Dynamics of country image: evidence from Malaysia

Purpose – Previous research has posited country image to operate at two levels: the country’s macro image, based on general politico-economic descriptors of the country, and the country’s micro image, based on perceptions of products from the country. The purpose of this paper is to further explore this premise in a practical study, using a psychometric assessment of macro and micro country images by ascertaining the nature of differences in macro and micro images of leading exporters, the USA and China, for consumers in Malaysia, a top import destination of US and Chinese goods; the images of Malaysian goods were similarly assessed. Design/methodology/approach – The study used a systematic sample, with questionnaires distributed to adult respondents using a street intercept. Interviewers asked every other passer-by to fill out a questionnaire, and stood in close proximity to address any questions from respondents. The study hypothesized that there is a significant difference between country macro and micro image, respectively for the USA, China and Malaysia, and that there is significant relationship between country macro image and country micro image in each country, respectively, USA, China and Malaysia. Findings – The study found support for the reliability of existing country micro and macro image measures, and further refined them for increased validity. The study compared between the countries and found significant differences on both macro and micro dimensions of country image. The US scored highest on technological research, high quality products, standards of living, labor costs, welfare system, industrialization, civilian government, development, literacy, free-market system and democracy, followed by China on technological research, industrialization, development and free-market system, with Malaysia scoring higher on product quality, labor costs, welfare system, civilian government is civilian/non-military, literacy, free-market system and democracy. Research limitations/implications – A broader study of countries that share geopolitical and cultural similarities might offer additional insights into country macro and micro image. Practical implications – The study cautions marketers to assess the acceptance of their products in the context of their country’s macro and micro image perceptions in target markets, and steer those perceptions in a manner that would be beneficial to their marketing efforts. Originality/value – The conceptualization of the macro and micro aspects of country image has been one of the less studied dimensions of country image. This study is the first to address these dimensions from an emerging-market perspective, suggesting that, at the macro level, country perceptions regarding technology, economy, and politics contribute to an overall impression of the country, which would then influence the desirability of its products originating there. For the micro country image, products from countries perceived as innovative, excelling in product design, and producing prestigious products, are likely to be perceived as desirable

10 kW Grid-Connected PV System Cost and Environmental Analysis for Government Offices: Darbandikhan Technical Institute as a Case Study

The Iraqi Kurdistan region has significant potential for implementing solar energy with an average annual rate of 5.245 kWh/m2. However, most of its energy supply currently comes from nonrenewable energy sources. With the continually increasing demand for energy, an alternative energy-generation technique is required. Among the various renewable energy resources, generating electricity directly from sunlight is the best option because it can be applied by the average household and is environmentally friendly. In this study, a cost and environmental analysis for a 10 kW grid-connected photovoltaic system is presented for a government building with the aim of reducing the load demand on the grid during weekdays and also to inject the generated power into the power grid during weekends. A simulation of the proposed PV system was generated by using Photovoltaic Geographic Information System software to estimate the system’s production performance. The software showed that the highest energy production was 1,660 kWh, which occurred in August; the total electricity production was 16,184 kWh over a 1-year period. The study also showed that the geographical location of Darbandikhan City is quite sufficient for generating electric power from solar energy. It further showed that it can reduce CO2 emissions by 356.60 tons during its lifetime when compared with a gasoline generator and by 131.38 tons when compared with that of a natural gas generator. The proposed system could serve as a good revenue source for the government by exporting the generated electricity to the grid while at the same time serving as motivation for households in the region; furthermore, this system can also be applied to other governmental offices in Kurdistan to generate some or all of its energy needs

Hospital pharmacists’ self-evaluation of their competence and confidence in conducting pharmacy practice research

Objectives: Research is essential to the advancement of pharmacy practice and healthcare. Pharmacists have a pivotal role to play in this strategy. However, there is a paucity of data about hospital pharmacists’ competence and ability in conducting health-related research. This study primarily aims to determine the research demographics of hospital pharmacists in Qatar and to assess the pharmacists’ perceptions of their competence and confidence to conduct research.Methods: A multi-centered survey using a 70-item piloted questionnaire was conducted among a randomly selected sample of pharmacists practicing at seven Hamad Medical Corporation-managed hospitals. Both descriptive and inferential statistical analyses were applied using IBM-SPSS® version 20.Key findings: A total of 120 participants responded to the survey (67% response rate). About 70% of the participants did not have any previous research experience. At least 20% of the respondents self-reported inadequate competence and/or confidence in developing research protocols, critically appraising the literature, undertaking and applying appropriate statistical techniques, and interpreting research findings. The level of education along with the current hospital of practice had significant effects on pharmacists’ self-assessed competence (p<0.05). Overall, 85% of the participants were interested in pursuing postgraduate studies or research-related training.Conclusions: A large proportion of hospital pharmacists in Qatar self-assessed themselves as having deficiencies in several domains of research process or competencies, although they recognized the value of research in advancing pharmacy practice. These findings have important implications for developing informal research training programs and promoting the pursuit of formal postgraduate programs to bridge the knowledge gaps found among hospital-practicing pharmacists.Open Access funded by King Saud Universit

