Search results for: sample hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7835

Search results for: sample hospital

4445 Implementing a Hospitalist Co-Management Service in Orthopaedic Surgery

Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

Abstract:

Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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4444 A Fluorescent Polymeric Boron Sensor

Authors: Soner Cubuk, Mirgul Kosif, M. Vezir Kahraman, Ece Kok Yetimoglu

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Boron is an essential trace element for the completion of the life circle for organisms. Suitable methods for the determination of boron have been proposed, including acid - base titrimetric, inductively coupled plasma emission spectroscopy flame atomic absorption and spectrophotometric. However, the above methods have some disadvantages such as long analysis times, requirement of corrosive media such as concentrated sulphuric acid and multi-step sample preparation requirements and time-consuming procedures. In this study, a selective and reusable fluorescent sensor for boron based on glycosyloxyethyl methacrylate was prepared by photopolymerization. The response characteristics such as response time, pH, linear range, limit of detection were systematically investigated. The excitation/emission maxima of the membrane were at 378/423 nm, respectively. The approximate response time was measured as 50 sec. In addition, sensor had a very low limit of detection which was 0.3 ppb. The sensor was successfully used for the determination of boron in water samples with satisfactory results.

Keywords: boron, fluorescence, photopolymerization, polymeric sensor

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4443 Job Satisfaction and Commitment among Academic Staff of Selected Colleges of Education in Kano and Kaduna States of Nigeria

Authors: Mary Okonkwo Ekwy

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The problem of the growing disillusionment of College of Education teachers with academic life vis-à-vis their job satisfaction and commitment was investigated in this study with a view to finding out if both their job satisfaction and commitment have suffered, and to find out if there was a relationship between job satisfaction and commitment among these College of Education teachers. Due consideration was also given in the study to the possible effects of demographic variables on attitudes to their job. To carry out a study of job satisfaction and commitment among the College of Education teachers and to explore the relationship between them, research instruments were used for measuring the levels of job satisfaction and commitment among them. A sample of 200 Colleges of Education teachers, comprising 15 Professors, 9 Principal Lecturers, 70 Senior Lecturer and 106 Lecturers was used for the study. Five major hypothesis were tested with regard to the relationship between job satisfaction and commitment among the teachers. The Pearson correlation, the F-ratio, and regression analysis were used for data analysis and hypothesis testing. The result of this investigation suggests that, perhaps the best way to secure the commitment of teachers is to ensure their job satisfaction. Future investigations will further enrich our knowledge about these very important themes.

Keywords: job satisfaction, commitment, academic staff, college of education

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4442 Impact of Risk Management Practices on Company Performance

Authors: Syed Atif Ali, Farzan Yahya

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This research paper covers the issue of risk management impact on the company performance. Degree of financial leverage (DFL), degree of operating leverage (DOL) and the working capital ratio (WCR) are taken as independent variables which are the representative of risk and the earning price per share (EPS), return on assets (ROA), return on equity (ROE), Sales and Net profits which are the representative of performance. Last 10 years (2004-2013) of Cement sector of Pakistan data is chosen as sample for analyze their relations by multiple regression technique. Through analyses, it is found that WCR impact adequately on the company performance because if company has enough liquidity than it perform its operations smoothly and enhance its performance very well. DFL should be control moderately because enough DFL leads performance of company downward. On the other hand, the DOL should be less because it causes the less profitability for a company from its operations.

Keywords: degree of financial leverage (DFL), degree of operating leverage (DOL), working capital ratio (WCR), earning per share (EPS), return on equity (ROE), return on assets (ROA)

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4441 The Development of Community Leadership Strategies for Career Development of the Benjarong Pottery Products in Eight Upper Central Provinces

Authors: Thanaporn Chaimongkol

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The objective of this research was aimed to examine the factors that influence the development of community leadership strategies to further develop the career regarding the Benjarong pottery products in eight upper central provinces, Thailand. The sample included (1) 1200 Benjarong pottery operators, (2) 30 involved representatives at both the policy level and support, and (3) OTOP network of 24 people. In this quantitative study, investigating data was conducted on individual session basis. The research instruments used included questionnaires and interview. The results showed that the components of the development of the community leadership strategies for career development of the Benjarong pottery products in eight upper central provinces were high overall; the Five Competitive Forces were of the highest average, followed by bargaining power of suppliers, and McKinsey 7's framework, respectively; where the highest average was strategy.

