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Actuator layout design is a vital procedure that is implemented to ensure active compensation for shape control in the design of active reflector antennas. Considering both the structural and electromagnetic properties of sectional offset reflector antennas, an actuator layout design method is proposed that incorporates a gain-oriented modal selection procedure. The modes are selected to represent the deformed surface shapes by combining the multidisciplinary contributions of both electromagnetic gain performance and structural vibration analysis. An offset reflector antenna with sectional panels is chosen as an example to demonstrate the effectiveness and generality of this proposed method. The simulation shows that compared with the design applied in a simple structural discipline, different modes are obtained by the gain-oriented modal selection procedure, and the proposed method is used to establish different actuator layout configurations with an improved performance requiring fewer actuators than the simple structural design.

Signal amplification is ubiquitous in biology and engineering. Protein enzymes, such as DNA polymerases, can routinely achieve >106-fold signal increase, making them powerful tools for signal enhancement. Considerable signal amplification can also be achieved using nonenzymatic, cascaded nucleic acid strand exchange reactions. However, the practical application of such kinetically trapped circuits has so far proven difficult due to uncatalyzed leakage of the cascade. We now demonstrate that strategically positioned mismatches between circuit components can reduce unprogrammed hybridization reactions and therefore greatly diminish leakage. In consequence, we were able to synthesize a three-layer catalytic hairpin assembly cascade that could operate in a single tube and that yielded 3.7 × 104-fold signal amplification in only 4 h, a greatly improved performance relative to previous cascades. This advance should facilitate the implementation of nonenzymatic signal amplification in molecular diagnostics, as well as inform the design of a wide variety of increasingly intricate nucleic acid computation circuits.

The properties and processing by injection molding and 3D printing of polyethylene terephthalate glycol (PET-G) filled with aluminum powder are investigated. The introduction of up to 5 vol.% of aluminum into the thermoplastic makes it possible to obtain a thermoplastic composite with a metal-like appearance, high mechanical properties and improved performance.

The need to provide a better and stronger protection against various kinds of ballistic impacts and threats has necessitated the continuous exploration and utilization of high-performance fibres, especially those that are derived from renewable sources for ballistic applications. The development of ballistic protection materials with improved performance and low weight has received much concerns in the past few decades due to the rising cases of threats and insurgencies. Owing to the necessity of improving the ballistic performance of body armour and protective wears especially for military personnel, with a huge consideration for eco-friendly requirement, a review of relevant studies in this area is necessary. Present review article aims to present an overview of the progress and the outstanding advances that have been witnessed in the development of natural-based anti-ballistic composites in the past few years. The article covers the type and selection of the fibre/matrix, failure modes, Impact energy absorption and ballistic simulation of NFRCs. It also highlights the economic cost analysis of replacing synthetic fibres with natural ones in a ballistic composite, and the methods of enhancing the composites for high performance and greater ballistic efficiency. The utilization of natural fibres in PMCs have shown their great potentials as substitutes to the existing advanced fibrous materials that are mostly dominated by synthetic fibres.

This paper presents the improvement in the performance of photovoltaic array for water pumping system by introducing fuzzy control in Sensorless vector control of induction motor drive instead of P...

Salient object detection is a challenging task in the computer vision due to complexity of images and insufficiency of a single feature for saliency map generation. The performance of saliency detection depends upon the manner in which these visual features are combined. In this paper, we propose an efficient features combination model in which different features are combined in an appropriate manner. To meet this objective, a metaheuristic optimization algorithm called teacher-learning-based optimization (TLBO) is employed to find an optimal weight vector for feature combination. TLBO is a parameterless, efficient, and robust algorithm as it does not require parameter tuning during its implementation. Furthermore, the optimization criteria of TLBO is modified using a novel fitness function for improved performance. To check the performance of the proposed model, we have conducted extensive experiments over six benchmark datasets and compared the results against seven state-of-the-art methods.

By integrating topology optimization and lattice-based optimization, a novel multi-scale design method is proposed to create solid-lattice hybrid structures and thus to improve the mechanical performance as well as reduce the structural weight. To achieve this purpose, a two-step procedure is developed to design and optimize the innovative structures. Initially, the classical topology optimization is utilized to find the optimal material layout and primary load carrying paths. Afterwards, the solid-lattice hybrid structures are reconstructed using the finite element mesh based modeling method. And lattice-based optimization is performed to obtain the optimal cross-section area of the lattice structures. Finally, two typical aerospace structures are optimized to demonstrate the effectiveness of the proposed optimization framework. The numerical results are quite encouraging since the solid-lattice hybrid structures obtained by the presented approach show remarkably improved performance when compared with traditional designs.

Resumen: Introducción: El entrenamiento de fuerza unilateral ha demostrado provocar aumentos de fuerza tanto en la extremidad entrenada como en la no entrenada. Una de las teorías actuales más aceptadas defiende que el origen de dicho aumento de rendimiento se encuentra en adaptaciones en el sistema nervioso, concretamente en la corteza motora primaria, siendo los aumentos en la excitabilidad corticoespinal (EC) medida con estimulación magnética transcraneal una de las principales adaptaciones observadas tras periodos crónicos de entrenamiento. Por ello, el principal objetivo es hacer un análisis de la literatura actual para determinar el grado de adaptación que se da en la EC y su posible relación funcional con el aumento de fuerza de la extremidad no entrenada. Desarrollo: Se llevó a cabo una búsqueda sistemática en la literatura existente entre enero de 1970 hasta diciembre de 2016 en las bases de datos online Medline (vía PubMed), Ovid, Web of Science y Science Direct con la siguiente estrategia de búsqueda: (Transcranial magnetic stimulation OR excitability) Y (strength training OR resistance training or force) Y (cross transfer OR contralateral limb OR cross education). Finalmente se incluyeron un total de 10 artículos. Conclusiones: Existe cierta inconsistencia en los resultados referentes al aumento de la EC. Aunque no se puede descartar que dicha inconsistencia se deba a aspectos metodológicos, los resultados parecen indicar que el aumento de fuerza y el incremento en la EC podrían no estar funcionalmente relacionados. Abstract: Introduction: Unilateral resistance training has been shown to improve muscle strength in both the trained and the untrained limb. One of the most widely accepted theories is that this improved performance is due to nervous system adaptations, specifically in the primary motor cortex. According to this hypothesis, increased corticospinal excitability (CSE), measured with transcranial magnetic stimulation, is one of the main adaptations observed following prolonged periods of training. The principal aim of this review is to determine the degree of adaptation of CSE and its possible functional association with increased strength in the untrained limb. Development: We performed a systematic literature review of studies published between January 1970 and December 2016, extracted from Medline (via PubMed), Ovid, Web of Science, and Science Direct online databases. The search terms were as follows: (transcranial magnetic stimulation OR excitability) AND (strength training OR resistance training OR force) AND (cross transfer OR contralateral limb OR cross education). A total of 10 articles were found. Conclusion: Results regarding increased CSE were inconsistent. Although the possibility that the methodology had a role in this inconsistency cannot be ruled out, the results appear to suggest that there may not be a functional association between increases in muscle strength and in CSE.

