Search results for: public hospital unions

Authors: Maria Giovanna Pacifico

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Maintenance, in Italy, is not yet a consolidated practice despite the benefits that could come from. Among the main reasons, there are the lack of financial resources and personnel in the public administration and a general lack of knowledge about how to activate and to manage a prevented and programmed maintenance. The experimentation suggests that users and tourists could be involved in the maintenance process from the knowledge phase to the monitoring ones by using mobile devices. The goal is to increase the quality of Facility Management for cultural heritage, prioritizing usage needs, and limiting interference between the key stakeholders. The method simplifies the consolidated procedures for the Information Systems, avoiding a loss in terms of quality and amount of information by focusing on the users' requirements: management economy, user safety, accessibility, and by receiving feedback information to define a framework that will lead to predictive maintenance. This proposal was designed to be tested in the Archaeological Park of Pompeii on the state property asset.

Keywords: asset maintenance, key stakeholders, Pompeii, user requirement

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Authors: Mekamı Hayet, Bounoua Nacer, Benabderrahmane Sidahmed, Taleb Ahmed

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Pose estimation is an important task in computer vision. Though the majority of the existing solutions provide good accuracy results, they are often overly complex and computationally expensive. In this perspective, we propose the use of dimensionality reduction techniques to address the problem of facial pose estimation. Firstly, a face image is converted into one-dimensional time series using Hilbert space filling curve, then the approach converts these time series data to a symbolic representation. Furthermore, a distance matrix is calculated between symbolic series of an input learning dataset of images, to generate classifiers of frontal vs. profile face pose. The proposed method is evaluated with three public datasets. Experimental results have shown that our approach is able to achieve a correct classification rate exceeding 97% with K-NN algorithm.

Keywords: machine learning, pattern recognition, facial pose classification, time series

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Authors: Irdawati Bay Nalls

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This study looked at Bilingual First Language Acquisition (BFLA) Spanish-English Mexican Americans across an elementary public school in the United States and the possibility of maintaining harmonious bilingualism. Adopting a phenomenological approach, with a focus on the status of bilingualism in education within a marginalized community, classroom observations, and small group and one-on-one interviews were conducted. This study explored the struggles of these bilinguals as they acculturated in America through their attempt to blend heritage and societal languages and cultural practices. Results revealed that bilinguals as young as 5 years old expressed their need to retain Spanish as a heritage language while learning English. 12 years old foresee that Spanish will not be taught to them in schools and highlighted the need to learn Spanish outside the school environments. Their voices revealed counter-narratives on identity and the need to maintain harmonious bilingualism as these students strived to give equal importance to the learning of English and Spanish as first languages despite the setbacks faced.

Keywords: BFLA, Mexican-American, bilingual, harmonious bilingualism

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Authors: Huey-Kuo Chen

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This paper applies directional marginal productivity model to study the shadow price of emissions by transportation modes in the years of 2011 and 2013 with the aim to provide a reference for policy makers to improve the emission of pollutants. One input variable (i.e., energy consumption), one desirable output variable (i.e., vehicle kilometers traveled) and three undesirable output variables (i.e., carbon dioxide, sulfur oxides and nitrogen oxides) generated by road transportation modes were used to evaluate directional marginal productivity and directional shadow price for 18 transportation modes. The results show that the directional shadow price (DSP) of SOx is much higher than CO2 and NOx. Nevertheless, the emission of CO2 is the largest among the three kinds of pollutants. To improve the air quality, the government should pay more attention to the emission of CO2 and apply the alternative solution such as promoting public transportation and subsidizing electric vehicles to reduce the use of private vehicles.

Keywords: marginal productivity, road transportation modes, shadow price, undesirable outputs

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Authors: Viana Hassan

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Each year, 600 million tourists travelled abroad to practice several types of tourism. Nowadays, whatever is the type of tourism practiced it considered as a real public health problem which can contribute the spread of several diseases such as AIDS, H1N1, NDM1 With regard to HIV/AIDS, Lebanon is always considered as a low HIV prevalence country. However, the potential risks associated with the mobility of the population, migration and tourism. The total number of cases reported by the ministry of health since 1989 until the end of 2011 is of 1455 cases, with an average of 85 new cases per year over the last three years. The main reason of the increased number is Travel and migration which represent 50% of the risks reported by cumulative cases. Given the interest of this kind of epidemic it would be interesting to study the Evolution of HIV/ AIDS and its relation with travel and tourism The main aim of this research is to study in general the relation between tourism and health, more specific to understand the relation between Tourism and AIDS, the problem of the transmission of HIV in Lebanon, the ways of contamination and the countries in which these people are contaminated.

