Search results for: business group affiliated firms
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11452

Search results for: business group affiliated firms

9322 Strengthening of Reinforced Concrete Beams Using Steel Plates

Authors: Ghusen al-Kafri, Mohammed Ali Abdallah Elsageer, Ahmed Mohamed Hadya Alsdaai, Abdeimanam Salhien Salih Khalifa

Abstract:

In this paper, external reinforcement to enhance a reinforced concrete structure performance has been done using externally bonded steel plate. This technique has been reported effective in enhancing the strength of reinforced concrete beam, a study to determine the effectiveness of steel plate as an external reinforcement was carried out. A total of two groups of beams and one group content five beams, each 750 mm long, 150 mm wide, and 150 mm deep were cast, strengthened and tested till failure under two point loads. One beam was act as a control beam without strengthening and other four beams were strengthened with steel plate at a different arrangement. Other group beams were strengthened with steel plate in shear zone and also strengthened at bottom as first group. The behaviours of the strengthened beams were studied through their load-deflection characteristic upon bending, cracking and mode of failure. The results confirmed that all steel plate arrangements enhanced the strength of the reinforced concrete beam, the positioning of the steel plate affect the moment carrying capacity of the beam.

Keywords: beams, bending, beflection, steel plates

Procedia PDF Downloads 399
9321 An Investigation of the Effectiveness and Quality Service of Thai Labor Fund

Authors: Chutikarn Sriviboon

Abstract:

The objectives of this research were to study the operation of the Labor Fund and to investigate the needs for money and assistance from Thai laborers both from within the system and out of the system and to compare between the assistance from domestic and international funds. The population of this study included three labor groups: group one was laborer in the system who were the members of saving cooperative, group two was laborer in the system who were not the members of saving cooperative, and group three was laborer who were not in the system. This was a mixed research of quantitative and qualitative methods. The findings can be categorized into four parts. First, the labor fund was beneficial to Thai laborers by giving access to government funds but the weakness was found to be poor public relations. Second, the labor funds should extend their assistance to laborer in the system who was not the members of saving cooperative. Third, the comparison between domestic labor funds and international labor funds revealed that there were no international funds which provided assistance the same way as Thai labor funds. Finally, there was a need to improve the management of labor funds and to provide long term assistance to Thai labors.

Keywords: effectiveness, quality, labor funds, service

Procedia PDF Downloads 340
9320 Spectral Clustering for Manufacturing Cell Formation

Authors: Yessica Nataliani, Miin-Shen Yang

Abstract:

Cell formation (CF) is an important step in group technology. It is used in designing cellular manufacturing systems using similarities between parts in relation to machines so that it can identify part families and machine groups. There are many CF methods in the literature, but there is less spectral clustering used in CF. In this paper, we propose a spectral clustering algorithm for machine-part CF. Some experimental examples are used to illustrate its efficiency. Overall, the spectral clustering algorithm can be used in CF with a wide variety of machine/part matrices.

Keywords: group technology, cell formation, spectral clustering, grouping efficiency

Procedia PDF Downloads 388
9319 Response of Insulin Resistance Indicators to Aerobic Exercise at Different Intensities in Obese College Students

Authors: Long-Shan Wu, Ming-Chen Ko, Chien-Chang Ho, Po-Fu Lee, Li-Yun Chen, Ching-Yu Tseng

Abstract:

The purpose of this study was to determine whether progressive aerobic exercise intensity effects the changes in insulin resistance indicators among obese college students in Taiwan. Forty-eight obese subjects [body mass index (BMI) ≧ 27 kg/m2, aged 18-26 years old] were randomized into four equal groups (n = 12): light-intensity training group (LITG): 40-50% of their heart rate reserve (HRR); middle-intensity training group (MITG): 50-70% of their HRR; high-intensity training group (HITG): 70-80% of their HRR, and control group (CG). The aerobic exercise training program was performed 60 minutes per day on a treadmill three days/week in a training period of 12 weeks. All subjects’ anthropometric data, blood biochemical parameters, and health-related physical fitness components were measured at baseline and after 12 weeks. At baseline, all insulin resistance indicators did not differ significantly among the four groups (p > 0.05). After 12-week exercise intervention, the HITG had significantly more changes in insulin level than the MITG, LITG, and CG. Our findings suggested that a short-term aerobic exercise program can play an important role in improving insulin resistance indicators; either middle-intensity training significantly increases the insulin level, but the high-intensity exercise training program effectively improves obese college students’ insulin resistance.