Camera assistance is important for proper visualization of the operative field in laparoscopic surgery. Navigation grid (NG) has been designed to help the camera assistants focus the camera on the target operative field. This is a randomized, controlled trial to study the effect of the NG on performance of camera assistants.Minimally invasive operations were randomized (1:1) to either with or without use of NG for the camera assistant. The operations were recorded and the time spent inside and outside of the target area were reported.A tertiary care teaching hospital.Fifty-eight operations (30 with and 28 without NG) were recorded. Sixteen camera assistants participated. Time spent outside the target area was significantly less with the use of NG (64.5 ± 63 seconds vs 396 ± 226.5 seconds; p0.0001). This impact of NG on performance of the camera assistants was significant regardless of their level of training.NG improved performance of the camera assistant during laparoscopic abdominal procedures. This is a feasible tool that can help camera holders better assist the operating surgeons.

The persistent use of MLCs through VMAT and IMRT is causing additional wear and tear on these mechanical parts, leading to an increase in MLC interlocks, breakdowns and failures. This study investigates the effect of an MLC clean and service procedure on MLC performance and positional accuracy demonstrated through in-house service logbook reports, Varian MLC backlash test results, daily MLC position QC results and Varian TrueBeam trajectory log file data. A service and clean of each individual MLC leaf was carried out on 3 standard MLC and 2 high definition MLC (HDMLC) Varian TrueBeam linacs. In-house service logbook reports, Varian backlash test results, daily MLC picket fence QC results and beam hold data from patient delivery trajectory log files were analysed for up to 6 months pre and 2 years post the MLC service/clean to assess the impact on unplanned MLC maintenance work and MLC performance. The median (range) of hardware faults reduced from 12 (1–17) pre clean to 0 (0–1) and 4 (1–11) at 12 and 24 months respectively for all linacs with the exception of a HDMLC linac where faults increased from 4 pre-clean to 13 and 20 again at 12 and 24 months respectively. The reduction in faults in the alternative 4 linacs was consistent with the reduction in the number of MLCs reaching the 0.3 mm and the 0.4 mm backlash recommendations in the first 12 and 24 months following the service/clean. The increase in faults in the HDMLC linac was also consistent with the increase in MLCs reaching the 0.3 mm backlash recommendation in the first 12 and 24 months. The median (range) of MLCs reaching a daily picket fence QC position tolerance of 0.25 mm reduced from 14 (1–40) pre clean to 0 (0) at both 12 and 24 months post-clean. This demonstrates the improvement in MLC performance caused by the MLC service/clean but also reveals factors other than MLC position accuracy influence hardware faults. Additionally, the number of beam hold-offs determined from patient delivery trajectory log files were found to have no correlation with the MLC service/clean. The MLC service/clean improves MLC performance and MLC position accuracy, reducing reactive repair work for engineering and physics staff. The results were maintained for 1 year post the MLC service/clean, with a trend back towards pre-clean levels in the subsequent 12–24 months. This suggests this preventative maintenance work could be performed at a frequency of > 2 years. This period of reduced faults and improved performance is significant given the 10 year expected lifespan of a linac.

Aim. The aim of our study was to verify the effectiveness of the innovative IntelligenceGym training in improving cognitive abilities in the elderly.Material and methods. We developed an original training method that requires interaction between motor and cognitive functions. In our study 123 women and 89 men, aged 68–76 were examined. The inclusion criteria were Mini-Mental State Examination (MMSE) scores of 23 to 25 at inclusion, autonomy in walking, medical certification to participate in light physical activity. We have proposed to the participants to attend IntelligenceGym training one hour twice a week for 24 weeks. Cognitive performance was assessed before and after intervention included MMSE, Forward and Backward Digit Span Test, Rey’s Auditory Verbal Learning test (RAVLT), TMT-A, TMT-B. Moreover, motor performance was tested by using the Time Up and Go (TUG) test.Results.The cognitive assessment after IntelligenceGym training showed statistically significant improvement in all the scores tested (t-test performed). The results showed that participants of the IntelligenceGym training had particularly improved performance in Digit Span, MMSE and TMT-B tests and also improvements in motor TUG test.Conclusion. These findings indicate that the IntelligenceGym training is an efficient tool to improve cognitive performance in older adults with borderline or mild cognitive deficiency.

Despite the availability of methods for analyzing protein complexes, systematic analysis of complexes under multiple conditions remains challenging. Approaches based on biochemical fractionation of intact, native complexes and correlation of protein profiles have shown promise. However, most approaches for interpreting cofractionation datasets to yield complex composition and rearrangements between samples depend considerably on protein–protein interaction inference. We introduce PCprophet, a toolkit built on size exclusion chromatography–sequential window acquisition of all theoretical mass spectrometry (SEC-SWATH-MS) data to predict protein complexes and characterize their changes across experimental conditions. We demonstrate improved performance of PCprophet over state-of-the-art approaches and introduce a Bayesian approach to analyze altered protein–protein interactions across conditions. We provide both command-line and graphical interfaces to support the application of PCprophet to any cofractionation MS dataset, independent of separation or quantitative liquid chromatography–MS workflow, for the detection and quantitative tracking of protein complexes and their physiological dynamics. ISSN:1548-7105 ISSN:1548-7091

Non-cubic equations of state (nCEOS) are increasingly showing improved performance at predicting volumetric properties of hydrocarbons, nitrogen, and carbon dioxide at high-pressure high-temperatur...