Keywords: AIDS, tourism, health, Lebanon

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Authors: Yunyong Guo, Sudhakar Ganti, Bryan Guo

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The rapid growth of telehealth Internet of Things (IoT) devices has raised concerns about energy consumption and efficient data processing. This paper introduces an energy-efficient model that integrates telehealth IoT devices with a fog and cloud computing-based platform, offering a sustainable and robust solution to overcome these challenges. Our model employs fog computing as a localized data processing layer while leveraging cloud computing for resource-intensive tasks, significantly reducing energy consumption. We incorporate adaptive energy-saving strategies. Simulation analysis validates our approach's effectiveness in enhancing energy efficiency for telehealth IoT systems integrated with localized fog nodes and both private and public cloud infrastructures. Future research will focus on further optimization of the energy-saving model, exploring additional functional enhancements, and assessing its broader applicability in other healthcare and industry sectors.

Keywords: energy-efficient, fog computing, IoT, telehealth

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Authors: Styliani Kotrotsiou, Evagelia Kotrotsiou, Fani Mokia, Theodosis Paralikas, Konstantinos Tsaras

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Objective: The objective of this study was the investigation of the mental health of patients undergoing chronic or transient hemodialysis at Artificial Kidney Unit, as well as its relationship to the demographic characteristic of patients. Material and Method: The study took place in Larisa during the month of December in 2016 and the sample was composed of 60 patients undergoing in chronic or transient hemodialysis at Artificial Kidney Unit of the University General Hospital of Larisa. For the investigation of the physical and mental health of patients who participated in the study, the tool measurement << General Health Questionnaire- 28 >> (GHQ-28) was used. The questionnaires were administered with the interview method during the hemodialysis. This survey is designed for the existence or not of a mental disorder. It examines four factors (physical symptoms, anxiety, social dysfunction and depression). Results: The hemodialysis patients gave the following scores: -to the physical symptoms, women showed a higher average value than men (1,16 ± 1,26 against 0,49 ± 0,93), -at the anxiety scale, it seems that women are superior to men (1,68 ± 1,20 against 0,90 ± 1,22), -at the social dysfunction scale, the elderly patients ( > 65 years old) were presented a with higher average (2,59), and -at the depression scale, patients with a higher average value were those who lived in non-urban areas. The appearance of mental disorder, in relation to patient characteristics, did not show significant statistical correlation. The sex, the age and the place of residence affect more the assessment of mental health, while education did not seem to have any significant effect on the other. Conclusions: The hemodialysis process can significantly affect the patient’s Quality of Life and it can bring adverse changes in lifestyle, affecting the physical, social and psychological state of the individual. For that reason, hemodialysis should be aimed not only at extending life but in upgrading the Quality of Life.

Keywords: hemodialysis, chronic kidney disease, depression, social dysfunction, physical condition

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Authors: Cecilia Sosa, Fernanda Figueroa, Leonardo Calzada

