E-government development is often complex, with multiple stakeholders, large user bases and complex goals. Consequently, even experts have difficulties in evaluating these systems, especially in an integrated and comprehensive way, as well as on an aggregate level, and thus, there is currently little knowledge about the actual impact and results of e-government. Expert systems are a candidate solution to evaluate such complex e-government systems. However, it is difficult for expert systems to cope with uncertain evaluation data that are vague, inconsistent, highly subjective or in other ways challenging to formalize. This paper presents an approach that 2 can handle uncertainty in e-government evaluation: The combination of Belief Rule Base (BRB) knowledge representation and Evidential Reasoning (ER). This approach is illustrated with a concrete prototype, known as the Belief Rule Based Expert System (BRBES) and implemented in the local e-government of Bangladesh. The results have been compared with a recently developed method of evaluating e-government, showing that the BRBES approach is more accurate and reliable. The BRBES can be used to identify the factors that need to be improved in e-government projects and can juxtapose different scenarios. Thus, the system can be used to facilitate decision making processes under uncertainty.

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Keywords: Atrial septal defect; Cosmetic approach; ThoracotomyOnline: 27 August 2009DOI: 10.3329/bmrcb.v35i2.2766Bangladesh Med Res Counc Bull 2009; 35: 75-76

Background: This prospective non-randomized clinical study was done to compare Off-pump and Onpump myocardial revascularization by Troponin I release in patients undergoing first elective coronary artery bypass graft used to evaluate myocardial injury. Methods: One hundred an twenty patients were non-randomly assigned to a Off-pump or On-pump myocardial revascularization group. Cardiac Troponin I (CTnI) were measured in serial venous blood samples drawn preoperatively in both groups. In On-pump group after aortic unclamping at 12 and 24 hours and in Off-pump group after the last distal anastomosis at 12 and 24 hours. Results: The total amount of CTnI release were significantly higher in On-pump group than in Off-pump group. In On-pump group it was 2.1±1.9 (mean±SD) ng/ml vs in Off-pump group it was 1.0±1.7 (mean±SD) ng/ml at 12 hours and in On-pump group it was 1.6±1.6 (mean±SD) ng/ml vs in Off-pump group it was .9±1.6 (mean±SD) ng/ml at 24 hours (P<0.0001 for the pattern). Conclusion: The lower release of CTnI in the Off-pump myocardial revascularization group indicates that the arrested heart coronary revascularization group causes more damage to the heart due to cardiopulmonary bypass than Off-pump myocardial revascularization group.

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