Cryptography is used for secretly sending information. The information or given data is protected by cryptographic technique. The technique is used in Text and images. The technique is supported by a lot of algorithms. RSA is a better encryption technique for smart cards. In this paper, an image in the Aadhaar card is encrypted using the RK-RSA algorithm for better protection and confidentiality. The proposed RK-RSA algorithm is very secure for smart cards and Aadhaar cards. The better performance of the RK-RSA is evaluated based on the Avalanche Effect, Speed, Throughput, and Power Consumption. The improved performance of the RK-RSA algorithm’s experimental results is reported. The mathematical justification supporting the RK-RSA algorithm is also detailed.

This quasi-experimental study was conducted to determine the effects of the Relating, Experiencing, Applying, Cooperating and Transferring (REACT) teaching model, which was based on the Riau–Malay cultural context, on the ability of high school students to solve mathematics problem and their motivation to achieve high performance. A total of 287 high school students were involved in this study. The treatment group consisted of 143 students, whereas the control group comprised 144 students. Data were analysed using the SPSS 25.0 software. Findings showed that students in the treatment and control groups had significantly different abilities to solve mathematical problems and motivations to achieve high performance. Students who underwent the REACT teaching model had better ability and higher motivation than those who learned conventionally. Findings imply the importance of using the REACT model based on the Riau–Malay cultural context to enhance students’ mathematical problem-solving ability and motivation for improved performance.

Device Modeling is utilized to engendering incipient device models for the demeanor of the electrical devices predicated on fundamental physics. Modeling of the device may also include the creation of Compact models. An emerging device type of transistor is the Tunnel Field-Effect transistor that achieves compactness and speed during device modeling. This article presents an analytical comparative study of duel material DG TFETs and triple Material DG TFETs with gate oxide structure . Here the implementation of device modeling is done by solving Poisson’s equation with Parabolic Approximation Technique(PAT).The process of formulation of drain current(Id) model is based on integrating the BTBT generation. A Transconductance model of the device is additionally developed utilizing this drain current model of TFET. Surface potential is calculated by utilizing the channel potential model. The electrical properties like Surface potential〖(Ψ〗_(s,i)), Drain current (Id ), and Electric field(Ei) have been compared for both Duel material DG-TFET and Triple material DG-TFET. The comparison statement of DMDG-TFETs and TMDG-TFETs provide improved performance. The analytical model of the device results are compared with simulated results for DMDG TFET and TMDG TFET and good acquiescent is examined.

This study presents the results of high-resolution dynamical downscaling of 5 km on maximum (TX) and minimum (TN) air temperature and precipitation, for Greece, with the Weather Research and Forecasting (WRF) model. The ERA-Interim (ERA-I) reanalysis dataset is used for initial and boundary conditions. The model results (WRF_5) are evaluated against available ground observations for the period 1980–2004 through the calculation of mean climatology, statistical metrics, and distributions of extreme events on daily, monthly and seasonal scales. WRF_5 model captures very well the geographical distribution of TX and TN of the study area, and illustrates finely the seasonal differences. Statistical results for TX (TN) indicate a cold (warm) bias of − 0.6 °C (1 °C) regarding WRF_5 and − 3 °C (0.5 °C) for ERA-I. The efficiency metrics for temperatures showed a highly improved performance of the model compared to reanalysis for all temporal scales investigated. The observed mean annual cycle and inter-annual variability of precipitation are also well represented by model simulation. Although WRF_5 overestimates rainfall during most of the year, the seasonal pattern of WRF_5 presented similar correlation coefficients for all stations with a range of 0.6–0.85, showing a good model ability to simulate the precipitation in Greece. The results reveal the capability of the configured WRF high resolution model to reproduce the main climatological variables of the study area, outperforming the coarse resolution ERA-Interim in a region that is dominated by highly variable topographic characteristics. This is deemed necessary for undertaking any further studies concerning future climate change impacts in various sectors.

This study assessed the impact of individual social risk factor variables and social determinants of health (SDOH) measures on hospital readmission rates and penalties used in the Centers for Medicare and Medicaid Services (CMS) Hospital Readmissions Reduction Program (HRRP). Using 2012-16 hospital discharge data from New York City, we projected HRRP penalties by augmenting CMS's readmission model for heart attack, heart failure, and pneumonia with SDOH scores constructed at each of four geographic levels and a measure of individual-level social risk. Including additional SDOH scores in the model, especially those constructed with the most granular geographic data, along with social risk factor variables substantially affects projected penalties for hospitals treating the highest proportion of patients with high SDOH scores. Improved performance occurred even after we included peer-group stratification in the HRRP model pursuant to the 21st Century Cures Act. Small improvements in model accuracy were associated with substantial shifts in projected performance. Our results suggest that CMS's continued omission of relevant patient and geographic data from the HRRP readmission model misallocates penalties attributable to SDOH and social risk factor effects to hospitals with the largest share of high-risk patients.

Background Studies on the optimal CT section thickness for detecting subsolid nodules (SSNs) with computer-aided detection (CAD) are lacking. Purpose To assess the effect of CT section thickness on CAD performance in the detection of SSNs and to investigate whether deep learning-based super-resolution algorithms for reducing CT section thickness can improve performance. Materials and Methods CT images obtained with 1-, 3-, and 5-mm-thick sections were obtained in patients who underwent surgery between March 2018 and December 2018. Patients with resected synchronous SSNs and those without SSNs (negative controls) were retrospectively evaluated. The SSNs, which ranged from 6 to 30 mm, were labeled ground-truth lesions. A deep learning-based CAD system was applied to SSN detection on CT images of each section thickness and those converted from 3- and 5-mm section thickness into 1-mm section thickness by using the super-resolution algorithm. The CAD performance on each section thickness was evaluated and compared by using the jackknife alternative free response receiver operating characteristic figure of merit. Results A total of 308 patients (mean age ± standard deviation, 62 years ± 10; 183 women) with 424 SSNs (310 part-solid and 114 nonsolid nodules) and 182 patients without SSNs (mean age, 65 years ± 10; 97 men) were evaluated. The figures of merit differed across the three section thicknesses (0.92, 0.90, and 0.89 for 1, 3, and 5 mm, respectively; P = .04) and between 1- and 5-mm sections (P = .04). The figures of merit varied for nonsolid nodules (0.78, 0.72, and 0.66 for 1, 3, and 5 mm, respectively; P < .001) but not for part-solid nodules (range, 0.93-0.94; P = .76). The super-resolution algorithm improved CAD sensitivity on 3- and 5-mm-thick sections (P = .02 for 3 mm, P < .001 for 5 mm). Conclusion Computer-aided detection (CAD) of subsolid nodules performed better at 1-mm section thickness CT than at 3- and 5-mm section thickness CT, particularly with nonsolid nodules. Application of a super-resolution algorithm improved the sensitivity of CAD at 3- and 5-mm section thickness CT. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Goo in this issue.