Keywords: community leadership, strategy development, Benjarong Pottery, 8 upper central provinces

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4440 An Efficient Algorithm of Time Step Control for Error Correction Method

Authors: Youngji Lee, Yonghyeon Jeon, Sunyoung Bu, Philsu Kim

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The aim of this paper is to construct an algorithm of time step control for the error correction method most recently developed by one of the authors for solving stiff initial value problems. It is achieved with the generalized Chebyshev polynomial and the corresponding error correction method. The main idea of the proposed scheme is in the usage of the duplicated node points in the generalized Chebyshev polynomials of two different degrees by adding necessary sample points instead of re-sampling all points. At each integration step, the proposed method is comprised of two equations for the solution and the error, respectively. The constructed algorithm controls both the error and the time step size simultaneously and possesses a good performance in the computational cost compared to the original method. Two stiff problems are numerically solved to assess the effectiveness of the proposed scheme.

Keywords: stiff initial value problem, error correction method, generalized Chebyshev polynomial, node points

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4439 Oxidative Antioxidative Status and DNA Damage Profile Induced by Chemotherapy in Algerian Children with Lymphoma

Authors: Assia Galleze, Abdurrahim Kocyigit, Nacira Cherif, Nidel Benhalilou, Nabila Attal, Chafia Touil Boukkoffa, Rachida Raache

Abstract:

Introduction and aims: Chemotherapeutic agents used to inhibit cell division and reduce tumor growth, increase reactive oxygen species levels, which contributes to their genotoxicity [1]. The comet assay is an inexpensive and rapid method to detect the damage at cellular levels and has been used in various cancer populations undergoing chemotherapy [2,3]. The present study aim to assess the oxidative stress and the genotoxicity induced by chemotherapy by the determination of plasma malondialdehyde (MDA) level, protein carbonyl (PC) content, superoxide dismutase (SOD) activity and lymphocyte DNA damage in Algerian children with lymphoma. Materials and Methods: For our study, we selected thirty children with lymphoma treated in university hospital of Beni Messous, Algeria, and fifty unrelated subjects as controls, after obtaining the informed consent in accordance with the Declaration of Helsinki (1964). Plasma levels of MDA, PC and SOD activity were spectrophotometrically measured, while DNA damage was assessed by alkaline comet assay in peripheral blood leukocytes. Results and Discussion: Plasma MDA, PC levels and lymphocyte DNA damage, were found to be significantly higher in lymphoma patients than in controls (p < 0.001). Whereas, SOD activity in lymphoma patients was significantly lower than in healthy controls (p < 0.001). There were significant positive correlations between DNA damage, MDA and PC in patients (r = 0.96, p < 0.001, r = 0.97, p < 0.001, respectively), and negative correlation with SOD (r = 0.87, p < 0.01). Conclusion and Perspective: Our results indicated that, leukocytes DNA damage and oxidative stress were significantly higher in lymphoma patients, suggesting that the direct effect of chemotherapy and the alteration of the redox balance may influence oxidative/antioxidative status.

Keywords: chemotherapy, comet assay, DNA damage, lymphoma

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4438 Screening for Diabetes in Patients with Chronic Pancreatitis: The Belfast Trust Experience

Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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4437 The Investigation of Relationship between Accounting Information and the Value of Companies

Authors: Golamhassan Ghahramani Aghdam, Pedram Bavili Tabrizi

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The aim of this research is to investigate the relationship between accounting information and the value of the companies accepted in Tehran Exchange Market. The dependent variable in this research is the value of a company that is measured by price coefficients, and the independent variables are balance sheet information, profit and loss information, cash flow state information, and profit quality characteristics. The profit quality characteristic index is to be related and to be on-time. This research is an application research, and the research population includes all companies that are active in Tehran exchange market. The number of 194 companies was selected by the systematic method as the statistics sample in the period of 2018-2019. The multi-variable linear regression model was used for the hypotheses test. The results show that there is no relationship between accounting information and companies’ value (stock value) that can be due to the lack of efficiency of the investment market and the inability to use the accounting information by investment market activists.