Keywords: aerobic training, exercise intensity, insulin resistance, obesity

Procedia PDF Downloads 284
9318 Protecting the Cloud Computing Data Through the Data Backups

Authors: Abdullah Alsaeed

Abstract:

Virtualized computing and cloud computing infrastructures are no longer fuzz or marketing term. They are a core reality in today’s corporate Information Technology (IT) organizations. Hence, developing an effective and efficient methodologies for data backup and data recovery is required more than any time. The purpose of data backup and recovery techniques are to assist the organizations to strategize the business continuity and disaster recovery approaches. In order to accomplish this strategic objective, a variety of mechanism were proposed in the recent years. This research paper will explore and examine the latest techniques and solutions to provide data backup and restoration for the cloud computing platforms.

Keywords: data backup, data recovery, cloud computing, business continuity, disaster recovery, cost-effective, data encryption.

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9317 Impact of Propolis on Cryopreservation of Arctic Charr (Salvelinus alpinus) Sperm

Authors: K. A. El-Battawy, E. Brannas

Abstract:

Cryopreservation of sperm causes damages and adversely affected sperm motility and viability resulting in lower hatching rates. The aim of this study is to determine whether propolis has potential protective effect on cryopreservation and fertilization ability of spermatozoa of Salvelinusalpinus. The extenders were prepared by using simple glucose solution (0.3 M glucose) to which 10% Me2SO added with different levels of propolis (0.4, 0.8 and 1 mg/ ml) and 10% egg yolk (as a control without propolis). The pooled semen samples diluted at the ratio of 1:3 by the extenders were subjected to cryopreservation. The percentage and duration of motility and fertilization tests of cryopreserved sperm samples have been done immediately after thawing and compared with control and fresh semen. The extenders containing propolis showed higher percentage motility and motility duration than control group (P < 0.05). Especially the group II (0.8 mg/ ml propolis) and the group III (1 mg/ ml propolis) showed significant positive effects on both post thaw motility and hatching ability. In conclusion, this study confirms that the propolis is an appropriate cryoptrotective agent in fish semen and it maintained the integrity of the spermatozoa during the cryopreservation process.

Keywords: propolis, arctic charr, semen, cryopreservation

Procedia PDF Downloads 264
9316 The Effect of Using LDOCE on Iranian EFL Learners’ Pronunciation Accuracy

Authors: Mohammad Hadi Mahmoodi, Elahe Saedpanah

Abstract:

Since pronunciation is among those factors that can have strong effects on EFL learners’ successful communication, instructional programs with accurate pronunciation purposes seem to be a necessity in any L2 teaching context. The widespread use of smart mobile phones brings with itself various educational applications, which can assist foreign language learners in learning and speaking another language other than their L1. In line with this supportive innovation, the present study investigated the role of LDOCE (Longman Dictionary of Contemporary English), a mobile application, on improving Iranian EFL learners’ pronunciation accuracy. To this aim, 40 EFL learners studying English at the intermediate level participated in the current study. This was an experimental research with two groups of 20 students in an experimental and a control group. The data were collected through the administration of a pronunciation pretest before the instruction and a post-test after the treatment. In addition, the assessment was based on the pupils’ recorded voices while reading the selected words. The results of the independent samples t-test indicated that using LDOCE significantly affected Iranian EFL learners' pronunciation accuracy with those in the experimental group outperforming their control group counterparts.

Keywords: LDOCE, EFL learners, pronunciation accuracy, CALL, MALL

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9315 Investigating the Relationship between Bank and Cloud Provider

Authors: Hatim Elhag

Abstract:

Banking and Financial Service Institutions are possibly the most advanced in terms of technology adoption and use it as a key differentiator. With high levels of business process automation, maturity in the functional portfolio, straight through processing and proven technology outsourcing benefits, Banking sector stand to benefit significantly from Cloud computing capabilities. Additionally, with complex Compliance and Regulatory policies, combined with expansive products and geography coverage, the business impact is even greater. While the benefits are exponential, there are also significant challenges in adopting this model– including Legal, Security, Performance, Reliability, Transformation complexity, Operating control and Governance and most importantly proof for the promised cost benefits. However, new architecture designed should be implemented to align this approach.