Linear alpha olefins (LAO) are a class of chemical compounds used in the production of such high-demand products as plasticizers, synthetic lubricants, surfactants, and co-polymers with improved performance. The world consumption of LAO derivatives grows annually, as does the role of LAO processing by scientific institutions, universities, and research departments of commercial companies. Analysis of the scientific literature of the last ten years revealed no general reviews of LAO processing. This work describes recent trends in the processing of LAOs that contain four or more carbon atoms into technologically important derivatives. It lists the main products obtained via LAO processing, along with the means of their production and applications. Existing technological processes for the production of LAO derivatives and the catalysts that are used are considered briefly. Current trends in LAO processing and promising ways to improve existing technologies are described, including the development of new types of catalysts. This review does not claim to be exhaustive, since its main purpose is to give a general idea of the major trends in LAO processing, the catalysts used in these processes, and current ways of improving them.

Learning fractions is a critical step in children’s mathematical development. However, many children struggle with learning fractions, especially fraction arithmetic. In this article, we propose a general framework for integrating understanding of individual fractions and fraction arithmetic, and we use the framework to generate interventions intended to improve understanding of both individual fractions and fraction addition. The framework, Putting Fractions Together (PFT), emphasizes that both individual fractions and sums of fractions are composed of unit fractions and can be represented by concatenating them (putting them together). To illustrate, both “3/9” and “2/9 + 1/9” can be represented by concatenating three 1/9s; similarly, 2/9 + 1/8 can be represented by concatenating two 1/9s and one 1/8. Interventions based on the PFT framework were tested in 2 experiments with fourth, fifth, and sixth grade children. The interventions led to improved performance on number line estimation and magnitude comparison tasks involving individual fractions and sums of fractions with equal and unequal denominators. Especially large improvements were observed on relatively difficult unequal-denominator fraction sum problems. The findings suggest that viewing individual nonunit fractions and sums of fractions as concatenations of unit fractions provides a sound conceptual foundation for improving children’s knowledge of both. We discuss implications of the research for teaching and learning fractions, children’s numerical development, and mathematics education in general. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

When children with ADHD are presented with behavioral choices, they struggle more than Typically Developing [TD] children to take into account contextual information necessary for making adaptive choices. The challenge presented by this type of behavioral decision making can be operationalized as a Conditional Discrimination Learning [CDL] task. We previously showed that CDL is impaired in children with ADHD. The present study explores whether this impairment can be remediated by increasing reward for correct responding or by reinforcing correct conditional choice behavior with situationally specific outcomes (Differential Outcomes). An arbitrary Delayed Matching-To-Sample [aDMTS] procedure was used, in which children had to learn to select the correct response given the sample stimulus presented (CDL). We compared children with ADHD (N = 45) and TD children (N = 49) on a baseline aDMTS task and sequentially adapted the aDMTS task so that correct choice behavior was rewarded with a more potent reinforcer (reward manipulation) or with sample-specific (and hence response-specific) reinforcers (Differential Outcomes manipulation). At baseline, children with ADHD performed significantly worse than TD children. Both manipulations (reward optimization and Differential Outcomes) improved performance in the ADHD group, resulting in a similar level of performance to the TD group. Increasing the reward value or the response-specificity of reinforcement enhances Conditional Discrimination Learning in children with ADHD. These behavioral techniques may be effective in promoting the learning of adaptive behavioral choices in children with ADHD. ispartof: Research on Child and Adolescent Psychopathology vol:49 issue:9 pages:1165-1178 ispartof: location:United States status: published

Jung-Min Pyun,1 Ji Sun Ryu,2 Ryan Lee,2 Kyu Hawn Shim,3 Young Chul Youn,4 Nayoung Ryoo,5 Sang-Won Han,5 Young Ho Park,5 Sungmin Kang,2 Seong Soo A An,6 SangYun Kim5 1Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu-si, Gyeonggi-do, Republic of Korea; 2Research and Development, PeopleBio Inc., Seongnam-si, Gyeonggi-do, Republic of Korea; 3Department of Neurology, Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea; 4Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea; 5Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; 6Department of Bionanotechnology, Gachon University, Seongnam-si, Gyeonggi-do, Republic of KoreaCorrespondence: SangYun KimDepartment of Neurology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of KoreaTel +82 31 787 7462 Fax +82 31 787 4059Email neuroksy@snu.ac.krPurpose: Among other emerging amyloid-targeting blood-based biomarkers, Multimer Detection System-Oligomeric Amyloid-β (MDS-OAβ) measures dynamic changes in concentration of oligomeric amyloid-β (OAβ), which is considered the main pathogenic culprit of Alzheimer’s disease (AD), in plasma after spiking with synthetic amyloid-β (Aβ). We aimed to investigate the predictability of MDS-OAβ on amyloid positron emission tomography (PET) positivity.Patients and Methods: A total of 96 subjects who visited Seoul National University Bundang Hospital for medical check-up complaining of cognitive decline and had undergone extensive medical assessment were recruited. Amyloid statuses were dichotomized into positive or negative based on visual assessment of amyloid PET. Plasma OAβ concentration was measured by MDS-OAβ. In the previous validation study, 0.78ng/mL was established as the cut-off value and the plasma OAβ concentration higher than or equal to the cut-off value was defined as MDS-OAβ positive.Results: MDS-OAβ positivity could discriminate amyloid PET positivity with the AUC value of 0.855 (95% CI 0.776– 0.933). Adding MDS-OAβ positivity to prediction models including age, MMSE score, and APOE ϵ4 status improved performance up to the AUC value of 0.926 (95% CI 0.871– 0.980).Conclusion: The Aβ oligomerization tendency in plasma could predict amyloid PET positivity with high performance, and, when it is combined with age, MMSE score, and APOE ϵ4 status, predictability was improved substantially. This suggests the potential of MDS-OAβ as a useful initial stage test in the clinical and research fields of AD.Keywords: multimer detection system-oligomeric amyloid-β, Aβ oligomer, predictability, amyloidopathy, blood-based biomarker