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Biosphere reserves (BR) are considered as the main strategy for biodiversity and ecosystems conservation. Mexican BR are mainly inhabited by rural communities who strongly depend on forests and their resources. Even though the dual objective of conservation and development has been sought in BR, land cover change is a common process in these areas, while most rural communities are highly marginalized, partly as a result of restrictions imposed by conservation to the access and use of resources. Achieving ecosystems conservation and social development face serious challenges. Factors such as financial support for development projects (public/private), environmental conditions, infrastructure and regional economic conditions might influence both land use change and wellbeing. Examining the temporal trends of conservation and development in BR is central for the evaluation of outcomes for these conservation strategies. In this study, we analyzed changes in primary vegetation cover (as a proxy for conservation) and the index of marginalization (as a proxy for development) in Mexican BR (2000-2015); we also explore the influence of various factors affecting these trends, such as conservation-development projects financial support (public or private), geographical distribution in ecoregions (as a proxy for shared environmental conditions) and in economic zones (as a proxy for regional economic conditions). We developed a spatial analysis at the municipal scale (2,458 municipalities nationwide) in ArcGIS, to obtain road densities, geographical distribution in ecoregions and economic zones, the financial support received, and the percent of municipality area under protection by protected areas and, particularly, by BR. Those municipalities with less than 25% of area under protection were regarded as part of the protected area. We obtained marginalization indexes for all municipalities and, using MODIS in Google Earth Engine, the number of pixels covered by primary vegetation. We used a linear mixed model in RStudio for the analysis. We found a positive correlation between the marginalization index and the percent of primary vegetation cover per year (r=0.49-0.5); i.e., municipalities with higher marginalization also show higher percent of primary vegetation cover. Also, those municipalities with higher area under protection have more development projects (r=0.46) and some environmental conditions were relevant for percent of vegetation cover. Time, economic zones and marginalization index were all important. Time was particularly, in 2005, when both marginalization and deforestation decreased. Road densities and financial support for conservation-development projects were irrelevant as factors in the general correlation. Marginalization is still being affected by the conservation strategies applied in BR, even though that this management category considers both conservation and development of local communities as its objectives. Our results suggest that roads densities and support for conservation-development projects have not been a factor of poverty alleviation. As better conservation is being attained in the most impoverished areas, we face the dilemma of how to improve wellbeing in rural communities under conservation, since current strategies have not been able to leave behind the conservation-development contraposition.

Keywords: deforestation, local development, marginalization, protected areas

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Authors: M. A. Abd-Allah, Mahmoud N. Ali, A. Said

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Lightning Protection Systems (LPS) for wind power generation is becoming an important public issue. A serious damage of blades, accidents where low-voltage and control circuit breakdowns frequently occur in many wind farms. A grounding system is one of the most important components required for appropriate LPSs in wind turbines WTs. Proper design of a wind turbine grounding system is demanding and several factors for the proper and effective implementation must be taken into account. This paper proposed procedure of proper design of grounding systems for a wind turbine was introduced. This procedure depends on measuring of ground current of simulated wind farm under lightning taking into consideration the soil ionization. The procedure also includes the Ground Potential Rise (GPR) and the voltage distributions at ground surface level and Touch potential. In particular, the contribution of mitigating techniques, such as rings, rods and the proposed design were investigated.

Keywords: WTs, Lightning Protection Systems (LPS), GPR, grounding system, mitigating techniques

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Authors: Eran Gusacov

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This article argues that, as a rule, having children and adolescents participate in adult public protests, in terms of educational thought, is ideological education, brainwashing or indoctrination, and not political education, as will be defined in the article. This is a modest argument in its scope: it does not declare categorically that from a perspective of educational thought, parents and teachers need to refrain from bringing children and teenagers to social protests. The perspective offered in this article neither automatically invalidates any indoctrination in educational activities nor does it oppose the legitimacy of protests initiated by adolescents. It does, however, argue that having children and teens participate in such protests is not political education – an argument that belongs to the educational field. Furthermore, the perspective offered here does not deal with the legal layer of the children’s rights to organize, to demonstrate and/or to protest or with issues of political thought. While the examples provided in the article mainly deal with the Israeli reality, it presents a general argument, which is relevant for wherever children participate in demonstrations.

Keywords: ideological education, indoctrination, political education, protest

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Authors: Ermias A. Tegegn, Million Meshesha

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Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major cause of death for most African countries. Ethiopia is one of the seriously affected countries in sub Saharan Africa. Previously in Ethiopia, having HIV/AIDS was almost equivalent to a death sentence. With the introduction of Antiretroviral Therapy (ART), HIV/AIDS has become chronic, but manageable disease. The study focused on a data mining technique to predict future living status of HIV/AIDS patients at the time of drug regimen change when the patients become toxic to the currently taking ART drug combination. The data is taken from University of Gondar Hospital ART program database. Hybrid methodology is followed to explore the application of data mining on ART program dataset. Data cleaning, handling missing values and data transformation were used for preprocessing the data. WEKA 3.7.9 data mining tools, classification algorithms, and expertise are utilized as means to address the research problem. By using four different classification algorithms, (i.e., J48 Classifier, PART rule induction, Naïve Bayes and Neural network) and by adjusting their parameters thirty-two models were built on the pre-processed University of Gondar ART program dataset. The performances of the models were evaluated using the standard metrics of accuracy, precision, recall, and F-measure. The most effective model to predict the status of HIV patients with drug regimen substitution is pruned J48 decision tree with a classification accuracy of 98.01%. This study extracts interesting attributes such as Ever taking Cotrim, Ever taking TbRx, CD4 count, Age, Weight, and Gender so as to predict the status of drug regimen substitution. The outcome of this study can be used as an assistant tool for the clinician to help them make more appropriate drug regimen substitution. Future research directions are forwarded to come up with an applicable system in the area of the study.

