1,119 research outputs found
Exploring an Objective Weighting System for Travel & Tourism Pillars
AbstractThe World Economic Forum employs Travel & Tourism Competitiveness Indexes (TTCI) to measure the travel & tourism (T&T) global competitiveness of a country. The TTCI overall scores are calculated with an arithmetic mean aggregation from the scores of the fourteen composite pillars with a subjective assumption of all the pillars having the same weights. This paper attempts to release such a subjective assumption by proposing a new solution framework to explore an objective weighting system for the pillars. The proposed solution framework employs the Expectation Maximization (EM) clustering algorithm to group the 139 ranked countries into three classes and then performs the Artificial Neural Network (ANN) analysis to explore the objective weighting system for the fourteen pillars. The results show that tourism infrastructure, ground transport infrastructure, air transport infrastructure, cultural resources, health and hygiene, and ICT infrastructure are the six most critical pillars contributing to the TTCI overall scores. Accordingly, the policy makers should allocate limited resources with priority to improve these six pillars to frog leap the T&T global competitiveness
Having a family doctor is associated with some better patient-reported outcomes of primary care consultations
<b>Background</b> Hong Kong (HK) has pluralistic primary care that is provided by a variety of doctors. The aim of our study was to assess patient-reported outcomes of primary care consultations in HK and whether having a family doctor (FD) made any difference.<p></p>
<b>Methods</b> We interviewed by telephone 3148 subjects from 5174 contacted households (response rate 60.8%) randomly selected from the general population of HK about the experience of their last primary care consultations in September 2007 and April 2008. We compared the patient-reported outcomes (PRO) and patient-centered process of care in those with a FD, those with other types of regular primary care doctors (ORD) and those without any regular primary care doctor (NRD). PRO included patient enablement, global improvement in health, overall satisfaction, and likelihood of recommending their doctors to family and friends. Patient-centered process of care indicators was explanations about the illness, and address of patient’s concerns.<p></p>
<b>Results</b> One thousand one hundred fifty, 746, and 1157 reported to have FD, ORD, and NRD, respectively. Over 80% of those with FD consulted their usual primary care doctors in the last consultation compared with 27% of those with NRD. Compared with subjects having ORD or NRD, subjects with FD reported being more enabled after the consultation and were more likely to recommend their doctors to family and friends. Subjects with FD and ORD were more likely than those having NRD to report a global improvement in health and satisfaction. FD group was more likely than the other two groups to report receiving an explanation on the diagnosis, nature, and expected course of the illness, and having their concerns addressed. Patient enablement was associated with explanation of diagnosis, nature, and expected course of illness, and address of patient’s concerns.<p></p>
<b>Conclusion</b> People with a regular FD were more likely to feel being enabled and to experience patient-centered care in consultations
A Study on the Boundary Conditions of 90° Paper Pop-up Structures
The design of a pop-up book or card has hitherto been labour intensive with tasks of trials and errors. The constructions of collapsible pop-up structures can be demanding and inefficient without adequate knowledge of their geometric properties. This paper examines the properties of creases in 90° pop-up structures. A 90° pop-up structure is one that erects fully when two adjacent base pages, on which it sits, are opened to a right angle. In particular, we define a boundary region for creating 90° pop-ups. Similarly, paper folds are able to achieve pop-up effects and can be integrated with 90° pop-up constructions. The development of these pop-up structures can be represented graphically. Through this study, a fundamental foundation for pop-up topology and geometry is built. This foundation would be vital for understanding the applications of pop-up making techniques. The mathematical relationships devised would be useful for developing computer-enhanced pop-up design.Singapore-MIT Alliance (SMA
Australian Group on Antimicrobial Resistance (AGAR) Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP) Annual Report 2017
From 1 January to 31 December 2017, 36 institutions around Australia participated in the Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2017 was to deter¬mine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are anti¬microbial resistant, with particular emphasis on susceptibility to methicillin and to characterise the molecular epidemiology of the methicillin-resistant isolates. A total of 2,515 S. aureus bacteraemia episodes were reported, of which 77% were community-onset. Approximately one in five S. aureus (19.0%) were methicillin resistant. The 30-day all-cause mortality associated with methicillin-resistant SAB was 18.7% which was significantly higher than the 14.0% mortality associated with methicillin-susceptible SAB. With the exception of the β-lactams and erythromycin, antimicrobial resistance in methicillin-susceptible S. aureus was rare. However in addition to the β-lactams approximately 42% of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin and ciprofloxacin and approxi¬mately 14% resistant to co-trimoxazole, tetracycline and gentamicin. When applying the EUCAST breakpoints teicoplanin resistance was detected in five S. aureus isolates. Resistance was not detected for vancomycin and linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to two healthcare-associated MRSA clones: ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). ST22-IV [2B] (EMRSA-15) is the predominant healthcare-associated clone in Australia. Seventy-five percent of methicillin-resistant SAB were due to community-associated clones. Although polyclonal approximately 74% of community-associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA), ST5-IV [2B], ST45-VT [5C2&5] and ST1-IV [2B]. CA-MRSA, in particular the ST45-VT [5C2&5] clone has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. ST45-VT [5C2&5] accounted for 12.8% of CA-MRSA. As CA-MRSA is well established in the Australian community it is important antimicrobial resistance patterns in community- and healthcare-associated SAB is monitored as this information will guide therapeutic practices in treating S. aureus sepsis