Background Simultaneous urothelial cancer manifestation in the lower and upper urinary tract affects approximately 2% of patients. Data on the surgical benchmarks and mid-term oncological outcomes of enbloc robot-assisted radical cystectomy and nephro-ureterectomy are scarce. Methods After written informed consent was obtained, we prospectively enrolled consecutive patients undergoing enbloc radical cystectomy and nephro-ureterectomy with robotic assistance from the DaVinci Si-HD® system in a prospective institutional database and collected surgical benchmarks and oncological outcomes. Furthermore, as one console surgeon conducted all the procedures, whereas the team providing bedside assistance was composed ad hoc, we assessed the impact of this approach on the operative duration. Results Nineteen patients (9 women), with a mean age of 73 (SD: 7.5) years, underwent simultaneous enbloc robot-assisted radical cystectomy and nephro-ureterectomy. There were no cases of conversion to open surgery. In the postoperative period, we registered 2 Clavien-Dindo class 2 complications (transfusions) and 1 Clavien-Dindo class 3b complication (port hernia). After a median follow-up of 23 months, there were 3 cases of mortality and 1 case of metachronous urothelial cancer (contralateral kidney).The total operative duration did not decrease with increasing experience (r = 0.174, p = 0.534). In contrast, there was a significant, inverse, strong correlation between the console time relative to the total operative duration and the number of conducted procedures after adjusting for the degree of adhesions and the type of urinary diversion(r = -0.593, p = 0.02). Conclusions These data suggest that en bloc simultaneous robot-assisted radical cystectomy and nephro-ureterectomy can be safely conducted with satisfactory mid-term oncological outcomes. With increasing experience, improved performance was detectable for the console surgeon but not in terms of the total operative duration. Simulation training of all team members for highly complex procedures might be a suitable approach for improving team performance. Trial registration: Not applicable.

In an emergency route planning technique, simulating the dynamic crowd has route capacity constraints and global target of evacuating all crowd evacuees. To stimulate the crowd, the new arena is developed to know the real-time situation to face the crowd evacuation on exit point. The crowd evacuation is done with the process of Hybrid Agent Reinforcement Learning (HARL) algorithm consisting of Improved Multi-Agent Reinforcement Learning (IMARL) and State-Action-Reward-State-Action (SARSA). In the proposed work, the appropriate route selection mechanism focused on finding optimum evacuation route(s) is done in the first phase. Dynamic crowd can also be evacuated to find its way with the support of the HARL process in the second phase. The proposed HARL method can also be implemented with multi-objective improved particle swarm optimization (IPSO) technique for crowd simulation. The experimented results demonstrate the effectiveness of stability in the HARL process, which provides an improved performance for crowd simulation

This article sought to investigate the influence of community participation in project planning on the performance of community water supply projects in Kericho County, Kenya. The indicators used to assess this included community participation in; Scope planning, Activity planning and Resource planning. The study adopted descriptive survey design and correlation research design. The descriptive survey design was used to describe characteristics of the population being studied whilst a correlational research was used to describe the degree to which variables under the study were related. The target population comprised 8369 people from which a sample of 382 was considered and out of which 310 responded. The sample comprised of household heads, management committee members and sub-County water officers. The research instruments for this study were: questionnaires, focus group discussion and interview schedules. Stratified proportional sampling, random sampling and census techniques were used to collect primary qualitative and quantitative data. The data was compiled, given codes and input into SPSS version 25 computer program for statistical analysis and presentation. The study findings showed that community participation in scope planning (R=0.580, p=0.00

The design of rolling bearings must be optimized to get an improved fatigue life. As the fatigue life is directly affected by the dynamic capacity, therefore the later is considered as an objective...

Solar energy is being used for the purpose of water distillation since long. The present work demonstrates the comprehensive experimental investigation of various heat transfer enhancement arrangem...

In this study the effect of a surface combat swimming (sCS) training program on performance in freestyle swimming and sCS was examined. Forty-five officer cadets were divided into three equivalent groups: a control group (CG), a group that was trained only with a swimsuit and fins (SF), and a group that was trained with combat uniform and equipment (UE). Groups SF and UE followed a 60-min training program with sCS for 4 weeks, 4 times per week. Before and after the training program all groups performed 4×50 and 400-m freestyle swimming, 250-m sCS with a uniform and equipment, 350-m with a swimsuit and fins, and 300-m with a swimsuit. The UE group showed improved performance in 4×50-m (mean±SD 14±9 s) and in 250-m sCS (24±14 s) (In this study the effect of a surface combat swimming (sCS) training program on performance in freestyle swimming and sCS was examined. Forty-five officer cadets were divided into three equivalent groups: a control group (CG), a group that was trained only with a swimsuit and fins (SF), and a group that was trained with combat uniform and equipment (UE). Groups SF and UE followed a 60-min training program with sCS for 4 weeks, 4 times per week. Before and after the training program all groups performed 4×50 and 400-m freestyle swimming, 250-m sCS with a uniform and equipment, 350-m with a swimsuit and fins, and 300-m with a swimsuit. The UE group showed improved performance in 4×50-m (mean±SD 14±9 s) and in 250-m sCS (24±14 s) (

Numerous studies have demonstrated improved performance results for sport skills through attentional focus instructions. However, few studies have examined the effects of cueing on expert kinematic performance, and this is the first to assess cueing’s kinematic effects on expert soccer players performing .common techniques This study assessed the lower extremity kinematics of an inside of the foot soccer trap via motion capture cameras under different attentional focus cues to analyze how the cues affect the movement pattern among expert performers. 10 NCAA Division 1 soccer players trapped a launched ball on a scoring mat after receiving coaching cues inducing an internal, external, holistic, or control focus of attention. Statistical analysis revealed movement differences between the internal and external cue conditions for the ankle and knee joints during the movement. The difference at the knee was a steeper flexion followed by a correction and, at the ankle, a steeper flexion, both during the internal cue condition. Attentional focus cues inducing a conscious control of the movement may disrupt the movement patterns of highly skilled expert performers. Coaches should be acutely aware of the language they use in instruction, even among expert performers.

Defect engineering can modify the physical and chemical properties of two-dimensional (2D) materials to advance their effectiveness for applications. Here, we have designed three kinds of single ca...