Keywords: security, cloud, banking sector, cloud computing

Procedia PDF Downloads 488
9314 When Bad News Are Good News: Ambivalent Feelings Towards Firms Adversity

Authors: Jacob Hornik, Matti Rachamim, Ori Grossman

Abstract:

Schadenfreude, a bittersweet phenomenon, is considered atypical and complicated state that might reflect ambivalent types of sentiments -a mixed of both positive and negative reactions towards others misfortunes. This brief note reports a study that examined the association between trait ambivalence, using the Trait Mixed Emotions Scale (TMES), and four different consumer schadenfreude affairs. Results propose that trait ambivalence offers a novel explanation for schadenfreude responses. Showing that trait ambivalence enhances schadenfreude, when consumers encounter misfortune type of information about a disliked or rival marketplace entity.

Keywords: schadenfreude, consumer behavior, mixed emotions, sentiments, ambivalence

Procedia PDF Downloads 115
9313 Research on the Effectiveness of Online Guided Case Teaching in Problem-Based Learning: A Preschool Special Education Course

Authors: Chen-Ya Juan

Abstract:

Problem-Based Learning uses vague questions to guide student thinking and enhance their self-learning and collaboration. Most teachers implement PBL in a physical classroom, where teachers can monitor and evaluate students’ learning progress and guide them to search resources for answers. However, the prevalence of the Covid-19 in the world had changed from physical teaching to distance teaching. This instruction used many cases and applied Problem-Based Learning combined on the distance teaching via the internet for college students. This study involved an experimental group with PBL and a control group without PBL. The teacher divided all students in PBL class into eight groups, and 7~8 students in each group. The teacher assigned different cases for each group of the PBL class. Three stages of instruction were developed, including background knowledge of Learning, case analysis, and solving problems for each case. This study used a quantitative research method, a two-sample t-test, to find a significant difference in groups with PBL and without PBL. Findings indicated that PBL incased the average score of special education knowledge. The average score was improved by 20.46% in the PBL group and 15.4% without PBL. Results didn’t show significant differences (0.589>0.05) in special education professional knowledge. However, the feedback of the PBL students implied learning more about the application, problem-solving skills, and critical thinking. PBL students were more likely to apply professional knowledge on the actual case, find questions, resources, and answers. Most of them understood the importance of collaboration, working as a team, and communicating with other team members. The suggestions of this study included that (a) different web-based teaching instruments influenced student’s Learning; (b) it is difficult to monitor online PBL progress; (c) online PBL should be implemented flexible and multi-oriented; (d) although PBL did not show a significant difference on the group with PBL and without PBL, it did increase student’s problem-solving skills and critical thinking.

Keywords: problem-based learning, college students, distance learning, case analysis, problem-solving

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9312 Gastro-Protective Actions of Melatonin and Murraya koenigii Leaf Extract Combination in Piroxicam Treated Male Wistar Rats

Authors: Syed Benazir Firdaus, Debosree Ghosh, Aindrila Chattyopadhyay, Kuladip Jana, Debasish Bandyopadhyay

Abstract:

Gastro-toxic effect of piroxicam, a classical non-steroidal anti-inflammatory drug (NSAID), has restricted its use in arthritis and similar diseases. The present study aims to find if a combination of melatonin and Murraya koenigii leaf extract therapy can protect against piroxicam induced ulcerative damage in rats. For this study, rats were divided into four groups namely control group where rats were orally administered distilled water, only combination treated group, piroxicam treated group and combination pre-administered piroxicam treated group. Each group of rats consisted of six animals. Melatonin at a dose of 20mg/kg body weight and antioxidant rich Murraya koenigii leaf extract at a dose of 50 mg /kg body weight were successively administered at 30 minutes interval one hour before oral administration of piroxicam at a dose of 30 mg/kg body weight to Wistar rats in the combination pre-administered piroxicam treated group. The rats of the animal group which was only combination treated were administered both the drugs respectively without piroxicam treatment whereas the piroxicam treated animal group was administered only piroxicam at 30mg/kg body weight without any pre-treatment with the combination. Macroscopic examination along with histo-pathological study of gastric tissue using haemotoxylin-eosin staining and alcian blue dye staining showed protection of the gastric mucosa in the combination pre-administered piroxicam treated group. Determination of adherent mucus content biochemically and collagen content through Image J analysis of picro-sirius stained sections of rat gastric tissue also revealed protective effects of the combination in piroxicam mediated toxicity. Gelatinolytic activity of piroxicam was significantly reduced by pre-administration of the drugs which was well exhibited by the gelatin zymography study of the rat gastric tissue. Mean ulcer index determined from macroscopic study of rat stomach reduced to a minimum (0±0.00; Mean ± Standard error of mean and number of animals in the group=6) indicating the absence of ulcer spots on pre-treatment of rats with the combination. Gastro-friendly prostaglandin (PGE2) which otherwise gets depleted on piroxicam treatment was also well protected when the combination was pre-administered in the rats prior to piroxicam treatment. The requirement of the individual drugs in low doses in this combinatorial therapeutic approach will possibly minimize the cost of therapy as well as it will eliminate the possibility of any pro-oxidant side effects on the use of high doses of antioxidants. Beneficial activity of this combination therapy in the rat model raises the possibility that similar protective actions might be also observed if it is adopted by patients consuming NSAIDs like piroxicam. However, the introduction of any such therapeutic approach is subject to future studies in human.