Keywords: HIV drug regimen, data mining, hybrid methodology, predictive model

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Authors: Belakhdar Salah Brahim

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The Urban management is a major element of social control of public space and thus the functioning of society. As such, it is a key element of a social conception of sustainable development. Also, it is a cross-cutting sector that relies on land management, infrastructure management, habitat management, management of social services, the management of economic development, etc. This study aims to study how urban management focusing on the study of problems related to urban waste management in developing countries. It appears from the study that the city management is to improve infrastructure and urban services in order to increase the city's development and improve living conditions in cities. It covers various aspects including management of urban space, economic management, administrative management, asset management or infrastructure and finally waste management. Environmental management is important because it solves the pollution problems of life and preserve resources for future generations. Changing perceptions of waste has led to the definition of new policies for integrated waste management requirements appropriate to the urban site.

Keywords: urbanization, urban management, environmental management, waste management

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Authors: Hessah Alsulami, Majedah Aldosari

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Introduction: Platelet threshold of 10x109 /L is recommended for clinically stable thrombocytopenic pediatric patients. Transfusions at a higher level (given the absence of research evidence, as determined by clinical circumstances, generally at threshold of 40x109 /L) may be required for patients with signs of bleeding, high fever, hyper-leukocytosis, rapid fall in platelet count, concomitant coagulation abnormality, critically ill patients, and those with impaired platelet function (including drug induced). Transfusions at a higher level may be also required for patients undergoing invasive procedures. Method: This study is a retrospective observational analysis of platelet transfusion thresholds in a single secondary pediatric hospital in Riyadh. From the blood bank database, the list of the patients who received platelet transfusions in the second half of 2018 was retrieved. Patients were divided into two groups; group A, those belong to the category of high platelet level for transfusion (such as those with bleeding, high fever, rapid fall in platelet count, impaired platelet function or undergoing invasive procedures) and group B, those who were not. Then we looked at the pre and post transfusion platelet levels for each group. The data was analyzed using GraphPad software and the data expressed as Mean ± SD. Result: A total of 112 of transfusion episodes in 61 patients (38% female) were analyzed. The age ranged from 24 days to 8 years. The distribution of platelet transfusion episodes was 64% (n=72) for group A and 36% (n= 40) for group B. The mean pre-transfusion platelet count was 46x103 ± (11x 103) for group A and 28x103 ± (6x103) for group B. the post-transfusion mean platelet count was 61 x 103 ± (14 x 103) and 60 x103 ± (24 x 103) for group A and B respectively. Among the groups the rise in the mean platelet count after transfusion was significant among stable patients (group B) compared to unstable patients (group A) (P < 0.001). Conclusion: The platelet count threshold for transfusion varied with the clinical condition and is higher among unstable patients’ group which is expected. For stable patients the threshold was higher than what it should be which means that the clinicians don’t follow the guidelines in this regard. The rise of platelet count after transfusion was higher among stable patients.

Keywords: platelet, transfusion, threshold, pediatric

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Authors: Sakapas Saengchai

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This research has objective to study and analysis, expending linkage of trading border of Thai-Myanmar and the way of development trading of Thai-Myanmar border. There are advantage of competition in ASEAN Community on collection data and observation, in-depth interview, group conversation and exchange opinion of public agency, entrepreneur and people. Result of study found that main development of border trade is 1) Cross-border service should be development infrastructure of land telecommunication, sea has support economics of cross-border trade, 2) International consumption service should be expand service with Myanmar and India for linkage with entrepreneur and trading from international to Thailand, 3) Establish business for provide service has development cooperation of logistics via Andaman of Thailand, and 4) Mobility personnel, exchange personnel including labor for development potential of border trade has competition advantage.