Cochlear-implant (CI) users experience less success in understanding speech in noisy, real-world listening environments than normal-hearing (NH) listeners. Perceptual restoration is one method NH listeners use to repair noise-interrupted speech. Whereas previous work has reported that CI users can use perceptual restoration in certain cases, they failed to do so under listening conditions in which NH listeners can successfully restore. Providing increased opportunities to use top-down linguistic knowledge is one possible method to increase perceptual restoration use in CI users. This work tested perceptual restoration abilities in 18 CI users and varied whether a semantic cue (presented visually) was available prior to the target sentence (presented auditorily). Results showed that whereas access to a semantic cue generally improved performance with interrupted speech, CI users failed to perceptually restore speech regardless of the semantic cue availability. The lack of restoration in this population directly contradicts previous work in this field and raises questions of whether restoration is possible in CI users. One reason for speech-in-noise understanding difficulty in CI users could be that they are unable to use tools like restoration to process noise-interrupted speech effectively.

The present study was carried out to study the effect of Spirulina supplementation on the growth and some physiological performances of the Gimmizah males exposed to heat stress (HS). A total number of 150 male 4 weeks old Gimmizah were randomly allocated in five groups (3 replicates, 10 chicks each). The first (positive control, PC) was reared under 22-24OC and PH 45-55% and fed unsupplied basal diet, B). Whereas, the other groups were reused under HS (38°C±1; 55-65 % RH) for three successive days /wk from 11.00 a.m until 15.00 p.m, through the experimental period (4 to 14 wks of age) in a battery brooders. The first HS group was used as a negative control (NC) and fed B. The 3rd and 4rd groups fed B plus 250 and 150 mg Spirulina /kg diet, respectively. The 5 group was fed the B plus 75 mg VE /kg diet. The feed consumption was significantly decreased for all groups under HS compared with PC group, while FCR for the groups under HS (supplied with Spirulina or VE) were significantly improved compared with NC. The differential of leukocytic count for the NC group recorded the significant increase on Lymphocyte, Heterophil and the ratio of H/L compared with other groups. The concentration of globulin and activity of GSH-PX were significantly improved for the groups supplied with both levels of Spirolina under HS compared with the NC group. The highest Infections Bronchitis titer was recorded for the group supplied with VE and PC group. In conclusion, addition of 150 and 250 mg Spirulina platensis /kg diet improved performance, immunity and can be decreased the adverse effect of heat stress for Gimmizah mail during growing period (4-14 wks of age).

Noteworthy advancements are seen in developing the earth-air heat exchanger (EAHE) models in the past several decades to reduce building energy consumption. However, it is still an ongoing challenge in selecting and implementing the most suitable and appropriate EAHE modelling technique in buildings based on the climates, performance, and limitations of the techniques. Therefore, this paper aims to review the published research related to the physical, and hybrid EAHE modelling techniques used in buildings, and highlight the prospects, benefits, progress, and challenges of these techniques. This is the first study that comprehensively evidences the prospects and technical challenges caused by unmeasured disturbances, assumptions, or the uncertainties generated in experimental and numerical works of all EAHE modelling techniques. Nevertheless, this study found that hybrid modelling is more effective than physical models for accurate prediction. On the contrary, the hybrid models suffer from high complexity if EAHE operating conditions and all key parameters are considered during the model development. Regarding the generalization capability, the physical models offer improved performance followed by the hybrid models. A minimum number of training data is needed for developing physical models, whereas medium training data is required for the hybrid models. The outcome of this study also provides valuable information regarding the physical and hybrid EAHE modelling techniques to the scientists, researchers, and so on in adopting the most appropriate EAHE modelling technique for their climates.

Automotive starter-generator applications require a high peak torque for cranking and a wide speed flux weakening region for generation. In such applications, the pole-changing winding induction machine offers a wide speed flux weakening region with a low pole number and a high peak torque capability when operated with a higher number of poles. In this article, a 6-phase, electronic pole-changing winding induction machine with improved performance over the existing 3-phase pole-changing is discussed. Compared to the 3-phase 120o phase belt winding, the proposed 6-phase pole-changing winding induction machine shows a 15 % increase in peak torque due to improved winding factor. Finite element analysis is used to predict the torque capability, losses and efficiency of the 6-phase and 3-phase pole-changing winding induction machines. A 1kW induction machine is prototyped and the improved torque capability of the 6-phase pole-changing machines over 3-phase counterparts is experimentally validated under various operating conditions.

A redox-active tetrazine moiety is immobilized within a metal-organic framework (MOF) aiming at targeted construction of a cathode with improved performance for lithium–oxygen batteries. A 1,2,4,5-...

Objective To assess the efficacy of an intern surgical skills curriculum involving a boot camp for core open and laparoscopic skills, self-guided practice with positive and negative incentives, and semiannual performance evaluations. Design Longitudinal cohort study. Setting Academic tertiary care center. Participants Intervention group (n = 15): residents who completed the intern surgical skills curriculum and had performance evaluations in fall of intern year, spring of intern year, and fall of second year. Control group (n = 8): second-year residents who were 1 year ahead of the intervention group in the same residency program, did not participate in the curriculum, and had performance evaluations in fall of second year. Results In fall of second year of residency, the intervention group had better performance (presented as median values with interquartile ranges) than the control group on one-hand ties (left hand: 9.1 [6.3-10.1] vs 14.6 [13.5-15.4] seconds, p = 0.007; right hand: 8.7 [8.5-9.6] vs 11.5 [9.9-16.8] seconds, p = 0.039). The intervention group also had better performance on all open suturing skills, including mattress suturing (vertical: 33.4 [30.0-40.0] vs 55.8 [50.0-67.6] seconds, p = 0.001; horizontal: 28.7 [27.3-39.9] vs 52.7 [40.7-57.8] seconds, p = 0.003), and a water-filled glove clamp, divide, and ligate task (28.0 [25.0-31.0] vs 59.1 [53.0-93.0] seconds, p < 0.001). Finally, the intervention group had better performance on all laparoscopic skills, including peg transfer (66.0 [59.0-82.0] vs 95.2 [87.5-101.5] seconds, p = 0.018), circle cut (82.0 [69.0-124.0] seconds vs 191.8 [155.5-231.5] seconds, p = 0.002), and intracorporeal suturing (195.0 [117.0-200.0] seconds vs 359.5 [269.0-450.0] seconds, p = 0.002). Conclusions Implementation of a comprehensive surgical skills curriculum was associated with improved performance on core open and laparoscopic skills. Further research is needed to understand and optimize motivational factors for deliberate practice and surgical skill acquisition.