Keywords: gastro-protective action, melatonin, Murraya koenigii leaf extract, piroxicam

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9311 Assessment of Acute Cardiovascular Responses to Moderate and Vigorous Intensity Aerobic Exercises in Sedentary Adults and Amateur Athletes

Authors: Caner Yilmaz, Zuhal Didem Takinaci

Abstract:

Introduction: Today, our knowledge about the effects of physical activity performed at the different intensity of the cardiovascular system are still not clear. Therefore, to contribute to the literature, in our study, sedentary individuals and amateur athletes were assessed in a single session with the aim of evaluating the cardiovascular effects of the moderate and severe exercise. Methods: 80 participants (40 amateur athletes and 40 sedentary, young adults) participated in our study. Participants were divided into two groups: amateur athletes (mean age: 25.0 ± 3.6 yrs) and sedentary in group II (mean age: 23.8 ± 3.7 yrs). Participants in both groups were assessed twice, namely, firstly, at moderate intensity (5km/h 30 min. walking) and secondly at the vigorous intensity (8km/h 20 min. jogging). Participants’ SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), HR (Heart Rate), SpO₂ (Oxygen Saturation), BT (Body Temperature) and RR (Respiratory Rate) were measured. Results: In our study, the findings showed that after moderate-intensity aerobic exercise, change in SBP, DBP, and SpO₂ were significantly higher in Group II (p < 0.05). After the severe intensity aerobic exercises, change in SBP, SpO₂, HR, and RR was significantly higher in Group II (p < 0.05). The BORG score of Group II was significantly higher after both moderate and severe intensity aerobic exercise (p < 0.05). Conclusion: The cardiovascular responses of amateur athletes were closer to initial values, and the differences between the two groups were increased in direct proportion to the intensity of the exercise. Both exercise intensities could be adequate.

Keywords: aerobic, exercise, sedantary, cardi̇ovascular

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9310 Effect of Operative Stabilization on Rib Fracture Healing in Porcine Experimental Model: A Pilot Study

Authors: Maria Stepankova, Lucie Vistejnova, Pavel Klein, Tereza Blassova, Marketa Slajerova, Radek Sedlacek, Martin Bartos, Jaroslav Chlupac

Abstract:

Background: Clinical outcome benefits of the segment rib fracture surgical therapy are well known and follow from better stabilization of the chest wall. Despite this, some authors still incline to conservative therapy and point out to possible rib fracture healing failure in connection with the bone vascular supply disturbance caused by metal plate implantation. This suggestion met neither experimental nor clinical verification and remains the object of discussion. In our pilot study we investigated the titanium plate fixation effect on the rib fracture healing in porcine model and its histological, biomechanical and radiological aspects. Materials and Method: Two porcine models (experimental group) underwent the operative chest wall stabilization with a titanium plate implantation after osteotomy. Two other porcine models (control group) were treated conservatively after osteotomy. Three weeks after surgery, all animals were sacrificed, treated ribs were explanted and the histological analysis, µCT imaging and biomechanical testing of the calluses tissue were performed. Results: In µCT imaging, experimental group showed a higher cortical bone volume compared to the control group. Histological analysis using the non-decalcified bone tissue blocks demonstrated more maturated callus with higher newly-formed osseous tissue ratio in experimental group in comparison to controls. In contrast, no significant differences in bone blood vessels supply in both groups were observed. This finding suggests that the bone blood supply in experimental group was not impaired. Biomechanical analysis using 3-point bending test demonstrated significantly higher bending stiffness and the maximum force in experimental group. Conclusion: Based on our observation, it could be concluded, that the titanium plate fixation of the rib fractures leads to faster bone callus maturation whereas does not cause the vascular supply impairment after 3 weeks and thus has a beneficial effect on the rib fracture healing.