Keywords: accounting information, company value, profit quality characteristics, price coefficient

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4436 Association Between Short-term NOx Exposure and Asthma Exacerbations in East London: A Time Series Regression Model

Authors: Hajar Hajmohammadi, Paul Pfeffer, Anna De Simoni, Jim Cole, Chris Griffiths, Sally Hull, Benjamin Heydecker

Abstract:

Background: There is strong interest in the relationship between short-term air pollution exposure and human health. Most studies in this field focus on serious health effects such as death or hospital admission, but air pollution exposure affects many people with less severe impacts, such as exacerbations of respiratory conditions. A lack of quantitative analysis and inconsistent findings suggest improved methodology is needed to understand these effectsmore fully. Method: We developed a time series regression model to quantify the relationship between daily NOₓ concentration and Asthma exacerbations requiring oral steroids from primary care settings. Explanatory variables include daily NOₓ concentration measurements extracted from 8 available background and roadside monitoring stations in east London and daily ambient temperature extracted for London City Airport, located in east London. Lags of NOx concentrations up to 21 days (3 weeks) were used in the model. The dependent variable was the daily number of oral steroid courses prescribed for GP registered patients with asthma in east London. A mixed distribution model was then fitted to the significant lags of the regression model. Result: Results of the time series modelling showed a significant relationship between NOₓconcentrations on each day and the number of oral steroid courses prescribed in the following three weeks. In addition, the model using only roadside stations performs better than the model with a mixture of roadside and background stations.

Keywords: air pollution, time series modeling, public health, road transport

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4435 SFE as a Superior Technique for Extraction of Eugenol-Rich Fraction from Cinnamomum tamala Nees (Bay Leaf) - Process Analysis and Phytochemical Characterization

Authors: Sudip Ghosh, Dipanwita Roy, Dipan Chatterjee, Paramita Bhattacharjee, Satadal Das

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Highest yield of eugenol-rich fractions from Cinnamomum tamala (bay leaf) leaves were obtained by supercritical carbon dioxide (SC-CO2), compared to hydro-distillation, organic solvents, liquid CO2 and subcritical CO2 extractions. Optimization of SC-CO2 extraction parameters was carried out to obtain an extract with maximum eugenol content. This was achieved using a sample size of 10 g at 55°C, 512 bar after 60 min at a flow rate of 25.0 cm3/sof gaseous CO2. This extract has the best combination of phytochemical properties such as phenolic content (1.77 mg gallic acid/g dry bay leaf), reducing power (0.80 mg BHT/g dry bay leaf), antioxidant activity (IC50 of 0.20 mg/ml) and anti-inflammatory potency (IC50 of 1.89 mg/ml). Identification of compounds in this extract was performed by GC-MS analysis and its antimicrobial potency was also evaluated. The MIC values against E. coli, P. aeruginosa and S. aureus were 0.5, 0.25 and 0.5 mg/ml, respectively.

Keywords: antimicrobial potency, Cinnamomum tamala, eugenol, supercritical carbon dioxide extraction

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4434 Review and Evaluation of Viscose Damper on Structural Responses

Authors: Ehsan Sadie

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Developments in the field of damping technology and advances in the area of dampers in equipping many structures have been the result of efforts and testing by researchers in this field. In this paper, a sample of a two-story building is simulated with the help of SAP2000 software, and the effect of a viscous damper on the performance of the structure is explained. The effect of dampers on the response of the structure is investigated. This response involves the horizontal displacement of floors. In this case, the structure is modeled once without a damper and again with a damper. In this regard, the results are presented in the form of tables and graphs. Since the seismic behavior of the structure is studied, the responses show the appropriate effect of viscous dampers in reducing the displacement of floors, and also the energy dissipation in the structure with dampers compared to structures without dampers is significant. Therefore, it is economical to use viscous dampers in areas that have a higher relative earthquake risk.

