively. The direct smear microscopy for Z-N staining showed sensitivity, 89.25%, specificity and positive predictive value (PPV) 100% and negative predictive value (NPV) 97.35% whereas KC method showed sensitivity 98.37%, specificity and PPV 100% and NPV 99.58% respectively. Kinyon’s method described is slightly longer to perform than the Ziehl-Neelsen technique but its ease of use and equal efficacy with Z-N method make it universally applicable, especially in those laboratories where facilities are poor.

A Combined Use of Soft and Neutrosophic Sets for Student Assessment with Qualitative Grades

A hybrid assessment method of a group’s overall performance with respect to a certain activity is developed in this paper using soft and neutrosophic sets as tools and it is applied for student assessment. The present method is compared with another method developed in an earlier authors’ work, which uses soft sets and grey numbers as tools for the assessment.

A Hybrid Approach for Assessing Problem Solving Skills under Fuzzy Conditions

Volumes of research have been written about problem solving, which is one of the most important components of the human cognition affecting the progress of the human society for ages. In this work a hybrid method is applied for the assessment of a student group’s problem solving skills with qualitative grades (i.e. under fuzzy conditions). Namely, soft sets are used as tools for a parametric assessment of the group’s performance, the calculation of the GPA index and the Rectangular Fuzzy Assessment Model are applied for evaluating the group’s qualitative performance, grey numbers are used as tools for assessing the group’s mean performance and neutrosophic sets are utilized when the teacher is not sure about the individual grades obtained by some (or all) students of the group

Comparative Study of Efficacy and Safety of Microneedling with Topical Autologous Platelet Rich Plasma Versus Microneedling Alone in Facial Atrophic Acne Scars

Introduction: Atrophic acne scars are dermal depressions resulting from destruction of collagen after inflammatory acne which can lead to poor self-image and treating them can help improve patients’ self-esteem. Objectives: This study compared the efficacy and safety of combination of microneedling using dermaroller with topical application of autologous platelet rich plasma versus microneedling using dermaroller alone in facial atrophic acne scars. Methods: Patients with atrophic acne scars were randomized into 2 groups of 20 patients each and treated with either dermaroller alone or with a combination of dermaroller and topical application of autologous PRP at 4 weeks intervals for 16 weeks. Final response was evaluated at 4 weeks after the last sitting. Goodman and Baron’s qualitative acne scarring grading system, Goodman and Baron’s quantitative acne scar grading system, physician’s global assessment (PGA) and visual analogue scale were used to evaluate the treatment outcome in both the groups. Side effects were also noted at each visit. Results: At the end of treatment, improvement in Goodman and Baron’s qualitative acne scar grades, decrease in mean Goodman and Baron’s quantitative acne scar scores, percentage decrease in mean Goodman and Baron’s quantitative acne scar scores, physician global assessment and visual analogue scale were significantly higher in patients treated with dermaroller in combination with topical autologous PRP as compared to patients treated with dermaroller alone without much adverse effects. Conclusion: The combination approach using dermaroller and PRP was a better treatment option compared to dermaroller alone in atrophic acne scars with similar safety profile.

Making the Grade during Pandemic: Early-stage and Late-stage Provisional Institutions

This is an article that draws on the institutional work literature about provisional institutions. To date, nearly every U.S. sector has been impacted by COVID-19. To sustain their core missions, highly institutionalized organizations such as universities have had to rethink foundational structures and policies. Using a historical ethnographic approach to investigate records from faculty senate deliberations at “Rural State University” (RSU), the authors examine the implementation of a temporary grading policy to supplement traditional, qualitative grades spring 2020 during the outbreak. The authors find that RSU implemented a temporary, supplemental grading policy as a provisional institution to momentarily supersede traditional grading as a means to—as soon as possible—return to it. This finding contrasts with the common understanding that provisional institutions operate primarily as a temporary solution to a social problem that leads to more stable and enduring, ostensibly nonprovisional institutions. The temporary grading policy, the authors argue, constitutes a “late-stage” provisional institution and, with this new lens, subsequently characterize the more commonplace understanding of provisional institutions as “early-stage.” This contribution has theoretical implications for studies of institutions and empirical implications for research on shared governance and disruption in higher education.

Quantitative T2 -mapping magnetic resonance imaging for assessment of muscle motor unit recruitment patterns.