Keywords: bone vascular supply, chest wall stabilization, fracture healing, histological analysis, titanium plate implantation

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9309 The Effect of Technology on International Marketing Trading Researches and Analysis

Authors: Omil Nady Mahrous Maximous

Abstract:

The article deals with the use of modern information technologies to achieve pro-ecological marketing goals in company-customer relationships. The purpose of the article is to show the possibilities of implementing modern information technologies. In B2C relationships, marketing departments face challenges stemming from the need to quickly segment customers and the current fragmentation of data across many systems, which significantly hinders the achievement of marketing goals. Thus, Article proposes the use of modern IT solutions in the field of marketing activities of companies, taking into account their environmental goals. As a result, its importance for the economic and social development of the emerging countries has increased. While traditional companies emphasize profit maximization as a core business principle, social enterprises must solve social problems at the expense of profit. This rationale gives social enterprises an edge over traditional businesses by meeting the needs of those at the bottom of the pyramid. This also represents a major challenge for social business, since social business acts on the one hand for the benefit of the public and on the other strives for financial stability. Otherwise, the company is unlikely to be fired from the company. Cultures play a role in business communication and research. Using the example of language in international relations, the article presents the problem of the articulation of research cultures in management and linguistics and of cultures as such. After an overview of current research on language in international relations, this article presents the approach to communication in international economy from a linguistic point of view and tries to explain the problems of communication in business starting from linguistic research. A step towards interdisciplinary research that brings together research in the fields of management and linguistics.

Keywords: international marketing, marketing mix, marketing research, small and medium-sized enterprises, strategic marketing, B2B digital marketing strategy, digital marketing, digital marketing maturity model, SWOT analysis consumer behavior, experience, experience marketing, marketing employee organizational performance, internal marketing, internal customer, direct marketing, mobile phones mobile marketing, Sms advertising

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9308 Interpretation of Two Indices for the Prediction of Cardiovascular Risk in Pediatric Obesity

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, children, FIB-4, obesity, triglycerides

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9307 Endoscopic Treatment of Patients with Large Bile Duct Stones

Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

Abstract:

Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

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9306 Process Modeling and Problem Solving: Connecting Two Worlds by BPMN

Authors: Gionata Carmignani, Mario G. C. A. Cimino, Franco Failli

Abstract:

Business Processes (BPs) are the key instrument to understand how companies operate at an organizational level, taking an as-is view of the workflow, and how to address their issues by identifying a to-be model. In last year’s, the BP Model and Notation (BPMN) has become a de-facto standard for modeling processes. However, this standard does not incorporate explicitly the Problem-Solving (PS) knowledge in the Process Modeling (PM) results. Thus, such knowledge cannot be shared or reused. To narrow this gap is today a challenging research area. In this paper we present a framework able to capture the PS knowledge and to improve a workflow. This framework extends the BPMN specification by incorporating new general-purpose elements. A pilot scenario is also presented and discussed.

Keywords: business process management, BPMN, problem solving, process mapping

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9305 An Attempt of Cost Analysis of Heart Failure Patients at Cardiology Department at Kasr Al Aini Hospitals: A Micro-Costing Study from Social Perspective

Authors: Eman Elsebaie, A. Sedrak, R. Ziada

Abstract:

Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.

Keywords: health care cost, heart failure, hospitalization, inpatient

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9304 Comparison Between Partial Thickness Skin Graft Harvesting From Scalp and Lower Limb for Scalp Defect

Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou

Abstract:

Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, graft, scalp, partial thickness

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9303 Understanding the Nature of Blood Pressure as Metabolic Syndrome Component in Children

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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9302 Achieving Appropriate Use of Antibiotics through Pharmacists’ Intervention at Practice Point: An Indian Study Report

Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta

Abstract:

Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.

Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling

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9301 Working within the Zone of Proximal Development: Does It Help for Reading Strategy?

Authors: Mahmood Dehqan, Peyman Peyvasteh

Abstract:

In recent years there has been a growing interest in issues concerning the impact of sociocultural theory (SCT) of learning on different aspects of second/foreign language learning. This study aimed to find the possible effects of sociocultural teaching techniques on reading strategy of EFL learners. Indeed, the present research compared the impact of peer and teacher scaffolding on EFL learners’ reading strategy use across two proficiency levels. To this end, a pre-test post-test quasi-experimental research design was used and two instruments were utilized to collect the data: Nelson English language test and reading strategy questionnaire. Ninety five university students participated in this study were divided into two groups of teacher and peer scaffolding. Teacher scaffolding group received scaffolded help from the teacher based on three mechanisms of effective help within ZPD: graduated, contingent, dialogic. In contrast, learners of peer scaffolding group were unleashed from the teacher-fronted classroom as they were asked to carry out the reading comprehension tasks with the feedback they provided for each other. Results obtained from ANOVA revealed that teacher scaffolding group outperformed the peer scaffolding group in terms of reading strategy use. It means teacher’s scaffolded help provided within the learners’ ZPD led to better reading strategy improvement compared with the peer scaffolded help. However, the interaction effect between proficiency factor and teaching technique was non-significant, leading to the conclusion that strategy use of the learners was not affected by their proficiency level in either teacher or peer scaffolding groups.