Outcomes of viral myocarditis in patients with and without COVID-19: a nationwide analysis from the United States

UNLABELLED: Cardiovascular complications contribute to 40% of coronavirus disease 2019 (COVID-19) related deaths. The viral myocarditis associated with COVID-19 accounts for significant morbidity and mortality. How COVID-19 myocarditis compares to other viral myocardites is unknown. METHODS: The authors conducted a retrospective cohort study using the National Inpatient Sample database to identify adult patients hospitalized for viral myocarditis in 2020 and to compare outcomes between those with and without COVID-19. The primary study outcome was in-hospital mortality. Secondary outcomes included in-hospital complications, length of stay, and total costs. RESULTS: The study population included 15 390 patients with viral myocarditis, of whom 5540 (36%) had COVID-19. After adjustment for baseline characteristics, patients with COVID-19 had higher odds of in-hospital mortality [adjusted odds ratio (aOR) 3.46, 95% CI 2.57-4.67], cardiovascular complications (aOR 1.46, 95% CI 1.14-1.87) including cardiac arrest (aOR 2.07, 95% CI 1.36-3.14), myocardial infarction (aOR 2.97, 95% CI 2.10-4.20), venous thromboembolism (aOR 2.01, 95% CI 1.25-3.22), neurologic complications (aOR 1.82, 95% CI 1.10-2.84), renal complications (aOR 1.72, 95% CI 1.38-2.13), and hematologic complications (aOR 1.32, 95% CI 1.10-1.74), but lower odds of acute heart failure (aOR 0.60, 95% CI 0.44-0.80). The odds of pericarditis, pericardial effusion/tamponade, cardiogenic shock, and the need for vasopressors or mechanical circulatory support were similar. Patients with COVID-19 had longer length of stay (7 days vs. 4 days, P\u3c0.01) and higher total costs ($21,308 vs.$14,089, P\u3c0.01). CONCLUSIONS: Among patients with viral myocarditis, COVID-19 is associated with higher in-hospital mortality and cardiovascular, neurologic, renal, and hematologic complications compared to non-COVID-19 viruses

Vibrational Signatures in the THz Spectrum of 1,3-DNB: A First-Principles and Experimental Study

Understanding the fundamental processes of light-matter interaction is important for detection of explosives and other energetic materials, which are active in the infrared and terahertz (THz) region. We report a comprehensive study on electronic and vibrational lattice properties of structurally similar 1,3-dinitrobenzene (1,3- DNB) crystals through first-principles electronic structure calculations and THz spectroscopy measurements on polycrystalline samples. Starting from reported x-ray crystal structures, we use density-functional theory (DFT) with periodic boundary conditions to optimize the structures and perform linear response calculations of the vibrational properties at zero phonon momentum. The theoretically identified normal modes agree qualitatively with those obtained experimentally in a frequency range up to 2.5 THz and quantitatively at much higher frequencies. The latter frequencies are set by intra-molecular forces. Our results suggest that van der Waals dispersion forces need to be included to improve the agreement between theory and experiment in the THz region, which is dominated by intermolecular modes and sensitive to details in the DFT calculation. An improved comparison is needed to assess and distinguish between intra- and intermolecular vibrational modes characteristic of energetic materials.Comment: 5 pages, 5 figure