Keywords: border trade, development, service, ASEAN

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Authors: Sherif Sabri, Suzy Fawzi, Sanaa Abdelshafy, Ayman Nagah

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Introduction: Static derangements in lactate homeostasis during ICU stay have become established as a clinically useful marker of increased risk of hospital and ICU mortality. Lactate indices or kinetic alteration of the anaerobic metabolism make it a potential parameter to evaluate disease severity and intervention adequacy. This is an inexpensive and simple clinical parameter that can be obtained by a minimally invasive means. Aim of work: Comparing the predictive value of dynamic indices of hyperlactatemia in the first twenty four hours of intensive care unit (ICU) admission with other static values are more commonly used. Patients and Methods: This study included 40 critically ill patients above 18 years old of both sexes with Hyperlactamia (≥ 2 m mol/L). Patients were divided into septic group (n=20) and low oxygen transport group (n=20), which include all causes of low-O2. Six lactate indices specifically relating to the first 24 hours of ICU admission were considered, three static indices and three dynamic indices. Results: There were no statistically significant differences among the two groups regarding age, most of the laboratory results including ABG and the need for mechanical ventilation. Admission lactate was significantly higher in low-oxygen transport group than the septic group [37.5±11.4 versus 30.6±7.8 P-value 0.034]. Maximum lactate was significantly higher in low-oxygen transport group than the septic group P-value (0.044). On the other hand absolute lactate (mg) was higher in septic group P-value (< 0.001). Percentage change of lactate was higher in the septic group (47.8±11.3) than the low-oxygen transport group (26.1±12.6) with highly significant P-value (< 0.001). Lastly, time weighted lactate was higher in the low-oxygen transport group (1.72±0.81) than the septic group (1.05±0.8) with significant P-value (0.012). There were statistically significant differences regarding lactate indices in survivors and non survivors, whether in septic or low-oxygen transport group. Conclusion: In critically ill patients, time weighted lactate and percent in lactate change in the first 24 hours can be an independent predictive factor in ICU mortality. Also, a rising compared to a falling blood lactate concentration over the first 24 hours can be associated with significant increase in the risk of mortality.

Keywords: critically ill patients, lactate indices, mortality in intensive care, anaerobic metabolism

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Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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Authors: Preethy Mary Donald, Renjith George

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Oral tori are localized non-neoplastic protuberances of maxilla and mandible. Torus palatinus (TP) is found on the midline of the roof of mouth existing as single growth or in clusters. Torus mandibularis(TM) is located on the lingual aspect of the mandible commonly between canine and premolar region. Etiology of their presence was not clear and was found to be multifactorial. Their variations in relation to age, gender, ethnicity and also the characteristics of TP and TM have become the interest of multiple studies. The objectives of this study were to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) among patients who have visited outpatient department, Faculty of Dentistry, Melaka Manipal Medical College. 108 patients were examined for the presence of oral tori at the outpatient department, Faculty of Dentistry, Melaka-Manipal Medical College. Factors such as age, gender, ethnicity of the patients and size, shape, location of the oral tori were studied. For TP, Malays (62.96%) have been found to have the highest prevalence than Chinese (43.3%) and Indians (35.71%). For TM, Chinese (7.46%) had predominated compared to Malays (7.41%) and Indians (0%). There is no significant association between occurrence of TP and TM with age, gender and ethnicity. For Torus palatinus, the most common size was Grade 1(1-3mm), most common location was molar region, and the most common shape was spindle. For Torus mandibularis, the most frequent location was canine premolar region and exists in unilateral single or bilateral single fashion. The overall prevalence rates were 47.2% for TP and 6.48% for TM. However, there is no significant association between occurrence of TP and TM with age, gender and ethnicity. The results showed variations in clinical characteristics and support the findings that occurrence of tori is a dynamic phenomenon which is multifactorial owing to the environmental factors such as stress from occlusion and dietary habits. It could be due to the genetic make-up of the individual.