Keywords: peer scaffolding, proficiency level, reading strategy, sociocultural theory, teacher scaffolding

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9300 STEM (Science–Technology–Engineering–Mathematics) Based Entrepreneurship Training, Within a Learning Company

Authors: Diana Mitova, Krassimir Mitrev

Abstract:

To prepare the current generation for the future, education systems need to change. It implies a way of learning that meets the demands of the times and the environment in which we live. Productive interaction in the educational process implies an interactive learning environment and the possibility of personal development of learners based on communication and mutual dialogue, cooperation and good partnership in decision-making. Students need not only theoretical knowledge, but transferable skills that will help them to become inventors and entrepreneurs, to implement ideas. STEM education , is now a real necessity for the modern school. Through learning in a "learning company", students master examples from classroom practice, simulate real life situations, group activities and apply basic interactive learning strategies and techniques. The learning company is the subject of this study, reduced to entrepreneurship training in STEM - technologies that encourage students to think outside the traditional box. STEM learning focuses the teacher's efforts on modeling entrepreneurial thinking and behavior in students and helping them solve problems in the world of business and entrepreneurship. Learning based on the implementation of various STEM projects in extracurricular activities, experiential learning, and an interdisciplinary approach are means by which educators better connect the local community and private businesses. Learners learn to be creative, experiment and take risks and work in teams - the leading characteristics of any innovator and future entrepreneur. This article presents some European policies on STEM and entrepreneurship education. It also shares best practices for training company training , with the integration of STEM in the learning company training environment. The main results boil down to identifying some advantages and problems in STEM entrepreneurship education. The benefits of using integrative approaches to teach STEM within a training company are identified, as well as the positive effects of project-based learning in a training company using STEM. Best practices for teaching entrepreneurship through extracurricular activities using STEM within a training company are shared. The following research methods are applied in this research paper: Theoretical and comparative analysis of principles and policies of European Union countries and Bulgaria in the field of entrepreneurship education through a training company. Experiences in entrepreneurship education through extracurricular activities with STEM application within a training company are shared. A questionnaire survey to investigate the motivation of secondary vocational school students to learn entrepreneurship through a training company and their readiness to start their own business after completing their education. Within the framework of learning through a "learning company" with the integration of STEM, the activity of the teacher-facilitator includes the methods: counseling, supervising and advising students during work. The expectation is that students acquire the key competence "initiative and entrepreneurship" and that the cooperation between the vocational education system and the business in Bulgaria is more effective.

Keywords: STEM, entrepreneurship, training company, extracurricular activities

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9299 Effect of vr Based Wii Fit Training on Muscle Strength, Sensory Integration Ability and Walking Abilities in Patients with Parkinson's Disease: A Randomized Control Trial

Authors: Ying-Yi Laio, Yea-Ru Yang, Yih-Ru Wu, Ray-Yau Wang

Abstract:

Background: Virtual reality (VR) systems are proved to increase motor performance in stroke and elderly. However, the effects have not been established in patients with Parkinson’s disease (PD). Purpose: To examine the effects of VR based training in improving muscle strength, sensory integration ability and walking abilities in patients with PD by a randomized controlled trial. Method: Thirty six participants with diagnosis of PD were randomly assigned to one of the three groups (n=12 for each group). Participants received VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group received no structured exercise program but fall-prevention education. Outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment (FGA). All outcomes were assessed at baseline, after training and at 1-month follow-up. Results: Both VRWii and TE groups showed more improvement in level walking velocity, stride length, FGA, muscle strength and vestibular system integration than control group after training and at 1-month follow-up. The VRWii training, but not the TE training, resulted in more improvement in visual system integration than the control. Conclusions: VRWii training is as beneficial as traditional exercise in improving walking abilities, sensory integration ability and muscle strength in patients with PD, and such improvements persisted at least for 1 month. The VRWii training is then suggested to be implemented in patients with PD.