MDM2 prevents spontaneous tubular epithelial cell death and acute kidney injury

Murine double minute-2 (MDM2) is an E3-ubiquitin ligase and the main negative regulator of tumor suppressor gene p53. MDM2 has also a non-redundant function as a modulator of NF-kB signaling. As such it promotes proliferation and inflammation. MDM2 is highly expressed in the unchallenged tubular epithelial cells and we hypothesized that MDM2 is necessary for their survival and homeostasis. MDM2 knockdown by siRNA or by genetic depletion resulted in demise of tubular cells in vitro. This phenotype was completely rescued by concomitant knockdown of p53, thus suggesting p53 dependency. In vivo experiments in the zebrafish model demonstrated that the tubulus cells of the larvae undergo cell death after the knockdown of mdm2. Doxycycline-induced deletion of MDM2 in tubular cell-specific MDM2-knockout mice Pax8rtTa-cre; MDM2f/f caused acute kidney injury with increased plasma creatinine and blood urea nitrogen and sharp decline of glomerular filtration rate. Histological analysis showed massive swelling of renal tubular cells and later their loss and extensive tubular dilation, markedly in proximal tubules. Ultrastructural changes of tubular epithelial cells included swelling of the cytoplasm and mitochondria with the loss of cristae and their transformation in the vacuoles. The pathological phenotype of the tubular cell-specific MDM2-knockout mouse model was completely rescued by co-deletion of p53. Tubular epithelium compensates only partially for the cell loss caused by MDM2 depletion by proliferation of surviving tubular cells, with incomplete MDM2 deletion, but rather mesenchymal healing occurs. We conclude that MDM2 is a non-redundant survival factor for proximal tubular cells by protecting them from spontaneous p53 overexpression-related cell death

Incarcerated Stomach in a Parastomal Hernia

Parastomal hernia is a rare cause of upper gastrointestinal bleeding. We present a case of an 82-year-old lady who presented with a one-month history of abdominal pain associated with coffee ground vomiting and intermittent melena. Gastroscopy showed bleeding from pyloric canal without a definite lesion. Abdominal CT showed herniation of the pre-pyloric and pyloric regions of the stomach into the hernial sac. She underwent a laparoscopic repair with extensive adhesiolysis, reduction of stomach, approximation of defect and placement of a mesh. She made excellent recovery and had no post- operative complications. Keywords: Parastomal hernia, Stomac

Potential effect of pharmaceutical care to improve outcomes in patients with chronic kidney disease-mineral bone disorder in Sulaimani dialysis centers

Objective: the present study was aimed to evaluate the role of pharmaceutical services in improving the outcome of mineral bone disorder in patients with advanced chronic kidney disease. Methodology: One hundred and twenty patients with chronic kidney disease-mineral bone disorder (CKD-MBD)   screened for eligibility, seventy-six patients enrolled in the study and randomly allocated into two groups: pharmaceutical care and usual care, both groups interviewed by the pharmacist using specific questionnaire for assessing the quality of life (QoL). All the drug related problems (DRPs) including drug-drug interactions (DDIs) were recorded by the pharmacist. Blood samples were collected and utilized for analyzing the levels of vitamin D, phosphorous, calcium, albumin and parathyroid hormone at baseline and three months after. The pharmaceutical care group received all the educations about their medications and how to minimize DRPs; improve the QoL. Additionally, the pharmaceutical intervention included correcting the biochemical parameters. Results: Pharmaceutical care significantly improved patients QoL and minimized DRPs and DDIs. It was also effective in improving the biochemical parameters. Conclusion: Pharmaceutical care has a positive impact on improving the outcome of patients with CKD-MBD through attenuating DRPs, improving the biochemical parameters and the QoL

Improving emergency departments: simulation-based optimization of patients waiting time and the number of staff present in a hospital

The emergency department (ED), operating around the clock every day of the year, serves a diverse range of patients with varying medical conditions, making it the vital core of a hospital. Consequently, optimizing and simulating the ED's processes becomes essential to enhance the quality of care provided. This study offers a case analysis employing simulation to assess patient flows in a hospital's emergency department. Our objective is to evaluate the impacts of system enhancements within the ED. This model aims to measure patients' time from their ED entry, determine daily patient numbers, and calculate the overall patient movement time within the department. If the patient's condition is serious, he will be presented immediately to the doctor without waiting. A doctor will be added to the unit if the number of patients exceeds the standard limit.</p

Compact Electrochromic Optical Recording of Bioelectric Potentials

Electrochromic optical recording (ECORE) is a label-free method that utilizes electrochromism to optically detect electrical signals in biological cells with a high signal-to-noise ratio and is suitable for long-term recording. However, ECORE usually requires a large and intricate optical setup, making it relatively difficult to transport and to study specimens on a large scale. Here, we present a compact ECORE apparatus that drastically reduces the spatial footprint and complexity of the ECORE setup whilst maintaining high sensitivity. An autobalancing differential photodetector automates common-mode noise rejection, removing the need for manually adjustable optics, and a compact laser module conserves space compared to a typical laser mount. The result is a simple, easy-to-use, and relatively low cost system that achieves a sensitivity of 16.7 {\mu}V (within a factor of 5 of the shot noise limit), and reliably detects action potentials from Human-induced pluripotent stem cell (HiPSC) derived cardiomyocytes. This setup can be further improved to within 1.5 dB of the shot noise limit by filtering out power-line interference.Comment: 11 pages, 4 figure