Educational evaluation helps to improve the learning and teaching process. The learning process can be assessed by the examination system. In the examination system, the learners have to answer a set of questions. The learning assessment ensures improved performance in the educational system. The success of the learning assessment is highly dependent on the listening and understanding ability of each student. The assessment of the question paper can be at two levels—cognitive level assessment and difficulty level. The cognitive level assessment is purely based on Bloom’s Taxonomy and the difficulty level assessment is purely based on the examination marks of each student. This article presents a technical method called Question Paper’s Difficulty Level (QPDL) that helps to identify the difficulty level of each question in the question paper. The QPDL method is incorporate in the implementation of ‘QAUDIT’ web application to assess the difficulty level of the question paper systematically. The systematic analysis to identify the difficulty level of the question paper is made for 239 question papers. Each question paper can be recognized based on three difficulty levels such as High, Moderate and Low.

Background: At high level of competition, sports require long periods of hard physical work. Each athlete should be able to perform desired actions efficiently, which will not be possible without coordinated activation of muscles in the kinetic chain. EMG studies demonstrate that lumbar paraspinal muscles fatigue is associated with Quadriceps Inhibition (QI), leading to speculation that these changes may not only have adverse effect for athletic performance but also increase the risk of injury in long term. This contrasts the evidence about the influence of fatigue on trunk muscles reflex activity. Method: 37 athletes (men) were recruited from city soccer clubs. The participants performed sub maximal isometric exercise of lower back extensors (Ito’s test) to induce fatigue. The two protocols were a single bout and repeated bouts of Lumbar Extension Isometric Exercise (LEIE). The Agility scores recorded at baseline, after single bout and after repeated bouts of LEIE were compared. Conclusion: The two experimental interventions differently affected the agility performance in the sample. On one hand, single bout intervention led to improved performance, repeated bout intervention resulted in relative deterioration of performance.

The cleft of the lip and palate (CLP) is a congenital disability affecting the craniofacial region and it impacts the speech production system. The current work focuses on the modification of misarticulations produced for unvoiced stop consonants in CLP speech. Three types of misarticulations are studied: glottal, palatal, and velar stop substitutions. The stop consonants are misarticulated due to inadequate buildup of intra-oral pressure caused by velopharyngeal dysfunction and oro-nasal fistula. The misarticulated stops affect the speech intelligibility and quality, and this further affects the use of speech-based applications. The misarticulated stops are analyzed and modified using the speech data collected from 60 Kannada speaking children (normal and CLP). An event-based modification approach is used to correct the misarticulated stops. At first, automatic detection of burst onset and vowel onset events is carried out. Then, the region from vowel onset to 20 ms duration of the vowel is extracted. Further, the region from burst onset point to 20 ms duration of the vowel is defined as the region for modification. It is transformed using the nonnegative matrix factorization (NMF) method. The objective and subjective evaluation results show that the proposed event-based transformation approach provides a relative improvement compared to the entire-word modification (signal processed without using the knowledge of burst and vowel onset events). The event-based transformed misarticulated stops showed close similarity with the normal stops in perceptual quality. The improved performance accuracy of modified stops suggests that the speech distortion is minimized.

Purpose Automotive coating materials are very important items for this industry. However, their performance is limited by the use of excessive amounts of solvents in their formulations, whereas the emission of volatile organic solvents is against the widely ascending principle of green chemistry. Thus, this study aims to overcome this global problem to save the environment without affecting the properties and performance of the coating. Design/methodology/approach High solid content paint formulation for automotive applications has been designed with low amount of volatile organic solvents with the aid of a functionalized hyperbranched modifier. Findings It was found that the presence of a hyperbranched additive allows a high solid content to be designed and facilitate the processing, which indicates its liability to compensate the role played by excessive solvents amounts. In addition, the mechanical properties and physical characteristics of the modified coatings showed outstanding performance and preservation of clarity in comparison with the commercial counterparts. Practical implications A high solid content coating with facile processing and improved performance leads to cheaper price beside the positive impact on the environment considering the limited emission of volatile organic contents. Social implications Limitation of the used volatile organic compounds in any industry helps to save the health of humans and keep the environment unaffected. Originality/value The use of functionalized hyperbranched additive to automotive coatings is a very promising additive for automotive coatings with optimized characteristics.

The information on the projected climate changes over China is of great importance for preparing the nation’s societal adaptiveness to the future natural ecosystem. This study reports the surface mean temperature changes during 2014–2100 over China and its four sub-regions (Northern China, Northwestern China, Southern China, and the Tibetan Plateau) by analyzing 20 models from the Coupled Model Intercomparison Project Phase 6 (CMIP6) under three Shared Socio-economic Pathway (SSP) scenarios: SSP126, SSP245 and SSP585. The multi-model ensemble mean (MMEM) of 20 CMIP6 models has cold biases over China during 1979–2014, with improved performance compared with the CMIP5 models. In contrast, the CMIP6 models simulate well in the spatial climatology with lower warming rates over China. Relative to 1986–2005, the regionally averaged surface mean temperatures from the MMEM over China under SSP126, SSP245, SSP585 scenarios are projected to increase by 1.31 °C, 1.32 °C, 1.45 °C in the near-term (2021–2040), 1.75 °C, 2.06 °C, 2.66 °C in the mid-term (2041–2060), and 1.08 °C, 2.97 °C, 5.62 °C in the long-term (2081–2100), respectively. The CMIP6 models simulate accelerated warming occurs over the Northwestern China and the Tibetan Plateau, suggesting that the arid and semi-arid regions are particularly sensitive to future climate warming. We quantify uncertainty for future projections of temperature changes over China, and the main sources of uncertainty are model and scenario uncertainty particularly for the regions with the largest cold bias. This suggests that the observational constraints on these regions will lead to significant improvements for climatic projections over China.

Solution-processed indium gallium tin oxide (InGaSnO, IGTO) thin film transistors (TFTs) are investigated as promising low-cost and stable materials for high-performance amorphous oxide semiconduct...

High-power, flexible electronic devices require substrates that effectively dissipate heat while maintaining mechanical compliance. Nanocomposite substrates with ∼20 μm graphite nanoplatelets were ...