Keywords: virtual reality, walking, sensory integration, muscle strength, Parkinson’s disease

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9298 Evaluation of Phonophoresis with Dexamethasone in Treatment of Hypertrophic Burn Scar

Authors: Alireza Pishgahi, Mohammad Rahbar, Javad Shokri, Shahla Dareshiri, Yaghoub Salekzamani, Fariba Eslamian

Abstract:

Background and Objectives: Hypertrophic scars are one of the complications following a burn injury. Intralesional corticosteroid injection is an invasive method for treatment of this complication. We had design a single blinded randomized control trial to deliver dexamethasone by phonophoresis and evaluate its efficacy on hypertrophic burn scars characteristics. Material and Methods: 56 cases of hypertrophic burn scar due to burn injury allocated randomly to dexamethasone and control group. Individuals in case group received 10 sessions of dexamethasone 0.4% phonophoresis. Patients in control group had placebo phonophoresis (ultrasound with normal routine aquatic gel without any dexamethasone) with the same protocol. At the beginning of study and one week after last session, hypertrophic scar characteristics and pruritus were measured by ‘Vancouver Scar Scale’, and ‘5-D Pruritus Scale’ respectively in both groups. Results: Despite mild improvement in Vancouver Scar Scale score one week after intervention in dexamethasone phonophoresis group in comparison to control subjects, but this difference was not significant (p=0.08). Pruritus score perceived subjectively were significantly lower one week after intervention in dexamethasone groups in comparison to control subjects (p=0.00). Conclusion: Dexamethasone phonophoresis is a safe and effective treatment method for burn hypertrophic scar pruritus, but its efficacy for scar characteristics improvement needs to be evaluated by larger studies with long-term follow-up period.

Keywords: dexamethasone, hypertrophic scar, phonophoresis, pruritus

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9297 The Effect of Customs Commission Customer Satisfaction

Authors: Menelik Tilahun Alemu

Abstract:

Customs administrations are now increasingly regarded as the key border agencies responsible for all transactions related to issues arising from the border crossings of goods and people. Raising revenue has traditionally been high on the agenda of governments, represented by the Ministry of Finance (MOF), because of the critical importance of import duties as a source of budget revenue for many developing countries. Most of these functions are undertaken in close cooperation with other national agencies. Due to the need to make structural reforms that consider the nature of business activities in the world and the needs of consumers, the institution was previously divided into the Ministry of Revenue and the Customs Commission. Accordingly, the Ministry of Revenue is primarily responsible for administering and collecting local taxes, while the Customs Commission is responsible for administering customs matters; It supports exports and collects revenue from it. The National Import and Export Trade Service System is working to make the world more transparent and standardized and adapt to the current situation by formulating various guidelines, rules and procedures to provide a clear, simple, predictable and accessible service to customers. As a result, the commission will be able to streamline the business process by enabling Paperless customer service to support the service delivery technology and eliminate the customer iteration without having to incur unnecessary costs and inconveniences.

Keywords: business, consumers, adapt, transparent

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9296 Impact of the Dog-Technic for D1-D4 and Longitudinal Stroke Technique for Diaphragm on Peak Expiratory Flow (PEF) in Asthmatic Patients

Authors: Victoria Eugenia Garnacho-Garnacho, Elena Sonsoles Rodriguez-Lopez, Raquel Delgado-Delgado, Alvaro Otero-Campos, Jesus Guodemar-Perez, Angelo Michelle Vagali, Juan Pablo Hervas-Perez

Abstract:

Asthma is a heterogeneous disease which has always had a drug treatment. Osteopathic treatment that we propose is aimed, seen through a dorsal manipulation (Dog Technic D1-D4) and a technique for diaphragm (Longitudinal Stroke) forced expiratory flow in spirometry changes there are in particular that there is an increase in the volumes of the Peak Flow and Post intervention and effort and that the application of these two techniques together is more powerful if we applied only a Longitudinal (Stroke). Also rating if this type of treatment will have repercussions on breathlessness, a very common symptom in asthma. And finally to investigate if provided vertebra pain decreased after a manipulation. Methods—Participants were recruited between students and professors of the University, aged 18-65, patients (n = 18) were assigned randomly to one of the two groups, group 1 (longitudinal Stroke and manipulation dorsal Dog Technic) and group 2 (diaphragmatic technique, Longitudinal Stroke). The statistical analysis is characterized by the comparison of the main indicator of obstruction of via area PEF (peak expiratory flow) in various situations through the peak flow meter Datospir Peak-10. The measurements were carried out in four phases: at rest, after the stress test, after the treatment, after treatment and the stress test. After each stress test was evaluated, through the Borg scale, the level of Dyspnea on each patient, regardless of the group. In Group 1 in addition to these parameters was calculated using an algometer spinous pain before and after the manipulation. All data were taken at the minute. Results—12 Group 1 (Dog Technic and Longitudinal Stroke) patients responded positively to treatment, there was an increase of 5.1% and 6.1% of the post-treatment PEF and post-treatment, and effort. The results of the scale of Borg by which we measure the level of Dyspnea were positive, a 54.95%, patients noted an improvement in breathing. In addition was confirmed through the means of both groups group 1 in which two techniques were applied was 34.05% more effective than group 2 in which applied only a. After handling pain fell by 38% of the cases. Conclusions—The impact of the technique of Dog-Technic for D1-D4 and the Longitudinal Stroke technique for diaphragm in the volumes of peak expiratory flow (PEF) in asthmatic patients were positive, there was a change of the PEF Post intervention and post-treatment, and effort and showed the most effective group in which only a technique was applied. Furthermore this type of treatment decreased facilitated vertebrae pain and was efficient in the improvement of Dyspnea and the general well-being of the patient.