Keywords: bending frame, displacement criterion, dynamic response spectra, earthquake, non-linear history spectrum, SAP2000 software, structural response, viscous damper

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4433 Water Saving and Awareness Actions

Authors: R. Morbidelli, C. Saltalippi, A. Flammini, J. Dari

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This work analyses what effect systematic awareness-raising of the population on domestic water consumption produces. In a period where the availability of water is continually decreasing due to reduced rainfall, it is of paramount importance to raise awareness among the population. We conducted an experiment on a large sample of homes in urban areas of Central Italy. In a first phase, lasting three weeks, normal per capita water consumption was quantified. Subsequently, instructions were given on how to save water during various uses in the household (showers, cleaning hands, use of water in toilets, watering small green areas, use of water in the kitchen, ...), and small visual messages were posted at water dispensers to remind users to behave properly. Finally, household consumption was assessed again for a further 3 weeks. This experiment made it possible to quantify the effect of the awareness-raising action on the reduction of water consumption without the use of any structural action (replacement of dispensers, improvement of the water system, ...).

Keywords: water saving, urban areas, awareness-raising, climate change

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4432 A User Study on the Adoption of Context-Aware Destination Mobile Applications

Authors: Shu-Lu Hsu, Fang-Yi Chu

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With the advances in information and communications technology, mobile context-aware applications have become powerful marketing tools. In Apple online store, there are numerous mobile applications (APPs) developed for destination tour. This study investigated the determinants of adoption of context-aware APPs for destination tour services. A model is proposed based on Technology Acceptance Model and privacy concern theory. The model was empirically tested based on a sample of 259 users of a tourism APP published by Kaohsiung Tourism Bureau, Taiwan. The results showed that the fitness of the model is well and, among all the factors, the perceived usefulness and perceived ease of use have the most significant influences on the intention to adopt context-aware destination APPs. Finally, contrary to the findings of previous literature, the effect of privacy concern on the adoption intention of context-aware APP is insignificant.

Keywords: mobile application, context-aware, privacy concern, TAM

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4431 A Case Report on Neonatal Conjunctivitis in Pugs

Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

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4430 The Role of Social Media in Activating Youth Participation in the Community

Authors: Raya Hamed Hilal Al Maamari

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The Gulf societies have been undergoing radical changes due to the technology transfer. It altered the humanities attitudes, especially, youth habits as they have become an addicted to using social media. This study aimed to find out the ratio of social media in guiding youth to participate with government’s institutions in decision-making and developing their societies. The study considered a descriptive study, social survey method was used on a sample of 100 young from different gulf countries, using an electronic questionnaire, as well as, some interviews with famous leaders of youth groups. Finally, the researcher suggested some effective ways activate youth efforts using social media in an effective manner to plan for the development policy in the community. The findings illustrated that social media plays a vital role in encouraging youth to participate enthusiastically in providing services. Noticeably, social media contains large numbers of youth. Therefore, the influences will be widely and feasible. Moreover, the study indicated the fact that most of the youth teamwork started in social media. Then, it has been growing in the real society.

Keywords: community, participation, social media, youth

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4429 Thermal Annealing Effects on Nonradiative Recombination Parameters of GaInAsSb/GaSb by Means of Photothermal Defection Technique

Authors: Souha Bouagila, Soufiene Ilahi, Noureddine Yacoubi

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We have used Photothermal deflection spectroscopy PTD to investigate the impact of thermal annealing on electronics properties of GaInAsSb/GaSb.GaInAsSb used as an active layer for Vertical Cavity Surface Emitting laser (VCSEL). We have remarked that surface recombination velocity (SRV) from 7963 m / s (± 6.3%) to 1450 m / s (± 3.6) for as grown to sample annealed for 60 min. Accordingly, Force Microscopy images analyses agree well with the measure of surface recombination velocity. We have found that Root-Mean-Square Roughness (RMS) decreases as respect of annealing time. In addition, we have that the diffusion length and minority carrier mobility have been enhanced according to annealing time. However, due to annealing effects, the interface recombination velocity (IRV) is increased from 1196 m / s (± 5) to 6000 m/s (5%) for GaInAsSb in respect of annealed times.