Keywords: torus palatinus, torus mandibularis, age, gender

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Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

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Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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Authors: Phutthiwat Waiyawuththanapoom

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This research is objected to study the pattern and channel of distribution of Ang Thong’s court doll OTOP product and try to develop the quality of distribution of the court doll product. The population of this research is 50 court doll manufacturers of Ang Thong’s court doll. The data and information was collected by using the questionnaire and use percentage, mean and standard deviation as an analysis tools. The distribution channel of Ang Thong’s court doll can be separated into 3 channels which are direct distribution from the manufacturer, via the middleman and via the co-operated manufacturing group. In the direct distribution from the manufacturer channel, it was found that the manufacturer is given the highest rate of importance to how they keep the inventory. In the distribution via the middleman channel, it was found that the manufacturer is given the highest rate of importance to the distribution efficiency. But in the distribution via the co-operated manufacturing group, it was found that the manufacturer is given the highest rate of importance to the public relationship.

Keywords: distribution, court doll, Ang Thong province, business and social sciences

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Authors: Liqiang Chen

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This study investigates the effects of political connections on the association between firms’ business strategy and their tax aggressiveness in an emerging economy such as China. By studying all public Chinese firms in the period from 2011 to 2017, we find that firms adopting innovative business strategy are more tax aggressive overall, but innovative firms with political connections are less tax aggressive compared to those without political connections. Moreover, we document several channels through which political connections affect the association between innovative business strategy and tax aggressiveness. In particular, we show that the mitigation effect of political connections on tax aggressiveness is stronger for innovative firms located in areas with a lower marketization index and for innovative firms with a lower leverage level or with less earnings management. Our results are robust to an instrumental variable approach to account for possible endogenous bias. Our study contributes to the understanding of firms’ tax behaviors in an emerging economy setting and suggests that there are costs associated with political connections, such as foregone tax saving opportunities, which are understudied in the prior literature.

Keywords: tax aggressiveness, business strategy, political connections, emerging economy

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Authors: E. N. R. de Silva

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The main purpose of this research is to set a policy framework for establishing a legal, institutional and social infrastructure that enhances the welfare, health, safety and economic interest of the consumers in Sri Lanka. It will help to develop an approach to continuously and successfully advocate for a consumer protection legal reform agenda and also it is significant as it gives directions to create national consumer protection associations in Sri Lanka. The methodology adopted for this research is purely a qualitative approach and it is generally and specifically categorized. Generally, part of this research looked at the existing laws, regulations and how effective they are in order to protect consumers. It will analyze the consumer protection framework and specially, consumer protection enhanced by the public organizations in Japan. This research offers a model with methods and legal instruments to enforce advocacy group to enhance consumer welfare, also brings out reforms to be made in the national legal framework on consumer welfare.

Keywords: consumer protection association, consumer protection law, consumer welfare, legal framework

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Authors: Abdolamir Allameh, Seyyed Mortaza Haghgoo, Adnan Khosravi, Esmaeil Mortaz, Mihan Pourabdollah-Toutkaboni, Sharareh Seifi

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Non-Small Cell Lung Carcinoma (NSCLC) is associated with a number of gene mutations in epidermal growth factor receptor (EGFR). The prognostic significance of mutations in exons 19 and 21, together with serum levels of EGFR, amphiregulin (AR), and Transforming Growth Factor-alpha (TGF-α) are implicated in diagnosis and treatment. The aim of this study was to examine the relationship of EGFR mutations in selected exons with the expression of relevant ligands in sera samples of NSCLC patients. For this, a group of NSCLC patients (n=98) referred to the hospital for lung surgery with a mean age of 59±10.5 were enrolled (M/F: 75/23). Blood specimen was collected from each patient. Besides, formalin fixed paraffin embedded tissues were processed for DNA extraction. Gene mutations in exons 19 and 21 were detected by direct sequencing, following DNA amplification which was done by PCR (Polymerase Chain Reaction). Also, serum levels of EGFR, AR, and TGF-α were measured by ELISA. The results of our study show that EGFR mutations were present in 37% of Iranian NSCLC patients. The most frequently identified mutations were deletions in exon 19 (72.2%) and substitutions in exon 21 (27.8%). The most frequently identified alteration, which is considered as a rare mutation, was the E872K mutation in exon 21, which was found in 90% (9 out of 10) cases. EGFR mutation detected in exon 21 was significantly (P<0.05) correlated with the levels of its ligands, EGFR and TGF-α in serum samples. Furthermore, it was found that increased serum AR (>3pg/ml) and TGF-α (>10.5 pg/ml) were associated with shorter overall survival (P<0.05). The results clearly showed a close relationship between EGFR mutations and serum EGFR and serum TGF-α. Increased serum EGFR was associated with TGF-α and AR and linked to poor prognosis of NSCLC. These findings are implicated in clinical decision-making related to EGFR-Tyrosine kinase inhibitors (TKIs).