Keywords: ANS, asthma, manipulation, manual therapy, osteopathic

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9295 A Comparison between Virtual Case-Based Learning and Traditional Learning: The Effect on Undergraduate Nursing Students’ Performance during Covid-19: A Pilot Study

Authors: Aya M. Aboudesouky

Abstract:

Covid-19 has changed and affected the whole world dramatically in a new way that the entire world, even scientists, have not imagined before. The educational institutions around the world have been fighting since Covid-19 hit the world last December to keep the educational process unchanged for all students. E-learning was a must for almost all US universities during the pandemic. It was specifically more challenging to use online case-based learning instead of regular classes among nursing students who take practical education. This study aims to examine the difference in performance and satisfaction between nursing students taking traditional education and those who take virtual case-based education during their practical study. This study enrolls 40 last-year nursing undergraduates from a mid-sized university in Western Pennsylvania. The study uses a convenient sample. Students will be divided into two groups; a control group that is exposed to traditional teaching strategy and a treatment group that is exposed to a case-based teaching strategy. The module designed for this study is a total parenteral nutrition (TPN) module that will be taught for one month. The treatment group (n=20) utilizes the virtual simulation of the CBL method, while the control group (n=20) uses the traditional lecture-based teaching method. Student evaluations are collected after a month by using the survey to attain the students’ learning satisfaction and self-evaluation of the course. The post-test is used to assess the end of the course performance.

Keywords: virtual case-based learning, traditional education, nursing education, Covid-19 crisis, online practical education

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9294 Photopolymerization of Dimethacrylamide with (Meth)acrylates

Authors: Yuling Xu, Haibo Wang, Dong Xie

Abstract:

A photopolymerizable dimethacrylamide was synthesized and copolymerized with the selected (meth)acrylates. The polymerization rate, degree of conversion, gel time, and compressive strength of the formed neat resins were investigated. The results show that in situ photo-polymerization of the synthesized dimethacrylamide with comonomers having an electron-withdrawing and/or acrylate group dramatically increased the polymerization rate, degree of conversion, and compressive strength. On the other hand, an electron-donating group on either carbon-carbon double bond or the ester linkage slowed down the polymerization. In contrast, the triethylene glycol dimethacrylate-based system did not show a clear pattern. Both strong hydrogen-bonding between (meth)acrylamide and organic acid groups may be responsible for higher compressive strengths. Within the limitation of this study, the photo-polymerization of dimethacrylamide can be greatly accelerated by copolymerization with monomers having electron-withdrawing and/or acrylate groups. The monomers with methacrylate group can significantly reduce the polymerization rate and degree of conversion.

Keywords: photopolymerization, dimethacrylamide, the degree of conversion, compressive strength

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9293 Driven Force of Integrated Reporting in Thailand

Authors: Nuttha Kirdsinsap, Watchaneeporn Setthasakko

Abstract:

This paper aims to gain opinions and perspectives of Certified Public Accountants (CPA) in Thailand regarding the driven force of Integrated Reporting. It employs in-depth interviews with CPA from different big 4 audits firms in Thailand, including PWC, Ernst and Young, Deloitte, and KPMG. It is found that the driven force of Integrated Reporting made CPA in Thailand awaken to the big change that is coming in the future, and it is said to be another big learning and integrating period between certified public accountants and other professionals (for example, engineers, environmentalists and lawyers), which, certified public accountants in Thailand will have to push themselves so hard to catch up.

Keywords: integrated reporting, learning, knowledge, certified public accountants, Thailand

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