In this study, we aimed to determine whether muscle transverse relaxation time (T2 ) magnetic resonance (MR) mapping results correlate with motor unit loss, as defined by motor unit recruitment patterns on electromyography (EMG). EMG and 3-Tesla MRI exams were acquired no more than 31 days apart in subjects referred for peripheral nerve MRI. Two musculoskeletal radiologists qualitatively graded T2 -weighted, fat-suppressed sequences for severity of muscle edema-like patterns and manually placed regions of interest within muscles to obtain T2 values from T2 -mapping sequences. Concordance was calculated between qualitative and quantitative MR grades and EMG recruitment categories (none, discrete, decreased) as well as interobserver agreement for both MR grades. Thirty-four muscles (21 abnormal, 13 control) were assessed in 13 subjects (5 females and 8 males; mean age, 46 years) with 14 EMG-MRI pairs. T2 -relaxation times were significantly (P < .001) increased in all EMG recruitment categories compared with control muscles. T2 differences were not significant between EMG grades of motor unit recruitment (P = .151-.702). T2 and EMG score concordance was acceptable (Harrell's concordance index [c index]: rater A, 0.71; 95% confidence interval [CI], 0.51-0.87; rater B, 0.77; 95% CI, 0.57-0.91). Qualitative MRI and EMG score concordance was poor to acceptable (c index: rater A, 0.60; 95% CI, 0.50-0.79; rater B, 0.72; 95% CI, 0.55-0.89). T2 values had moderate-to-substantial ability to distinguish between absent vs incomplete (ie, decreased or discrete) motor unit recruitment (c index: rater A, 0.78; 95% CI, 0.50-1.00; rater B, 0.86; 95% CI, 0.57-1.00). Quantitative T2 MR muscle mapping is a promising tool for noninvasive evaluation of the degree of motor unit recruitment loss.

Applications of Fuzzy Numbers to Hyperconnectivity and Computing

The present article focuses on two directions. First, a new fuzzy method using TFNs or TpFNs as tools is developed for evaluating a group's mean performance, when qualitative grades instead of numerical scores are used for assessing its members' individual performance. Second, a new technique is applied for solving linear programming problems with fuzzy coefficients. Examples are presented on real life situations connected to hyper connectivity and computing problems. Such examples illustrate the applicability of our methods in the modern practice of the forthcoming era of a new industrial revolution that will be characterized by the development of an advanced Internet of Things and energy and by the cyber-physical systems controlled through it. A discussion follows for the perspectives of future research on the subject and the article closes with the general conclusions.

Psychometric evaluation of the French version of the children’s chronotype questionnaire: sleep habits and academic performance of native and immigrant children in Luxembourg

ABSTRACT This paper examined the psychometric properties of the French version of the Children’s Chronotype Questionnaire (CCTQ) attending two elementary schools in Luxembourg (n = 172; ages 4–11 years, M = 8.0, SD = 2.1) of either Portuguese (n = 11), Luxembourgian (n = 147), or other (n = 15) ethnicity. Parents completed the CCTQ, from which we used two chronotype scales (i.e. midsleep point on free days; MSF, multi-item morningness/eveningness; M/E). Results indicated satisfactory internal consistency for M/E scale (α = .70), with high intercorrelation scores (r = .91 between items; r = .87 between scales). As hypothesized, the chronotype of morning and evening type children were different (p= .017, η2 = .06), with the former having an earlier MSF (M = 5:29 h) compared with the latter (M = 5:48 h). The evening group showing the poorest outcomes for the qualitative grades (2014/2015: F(7.308) = 2.34, p = .002; 2015/2016: F(7.996) = 2.46, p = .001). No significant differences in MSFc were found between natives and immigrants. The results indicate that the French version of the CCTQ has adequate reliability and validity for research studies. Evaluating chronotype and sleep behaviors in preschool and school-age children is important, as both may have a negative impact on academic performance.

Temporal Wedge Defects in Glaucoma: Structure/Function Correlation With Threshold Automated Perimetry of the Full Visual Field.