Keywords: lung cancer, Iranian patients, epidermal growth factor, mutation, prognosis

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Authors: Dipti Chand, Riya Saboo

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OBJECTIVES: Early and correct diagnosis may present a significant clinical challenge in diagnosis of patients presenting to Emergency Department with Acute Dyspnoea. The common cause of acute dyspnoea and respiratory distress in Emergency Department are Decompensated Heart Failure (HF), Chronic Obstructive Pulmonary Disease (COPD), Asthma, Pneumonia, Acute Respiratory Distress Syndrome (ARDS), Pulmonary Embolism (PE), and other causes like anaemia. The aim of the study was to measure NT-pro Brain Natriuretic Peptide (BNP) and exhaled End-Tidal Carbon dioxide (ETCO2) in patients presenting with dyspnoea. MATERIAL AND METHODS: This prospective, cross-sectional and observational study was performed at the Government Medical College and Hospital, Nagpur, between October 2019 and October 2021 in patients admitted to the Medicine Intensive Care Unit. Three groups of patients were compared: (1) HFrelated acute dyspnoea group (n = 52), (2) pulmonary (COPD/PE)-related acute dyspnoea group (n = 31) and (3) sepsis with ARDS-related dyspnoea group (n = 13). All patients underwent initial clinical examination with a recording of initial vital parameters along with on-admission ETCO2 measurement, NT-proBNP testing, arterial blood gas analysis, lung ultrasound examination, 2D echocardiography, chest X-rays, and other relevant diagnostic laboratory testing. RESULTS: 96 patients were included in the study. Median NT-proBNP was found to be high for the Heart Failure group (11,480 pg/ml), followed by the sepsis group (780 pg/ml), and pulmonary group had an Nt ProBNP of 231 pg/ml. The mean ETCO2 value was maximum in the pulmonary group (48.610 mmHg) followed by Heart Failure (31.51 mmHg) and the sepsis group (19.46 mmHg). The results were found to be statistically significant (P < 0.05). CONCLUSION: NT-proBNP has high diagnostic accuracy in differentiating acute HF-related dyspnoea from pulmonary (COPD and ARDS)-related acute dyspnoea. The higher levels of ETCO2 help in diagnosing patients with COPD.

Keywords: NT PRO BNP, ETCO2, dyspnoea, lung USG

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Authors: Kyle Yatich Terik, Collins Oduor

Abstract:

The current healthcare system has made healthcare more accessible and efficient by the use of information technology through the implementation of computer algorithms that generate menus based on the diagnosis. While many systems just like these have been created over the years, their main objective is to help healthy individuals calculate their calorie intake and assist them by providing food selections based on a pre-specified calorie. That application has been proven to be useful in some ways, and they are not suitable for monitoring, planning, and managing hospital patients, especially that critical condition their dietary needs. The system also addresses a number of objectives, such as; the main objective is to be able to design, develop and implement an efficient, user-friendly as well as and interactive dietary management system. The specific design development objectives include developing a system that will facilitate a monitoring feature for users using graphs, developing a system that will provide system-generated reports to the users, dietitians, and system admins, design a system that allows users to measure their BMI (Body Mass Index), the system will also provide food template feature that will guide the user on a balanced diet plan. In order to develop the system, further research was carried out in Kenya, Nairobi County, using online questionnaires being the preferred research design approach. From the 44 respondents, one could create discussions such as the major challenges encountered from the manual dietary system, which include no easily accessible information of the calorie intake for food products, expensive to physically visit a dietitian to create a tailored diet plan. Conclusively, the system has the potential of improving the quality of life of people as a whole by providing a standard for healthy living and allowing individuals to have readily available knowledge through food templates that will guide people and allow users to create their own diet plans that consist of a balanced diet.