Keywords: nonradiative lifetime, mobility of minority carrier, diffusion length, Surface and interface recombination velocity

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4428 Identifying Children at Risk for Specific Language Impairment Using a Wordless Picture Narrative: A Study on Hindi, an Indian Language

Authors: Yozna Gurung

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This paper presents preliminary findings from an on-going study on the use of Internal State Terms (IST) in the production of narratives of Hindi-English bilinguals in an attempt to identify children at risk for Specific Language Impairment. Narratives were examined for macrostructure (story structure and story complexity) and internal state terms or mental state terms (IST/MST). 31 students generated stories based on six pictures that were matched for content and story structure in L1 (Hindi) and L2 (English) using a wordless picture narrative. From 30 sample population, 2 students are at risk of Specific Language Impairment, according to this study i.e 6.45%. They showed least development in story grammar as well as IST in both their languages.

Keywords: internal state terms, macrostructure, specific language impairment, wordless picture narrative

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4427 Antibacterial Activity of Copper Nanoparticles on Vancomycin Resistant Staphylococcus Aureus in Vitro and Animal Models

Authors: Sina Gharevali

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Staphylococcus aureus is one of the most important factors for nosocomial infections and infections acquired in a hospital setting role as is. Drug-resistant bacteria methicillin, which in 1961 was reported in many parts of the world, Made the role as the last drug, vancomycin, in the treatment of infections caused by the Staphylococcus aureus chain be taken into consideration. The aim of this study was to evaluate the antimicrobial effects of copper nanoparticles and compared it with antibiotics on Staphylococcus aureus resistant to vancomycin in vitro and animal model. In this study, this test was performed, and the most effective antibiotic for vancomycin-resistant Staphylococcus aureus was determined by disk diffusion method. After various concentrations of copper nanoparticles and antibiotics were prepared and vancomycin resistant Staphylococcus aureus bacteria with serial dilution method for determining antibiotic ciprofloxacin. Minimum Inhibitory Concentration and Minimum Bactericidal Concentrationcopper nanoparticles was performed. The agar dilution method for bacterial growth in different concentrations of copper nanoparticles and antibiotics ciprofloxacin was performed. The agar dilution method for bacterial growth in different concentrations of copper nanoparticles and antibiotics ciprofloxacin was performed. Then the broth dilution method for the antibiotic ciprofloxacin, nano-particles, and nano-particles of copper and copper-established antibiotic synergy MIC and MBC were obtained. MBC was obtained from the experimental animal model test method, and the results were compared. The results showed that copper nanoparticles compared with the antibiotic ciprofloxacin in vitro and animal model more effective in inhibiting the growth of Staphylococcus aureus resistant to vancomycin and ciprofloxacin and extent of the impact of the Synthetic effect of lower copper nanoparticles. Which can then be used to treat clinical research as a candidate.

Keywords: nanoparticles, copper, staphylococcus, aureus

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4426 The Study of Consumer Behavior towards Online Travel Agents in Purchasing Tourism Related Products and Services

Authors: Punrapha Praditpong, Surangkana Pipatchokchaiyo

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The objectives of this study were to study the consumer behavior of the Baby boomers, the X & the Y generation towards Online Travel Agents in purchasing tourism-related products and services. The research methodology of this research used the quantitative study and the sample size consisted of 400 questionnaires in five districts of Bangkok. The data was analyzed by frequency, percentage, mean and SD. Moreover, all the hypotheses were tested by One-Way ANOVA and Pearson-Correlation statistics. The research findings were as follows: 1) There were significant effects to the purchasing decision making process towards purchasing tourism related products and services via OTAs; 2) There were different consumer behaviors from the Baby boomers, the X generation and the Y generation towards purchasing tourism related products and services via OTAs, which are explained in detail in finding. The research offers a discussion and presents some recommendations for the OTA websites.