We used the Open Perimetry Interface (OPI) to design a static automated perimetry test of the full visual field. About half of our glaucoma cohort had defects in the far peripheral inferotemporal visual field that correlate well with related damage to the superior nasal optic disc. To test the hypothesis that in glaucoma patients with mild visual loss, perimetric nerve fiber bundle defects present outside 30 degrees will correlate well with areas of Cirrus ocular coherence tomography (OCT) retinal nerve fiber layer thinning. We tested 27 consecutive glaucoma subjects with mild vision loss (mean deviation better than -4 dB) with a SITA standard test, 2 size V custom OPI tests (OPI 30-2 and OPI Peripheral) and Cirrus OCT. Two observers assigned qualitative grades to each type of visual field test based on their level of correlation with OCT retinal nerve fiber layer and ganglion cell thickness. Discrete temporal wedge defects were found on the OPI peripheral V test in 26% of cases whereas more extensive inferior temporal loss (including inferior temporal wedge defect region) was present in 22% of other cases. OCT data correlated best with the OPI peripheral test for 8 glaucoma subjects. The OPI central 30-2 test correlated best for 9 glaucoma subjects; the remainder of subjects had equal central/peripheral correlations. About half of our glaucoma cohort have defects in the far peripheral inferotemporal visual field that correlate well with related damage to the superior nasal optic disc. Adding a threshold automated perimetry test of the far periphery improves structure/function correlations and adds useful clinical information.

A Randomized Study to Evaluate the Efficacy Fractional CO2Laser, Microneedling and Platelet Rich Plasma in Post-Acne Scarring.

Background:Acne scarring commonly seen in young adults causes marked psychological distress. Commonly used procedural treatments for post-acne scarring have limited efficacy. This prospective, randomized study was undertaken to evaluate the efficacy and adverse effects offractional CO2 laser, microneedling, and platelet-rich plasma (PRP) in post-acne scarring.Materials and Methods:Sixty clinically diagnosed cases of post-acne scarring of both sexes were enrolled and divided into three groups of 20 patients each. The severity of scarring was graded as per the qualitative and quantitative grading system proposed by Goodman and Baron. Group A, B, and C patients were treated with fractional CO2 laser, microneedling, and PRP,respectively, at monthly intervals for foursessions. Improve men tin quantitative and qualitative grades of scars and adverse effects were noted at each session and 1 month after the final sitting. Statistical analysis was done using Student 't' test for quantitative values and Chi square test for qualitative values.Results:At the end of foursessions, based on mean percentage of improvement in quantitative grade, the efficacy of fractional CO2 laser is significantly greater than that of PRP (P = 0.00), while CO2 laser and microneedling did not show significant difference (P = 0.106). Based on qualitative scores, fractional CO2 laser group showed statistically higher therapeutic efficacy compared to microneedling and PRP (P = 0.00).No significant adverse effects were encountered in any groups.Conclusion:Fractional CO2 laser resurfacing is more efficacious than microneedling and PRP. Unsatisfactory results were obtained with PRP as monotherapy in post-acne scarring.

Supporting risk management decision making by converting linguistic graded qualitative risk matrices through interval type-2 fuzzy sets

Risk matrices are widely used to present results of qualitative and semi-quantitative risk assessment for risk management decision making. There are different types of risk matrix category definitions according to the function and risk acceptance criteria. This paper reviews some general weaknesses of current risk matrices and proposes a method to improve the reading ambiguity of linguistically graded qualitative risk matrices. Main topic of this paper is the type of risk matrix that grades event consequence and frequency categories in linguistic terms. Because different people understand the meaning of these terms differently, the aim is to convert subjective quantified term inputs produced by a number of experts independently as much as possible to objective values creating at the same time a clearer and more discriminative result. In other words, the method involves asking various expert users independently to estimate numerical intervals of linguistic grades of event consequence and frequency on a continuous scale while maintaining risk acceptance levels. It is applying a second-generation fuzzy logic technique to express linguistic terms in numbers, called computing with words. This interval type-2 fuzzy system has evolved lately as a decision-making support tool and appears to be well suited to handle uncertainty intrinsic to qualitative linguistic grades, fusing different individual expert estimates in an objective way and to facilitate the reading resolution by introducing gliding numerical scales instead of discrete categories. Examples are given to illustrate the method as well as the use of the technique to aggregate a number of different qualitative risk matrix types into one unified risk matrix. The latter is useful in case a corporate-wide risk matrix exists to standardize risk management across the company, but older versions may still be around which should be fused with the newer ones.