Keywords: DMS, dietitian, patient, administrator

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Authors: Tina Abrefa-Gyan

Abstract:

Background: In Ghana and the rest of sub-Saharan Africa, HIV/AIDS is a public health threat and also causes medical crises for many who are infected with the virus. Objective: This study tested a social care intervention developed to help improve the quality of life of those living with HIV/AIDS in Ghana. Method: Adult respondents (N = 248) were assigned to receive the intervention or usual care for six weeks. Results: Results of the study revealed significant differences between the treatment and control groups in their reports of quality of life. Respondents reported better quality of life upon receiving the intervention. Implication: This study sheds light on the positive relationship between the intervention and quality of life among those living with HIV/AIDS in Ghana. Conclusion: The intervention is innovative and novel in the setting. It will, therefore, help to reduce the risks such as depression, low cognitive functioning, and low physical functioning associated with low quality of life among people living with HIV/AIDS in Ghana in specific, and in sub-Saharan Africa in general.

Keywords: social care intervention, HIV/AIDS, Ghana, quality of life

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Authors: K. Y. Chen, Y. N. Jia, H. Chua, C. W. Kan

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In United States (US), the environmental policy went through two stages that are government control period and market mechanism period. In the government control period in the 1970s, environmental problems in U.S. are treated by mandatory direct control method, including promulgation of laws, formulation of emission standards and mandatory installation of pollution treatment equipment. After the 1980s, the environmental policy in U.S. went into the second stage, in which the government strengthened the incentives and coordination effects of market. Since then, environmental governance had been partially replaced by means of economic regulation of the market. Green Tax Policy and Marketable Pollution Permits are good examples of government's economic interventions. U.S. Federal Government regards environmental industry as high-tech industry which is promoted in this period. Therefore, in the paper, we aim to analyse the effect of environmental investment on the sustainable development in the US. Acknowledgment: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: United States, public environmental investment, analysis, sustainable development

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Authors: Muhammad Ilham Agus Salim, Muhammad Ikbal

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The ASEAN Economic Community (AEC) was set up in 2003 with the objectives of creating a single market and production base, enhancing equitable economic development as well as facilitating the integration into the global economy. The AEC involves liberalization and facilitation of trade in goods, skilled labour, services, and investment, as well as protection and promotion of investment. The thesis outlines the AEC Blueprint actions in scope of globalization of investment and capital market. Free flows of investment and freer flows of capital market urge countries in South East Asia to coordinate and to collaborate in securing the interest of public, and this leads to the importance of financial services authorities in ASEAN to prepare the mechanism of guarding the flows of investment. There is no exception, especially for Indonesian Financial Services Authority (OJK) as one of the authorized body in capital market supervision, to enforce its authorities as supervisory body.

Keywords: AEC blueprint, OJK, capital market, integration

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Authors: J. J. Mathew

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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

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Authors: Azadeh Bashiri

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Introduction: In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. Background: This study, provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. Methods: This is a cross-sectional study that was conducted in 2013. The student community was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also, Visual Paradigm software was used to design a conceptual model. Result: Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. Conclusion: According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, provide the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Keywords: structured radiology report, information needs, minimum data set, electronic health record system in Iran

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Authors: W. H. Wan Zakiyatussariroh, A. A. Nasuhar, W. Y. Wan Fairos, Z. A. Nazatul Shahreen

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Forecasting dengue incidence in a population can provide useful information to facilitate the planning of the public health intervention. Many studies on dengue cases in Malaysia were conducted but are limited in modeling the outbreak and forecasting incidence. This article attempts to propose the most appropriate time series model to explain the behavior of dengue incidence in Malaysia for the purpose of forecasting future dengue outbreaks. Several seasonal auto-regressive integrated moving average (SARIMA) models were developed to model Malaysia’s number of dengue incidence on weekly data collected from January 2001 to December 2011. SARIMA (2,1,1)(1,1,1)52 model was found to be the most suitable model for Malaysia’s dengue incidence with the least value of Akaike information criteria (AIC) and Bayesian information criteria (BIC) for in-sample fitting. The models further evaluate out-sample forecast accuracy using four different accuracy measures. The results indicate that SARIMA (2,1,1)(1,1,1)52 performed well for both in-sample fitting and out-sample evaluation.

Keywords: time series modeling, Box-Jenkins, SARIMA, forecasting

Procedia PDF Downloads 486