The study aims to evaluate the moderating role of service innovation on the relationship between corporate reputation and the performance of hotels in Kenya. The study design used was cross-sectional descriptive utilizing the mixed approach. The target that served as the study population, was General Managers of all the 4-star hotels in Kenya. Primary data was collected by the use of a self-administered semi-structured questionnaire and secondary data from hotel records, journals, and government publications. Data analysis involved qualitative and quantitative techniques, analyses of variance (ANOVA), and Structural Equation Modelling (SEM) which tested the hypothesized relationship in this study. Statistical software such as Statistical Package for Social Sciences version 21, MS-Excel for Windows 8, Analysis of Moment Structures version 17, and SmartPLS version 2.0 was used for analysis. The theoretical models and hypotheses were tested based on empirical data gathered from 43 General Managers. The study findings indicate that corporate reputation positively and significantly influences performance (C.R = 5.907 at 5% ?-level) and service innovation moderates (R2 change = 0.054) the relationship between corporate reputation and performance. The study results are meant to benefit hotel industry policymakers, academicians, and other opportunistic entrepreneurs. The recommendation is that the hotel industry should invest seriously in corporate reputation so as to influence customer purchase behavior and improved performance.

Objective: Past research with one-person showup identification procedures suggests that providing witnesses with an explicit option to opt-out reduces innocent-suspect identifications without reducing culprit identifications (Weber & Perfect, 2012). This finding suggests that improving performance from identification procedures might be as simple as providing witnesses with the option to opt-out from deciding. We examined whether providing witnesses with an option to say "not sure" improved performance from showup procedures. Hypotheses: We predicted that participants would opt-out more when given a poor view. We also predicted that classification performance would be better for those who had option to opt-out, and this improvement would be more pronounced for those who had a poor view. Finally, we predicted that the opt-out option would reduce more low-confidence than high-confidence decisions. Method: We randomly assigned Amazon Mechanical Turk Workers (Experiment 1A: N = 2,003, average age = 36.90 [SD = 11.67], 57.86% female) and university students (Experiment 1B: N = 721, average age = 19.91 (SD = 3.99), 69.72% female) to a 2 (culprit: present, absent) × 2 (memory strength: strong, weak) × 2 (not sure option: yes, no) between-participants design. We manipulated memory strength by giving witnesses either a clear or degraded view of the encoding video. After watching the encoding video, participants completed a 10-min filler task and were then presented with a showup procedure. Results: Participants who were given a poor view were more likely to opt-out than were participants who were given a clear view. Participants who were given the option to respond not sure reported higher confidence in their decisions. However, the not sure option did not improve classification performance. Conclusion: Contrary to our prediction, we found no evidence that an opt-out option improves performance from a showup procedure, which is consistent with past research examining opt-out options with lineup procedures. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

الملخص: أهداف البحث: هدفت هذه الدراسة إلى صياغة وتنفيذ وحدة وظائف الجهاز القلبي الوعائي بنظام التدريس القائم على دراسة الحالة وذلك لطلبة السنة الثانية للصيدلة الإكلينيكية. كما قمنا بتقويم مرئيات الطلبة وتمت مقارنة الأداء الأكاديمي لمجموعة الطلبة الذين تم تدريسهم بنظام التدريس القائم على الحالة مع مجموعة الطلبة الذين تلقوا المحاضرات التعليمية التقليدية. طرق البحث: أجريت هذه الدراسة الوصفية الكمية على ١٨١ طالبا الذين تم تقسيمهم إلى مجموعتين. وخضعت المجموعة ١ (٧٧ طالبا) إلى المحاضرات التعليمية التقليدية وتلقت المجموعة ٢ (٩٤ طالبا) نفس الموضوعات بنظام التدريس القائم على دراسة الحالة. تم إجراء امتحان كتابي في نهاية كلا الوحدتين. وتم استخدام استبانة موثقة للحصول على المرئيات حيال نظام التدريس القائم على دراسة الحالة ودرجات التقييم من جميع المجموعات وكانت نسبة الاستجابة ٩٣.٦٪. النتائج: كانت ردود الطلاب حول نظام التدريس القائم على دراسة الحالة إيجابية، وذكر معظم الطلاب ٦٣ (٧٢٪) أنهم يفضلون نظام التدريس القائم على دراسة الحالة الذي جعل التعلم والفهم تجربة ممتعة. كما ذكر المشاركون أن التدريس القائم على دراسة الحالة حفز التفكير النقدي (٦٧; ٧٦٪) وساهم في ربط النظرية بالممارسة (٦٩؛ ٧٨٪). وعلاوة على ذلك، فضل ٧٠ (٨٠٪) منهم هذا النوع من التدريس والتقييم في المستقبل، واتفق ٧٠ (٨٠٪) على تضمين نظام التدريس القائم على دراسة الحالة في جميع المواد ما قبل السريرية. كما جاءت نتائج الاختبارات متوافقة مع مرئيات الطلبة، حيث كان متوسط النسبة المئوية لدرجات الاختبار في مجموعة التدريس القائم على دراسة الحالة أعلى بكثير مقارنة بالمجموعة التي تلقت المحاضرات التعليمية التقليدية. كشفت مقارنة أخرى داخل مجموعة التدريس القائم على دراسة الحالة عن تحسن في أداء الطلاب في الأسئلة ”المستندة إلى حالة“ مقارنة بالأسئلة التقليدية. الاستنتاجات: في هذه الدراسة، يحظى نظام التدريس القائم على دراسة الحالة على تقدير كبير من قبل الطلاب لأنه يحفز التفكير المنطقي والمشاركة النشطة في الفصل، مما يؤدي إلى تحسين الأداء في الاختبارات. Abstract: Objective: This study aimed to formulate and implement a case-based cardiovascular physiology module for second year clinical pharmacy (CP) students. We also evaluated the students' feedback and compared the academic performance between a case-based teaching (CBT) group and a traditional didactic lectures (TDL) group. Methods: This descriptive quantitative study was conducted on 181 students who were divided into two groups. Group 1 (77 students) underwent TDL and the same topics were delivered to Group 2 (94 students) through CBT. A written examination was conducted at the end of both modules. A validated questionnaire was used to obtain feedback from the CBT group regarding CBT and their assessment grades (response rate - 93.6%). Results: Students' feedback about CBT was positive. The majority of students, 63 (72%), preferred learning and understanding through CBT, finding it an enjoyable experience. Participants stated that CBT stimulated critical thinking (67; 76%) and linked theory to practice (69, 78%). Furthermore, 70 (80%) preferred this type of teaching and assessment in the future and 70 (80%) agreed to include CBT in all preclinical subjects. Students feedback was supported by exam results: the mean percentage of exam scores in the CBT group was significantly higher in comparison to the TDL group (81.2% vs. 79%, p value