A numerical method for rapid estimation of drawbead restraining force based on non-linear, anisotropic constitutive equations
AbstractNumerical procedures to predict drawbead restraining forces (DBRF) were developed based on the semi-analytical (non-finite-element) hybrid membrane/bending method. The section forces were derived by equating the work to pull sheet material through the drawbead to the work required to bend and unbend the sheet along with frictional forces on drawbead radii. As a semi-analytical method, the new approach was especially useful to analyze the effects of various constitutive parameters with less computational cost. The present model could accommodate general non-quadratic anisotropic yield function and non-linear anisotropic hardening under the plane strain condition. Several numerical sensitivity analyses for examining the effects of process parameters and material properties including the Bauschinger effect and the shape of yield surface on DBRF were presented. Finally, the DBRFs of SPCC steel sheet passing a single circular drawbead were predicted and compared with the measurements
Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2019
From 1 January to 31 December 2019, thirty-nine institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aim of AESOP 2019 was to determine the proportion of enterococcal bacteraemia isolates in Australia that were antimicrobial resistant, and to characterise the molecular epidemiology of the E. faecium isolates. Of the 1,361 unique episodes of bacteraemia investigated, 95.2% were caused by either E. faecalis (51.4%) or E. faecium (43.8%). Ampicillin resistance was not detected in E. faecalis but was detected in 91.1% of E. faecium. Vancomycin non-susceptibility was detected in 0.1% of E. faecalis and in 41.8% of E. faecium. Overall, 45.4% of E. faecium harboured vanA and /or vanB genes. For the vanA / vanB positive E. faecium isolates, 49.1% harboured vanA genes only and 50.6% vanB genes; 0.3% harboured both vanA and vanB genes. The percentage of E. faecium bacteraemia isolates resistant to vancomycin in Australia is substantially higher than that seen in most European countries. E. faecium consisted of 78 multilocus sequence types (STs), of which 75.0% of isolates were classified into six major STs containing ten or more isolates. All major STs belong to clonal cluster (CC) 17, a major hospital-adapted polyclonal E. faecium cluster. The predominant STs (ST1424, ST17, ST796, ST80, ST1421, and ST78) were found across most regions of Australia. The most prevalent clone was ST1424, which was identified in all regions except the Northern Territory and Western Australia. Overall, 51.4% of isolates belonging to the six predominant STs harboured vanA or vanB genes. In 2019, AESOP has shown that enterococcal bacteraemias in Australia are frequently caused by polyclonal ampicillin-resistant high-level gentamicin-resistant vanA or vanB E. faecium which have limited treatment options
Duodenal ulcer is a multifactorial disorder the role of pepsinogen I
Serum pepsinogen I (PGI) levels were measured in 231 duodenal ulcer (DU) patients and 100 sex and age-comparable healthy controls. Significantly higher mean serum PGI levels were found in DU patients than in controls (124,7 ± 3,4 ng/ml v. 92,9 ± 2,3 ng/ml; P < 0,001) (mean ± SE). These levels were higher in male DU patients than in female DU patients (128,5 ± 3,9 ng/IDl v. 107,4 ± 6,4 ng/ml; P < 0,05). Smoking was associated with elevated serum PGI levels in DU patients (145,3 ± 5,1 ng/ml v. 109,0 ± 4,2 ngl/ml; P < 0,001). Healed DUs were associated with lower mean serum PGI levels than active ulcers (110,9 ± 7,6 ng/ml v. 129,4 ± 3,8 ng/ml, P < 0,05). Whether patients were positive or negative for Helicobacter pylori, infection did not affect mean serum PGI levels. All the risk factors for DU may not affect serum PGI levels and DU may therefore be considered a multifactorial disease
A sensitive bithiophene-based biosensor for interferon-gamma characterization and analysis
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The influence of microsatellite polymorphisms in sex steroid receptor genes ESR1, ESR2 and AR on sex differences in brain structure.
The androgen receptor (AR), oestrogen receptor alpha (ESR1) and oestrogen receptor beta (ESR2) play essential roles in mediating the effect of sex hormones on sex differences in the brain. Using Voxel-based morphometry (VBM) and gene sizing in two independent samples (discovery n = 173, replication = 61), we determine the common and unique influences on brain sex differences in grey (GM) and white matter (WM) volume between repeat lengths (n) of microsatellite polymorphisms AR(CAG)n, ESR1(TA)n and ESR2(CA)n. In the hypothalamus, temporal lobes, anterior cingulate cortex, posterior insula and prefrontal cortex, we find increased GM volume with increasing AR(CAG)n across sexes, decreasing ESR1(TA)n across sexes and decreasing ESR2(CA)n in females. Uniquely, AR(CAG)n was positively associated with dorsolateral prefrontal and orbitofrontal GM volume and the anterior corona radiata, left superior fronto-occipital fasciculus, thalamus and internal capsule WM volume. ESR1(TA)n was negatively associated with the left superior corona radiata, left cingulum and left inferior longitudinal fasciculus WM volume uniquely. ESR2(CA)n was negatively associated with right fusiform and posterior cingulate cortex uniquely. We thus describe the neuroanatomical correlates of three microsatellite polymorphisms of steroid hormone receptors and their relationship to sex differences
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