Keywords: consumer behavior, online travel agent, x generations, y generations

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4425 Ventriculo-Gallbladder Shunt: Case Series and Literature Review

Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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4424 Determination of the Best Fit Probability Distribution for Annual Rainfall in Karkheh River at Iran

Authors: Karim Hamidi Machekposhti, Hossein Sedghi

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This study was designed to find the best-fit probability distribution of annual rainfall based on 50 years sample (1966-2015) in the Karkheh river basin at Iran using six probability distributions: Normal, 2-Parameter Log Normal, 3-Parameter Log Normal, Pearson Type 3, Log Pearson Type 3 and Gumbel distribution. The best fit probability distribution was selected using Stormwater Management and Design Aid (SMADA) software and based on the Residual Sum of Squares (R.S.S) between observed and estimated values Based on the R.S.S values of fit tests, the Log Pearson Type 3 and then Pearson Type 3 distributions were found to be the best-fit probability distribution at the Jelogir Majin and Pole Zal rainfall gauging station. The annual values of expected rainfall were calculated using the best fit probability distributions and can be used by hydrologists and design engineers in future research at studied region and other region in the world.

Keywords: Log Pearson Type 3, SMADA, rainfall, Karkheh River

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4423 Welfare State and Income Distribution to School-Age Children

Authors: Kanyarat Bussaban, Siriporn Poolsuwan

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This study is conducted with the objective to prove how the distorted distribution of welfare affects the quality of school-age children lives differently in the case of an urban community in Bangkok. 334 samples are households from Suan Oi and Ratchapatubtim communities. The study of sample communities found the difference between two community areas that are close. The people of Suan Oi community are economically better off people than the people of the Ratchapatubtim community. They share the benefits of using most services except the welfare of a child’s education. The resulting analysis of the variability in quality of life of the school age children indicate that heads of the households are women looking for quality of life benefits when the compulsory school age is less. A study of the two communities suggests that the inequality in income distribution currently affects the quality of life of school-age children.

Keywords: inequality, income distribution, quality of school-age children lives, welfare state

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4422 Demographic Characteristics and Factors Affecting Mortality in Pediatric Trauma Patients Who Are Admitted to Emergency Service

Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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4421 The Performance of Saudi Banking Industry 2000 -2011: Have the Banks Distinguished Themselves from One Another?

Authors: Bukhari M. S. Sillah, Imran Khokhar, Muhammad Nauman Khan

Abstract:

This paper studies the technical efficiency of Saudi banking sector using stochastic frontier model. A sample of 12 banks over the period 2000-2011 is selected to investigate their technical efficiencies in mobilizing deposits, producing investment and generating income. The banks are categorized as Saudi-owned banks, Saudi-foreign-owned banks and Islamic banks. The findings show some consistent pattern of these bank types; and there exist significant disparities among the banks in term of technical efficiency. The Banque Saudi Fransi stands out as a benchmark bank for the industry, and it is a Saudi-foreign owned bank type. The Saudi owned bank types have shown fluctuating performance during the period; and the Islamic bank types are no significantly different from Saudi-owned bank types.

Keywords: technical efficiency, production frontier model, Islamic banking

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4420 Photocatalytic Degradation of Organic Pollutants Using Strontium Titanate Synthesized by Electrospinning Method

Authors: Hui-Hsin Huang, Yi-Feng Lin, Che-Chia Hu

Abstract:

To date, photocatalytic wastewater treatment using solar energy has attracted considerable attention. In this study, strontium titanates with various morphologies, i.e., nanofibers and cubic-like particles, were prepared as photocatalysts using the electrospinning (ES), solid-state (SS), and sol-gel (SG) methods. X-ray diffraction (XRD) analysis showed that ES and SS can be assigned to pure phase SrTiO3, while SG was referred to Sr2TiO4. These samples displayed optical absorption edges at 385-395 nm, indicating they can be activated in UV light irradiation. Scanning electron microscope (SEM) analyses revealed that ES SrTiO3 has a uniform fibrous structure with length and diameter of several microns and 100-200 nm, respectively. After loading of nanoparticulate Ag as a co-catalyst onto the surface of strontium titanates, ES sample exhibited highest photocatalytic activity to degrade methylene orange dye solution in comparison to that of SS and SG ones. These results indicate that Ag-loaded ES SrTiO3, which has a desirable SrTiO3 phase and a facile electron transfer along the preferential direction in fibrous structure, can be a promising photocatalyst.

Keywords: photocatalytic degradation, strontium titanate, electrospinning, co-catalyst

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4419 A Generalized Family of Estimators for Estimation of Unknown Population Variance in Simple Random Sampling

Authors: Saba Riaz, Syed A. Hussain

Abstract:

This paper is addressing the estimation method of the unknown population variance of the variable of interest. A new generalized class of estimators of the finite population variance has been suggested using the auxiliary information. To improve the precision of the proposed class, known population variance of the auxiliary variable has been used. Mathematical expressions for the biases and the asymptotic variances of the suggested class are derived under large sample approximation. Theoretical and numerical comparisons are made to investigate the performances of the proposed class of estimators. The empirical study reveals that the suggested class of estimators performs better than the usual estimator, classical ratio estimator, classical product estimator and classical linear regression estimator. It has also been found that the suggested class of estimators is also more efficient than some recently published estimators.

Keywords: study variable, auxiliary variable, finite population variance, bias, asymptotic variance, percent relative efficiency

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4418 Wearable Heart Rate Sensor Based on Wireless System for Heart Health Monitoring

Authors: Murtadha Kareem, Oliver Faust

Abstract:

Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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4417 Primary Care Physicians in Urgent Care Centres of the United Kingdom

Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

Abstract:

Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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4416 Metastatic Esophageal Squamous Cell Carcinoma Presenting with COVID-19 Infection and Cardiac Tamponade

Authors: Sutinon Yuchomsuk, Satchachon Changthom, Pruet Areesawangvong, Monsiri Jinapen

Abstract:

Background: Esophageal squamous cell carcinoma can be presented with many symptoms, such as dysphagia or weight loss. However, in some circumstances, rare presentations can be found, e.g., dyspnea, which is more common in pulmonary malignancy. And dyspnea is also one of the most common presentations of COVID-19 infection. So, in this case, we can learn from many points in patient symptoms and findings leading to the diagnosis of esophageal squamous cell carcinoma. Method: This research is a case-report study including one patient from Mahasarakham Hospital, Thailand. Data were collected during December 2021. Result: A 55-year-old Thai male patient with an unknown past medical history presented with dyspnea and shortness of breath for the duration of three days prior to admission. His symptom also included cough, fever, and sore throat. Laboratory results indicated that the patient had COVID-19 pneumonia. Further investigation showed that he had cardiac tamponade and suspected pulmonary/esophageal cancer. Lung biopsy and pericardiocentesis were done, which were positive for carcinoma from pericardial effusion but negative for malignancy from the lung biopsy. Later esophagogastroduodenoscopy was done with endoscopic tissue biopsy; the result was positive for squamous cell carcinoma of the esophagus. Conclusion: Most commonly, esophageal cancer is presented with dysphagia or weight loss. However, in some rare cases, patients can also be presented with dyspnea due to cardiac tamponade. And in recent years, COVID-19 has become a pandemic all over the world, sometimes masking symptoms of other diseases. Such as in this case, the patient didn’t improve after the pneumonia was resolved, which led to the final diagnosis of metastatic esophageal cancer.

Keywords: esophageal cancer, cardiac tamponade, metastatic squamous cell carcinoma, COVID-19 infection

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