Benefits Of Usage Research Articles

Glucosa-Insulin-Potassium (GIK) Solution Used with Diabetic Patients Provides Better Recovery After Coronary Bypass Operations

Tight blood glucose control has become a therapeutical goal for anesthetic management for patients scheduled for cardiac surgery, especially if they are diabetic patients. This study was created to confirm the benefits of intraoperative GIK solution usage during coronary bypass operation of diabetic patients. Patients with type 1 and 2 diabetes mellitus (DM) referred for coronary artery bypass grafting (CABG) were randomized to receive GIK solution (GIK--study group) in the first 24 hours intraoperatively or to receive official Clinical protocol without GIK solution (non GIK - control group). The primary clinical outcome was the cardiac index (CI) since it represents the most sensitive measure of cardiac work in the immediate postoperative period, and the secondary clinical outcomes were the glycemic control, insulin consumption, duration of mechanical ventilation (MV), potassium level and atrial fibrillation (AF) appearance. One hundred diabetic patients, divided into two groups, were included in the study. The cardiac index did not show a significant difference, although the study group had CI with only minor variations than those of the controlled group, hence the reason we considered the study group as the more stable. The atrial fibrillation showed a difference between two groups, with 14 (28%) patients with postoperative AF in the control group compared with 3 (6%) patients with postoperative AF in the study group. As potassium values were stable in study group, we concluded that it can be one of the reasons for less postoperative AF in this group. The duration of MV showed a significant difference (0,003) between the two groups as well. In the study group the average MV time was 534,38 minutes, compared with the control group with 749,20 minutes. The average value of glucose was 11.1 mmol/l in the control group vs. 9.8 mmol/l in the study group. The study group had less insulin consumption in order to maintain target glycemia (p = 0.001). In the non GIK group average insulin consumption was 44 IJ per patient vs. 28.5 IJ in the GIK group. Intraoperative GIK solution given to diabetic patients with CABG operation provides more stable CI, shorter time of MV, more stable values of potassium which provides normal rhythm and less AF onset, less insulin to maintain target glycemia. All the above mentioned provides more stable intraoperative hemodynamic and better recovery of diabetic

A Comparison of conventional and nonconventional methods of DC motor speed control

In this paper we study the speed control of a DC motor with conventional (PID) and nonconventional (Neural Network – NN) methods. DC motor model and performance indicators criteria are defined. PID controller is tuned through Matlab scripting and tools and relevant results of closed loops system are received. For nonconventional method inverse model control schema is used, where a three layer NN presents the inverse model, and it is trained by back propagation algorithm. Simulation results are presented to compare the two control methods and conclude the benefits of NN usage in control. Considering the broad range of DC motor usage, where robotics is included, the study is presented as a way for improving the closed system's dynamics.

Sailing between Scylla and Charybdis: oral long-term anticoagulation in dialysis patients

End-stage renal disease (ESRD) patients exhibit an increased risk of bleeding compared with non-chronic kidney disease (CKD) patients due to uraemic platelet dysfunction, altered vessel architecture and other factors. This renders any long-term oral anticoagulation potentially difficult. While there is little doubt that ESRD patients with recurrent thromboembolism or a mechanical cardiac valve should receive vitamin K antagonists (coumarins), the use of coumarins in ESRD patients with atrial fibrillation is a matter of debate. In non-CKD patients, current guidelines strongly recommend the use of oral anticoagulants for stroke prophylaxis in atrial fibrillation if certain risk factors are present (CHA2DS2-VASc score). This recommendation is often extrapolated to patients with advanced CKD or ESRD but data supporting this practice are weak to absent. Besides an increased bleeding risk in ESRD patients, coumarins will also accelerate cardiovascular calcification and are potent risk factors for the development of calcific uraemic arteriolopathy (calciphylaxis). Novel coumarin alternatives such as direct thrombin inhibitors are promising but none is currently approved for use in ESRD patients. Whether interventional treatment strategies such as atrial appendage occlusion are safe and effective options in advanced CKD is also as yet unresolved. This review attempts to balance the potential risks and benefits of coumarin usage in ESRD patients and to give the best possible recommendations for everyday patient care.

Update on tolvaptan for the treatment of hyponatremia

Tolvaptan is a member of a new class of drugs, called the vaptans, that antagonize receptors of the neurohormone arginine vasopressin. From a clinical perspective, tolvaptan has been shown to be efficacious in the treatment of hyponatremia, whether it is idiopathic or disease related, and it may have a more favorable benefit/risk profile than other treatment modalities. From an economic perspective, tolvaptan is an expensive drug for treating hyponatremia, but recent economic cost-offset models provide evidence that tolvaptan can be cost effective. The cost–effectiveness of tolvaptan is driven by reduced healthcare resource usage and hospitalization costs. More comparative research of tolvaptan versus other pharmacotherapies and analyses of patients treated with tolvaptan in the real world are needed to better determine the benefits of tolvaptan usage to patient outcome, and more accurately assess its value in the treatment of hyponatremia, an independent predictor of morbidity, mortality and cost.

Effects of yeast cell wall-derived mannan-oligosaccharides on jejunal gene expression in young broiler chickens

The use of mannan-oligosaccharides (MOS) as alternatives to antibiotic growth promoters (AGP) has gained in popularity in recent years due to regulatory restrictions of using AGP in food animal production. Benefits of MOS usage include improvement on animal performance, feed efficiency, and gastrointestinal health. The molecular mechanisms of these functions however are not clear. The goal of the current study was to use a transcriptomics approach to investigate the effects of MOS on the intestinal gene expression profile of young broilers and characterize biological gene pathways responsible for the actions of MOS. One hundred and twenty 1-d-old Cobb 500 broiler chicks were randomly divided into 2 groups and were fed either a standard wheat-soybean meal-based (control) diet or the same diet supplemented with 2.2 g/kg of MOS (Bio-Mos, Alltech, Nicholasville, KY) for 3 wk, followed by jejunal gene expression profiling analysis using chicken-specific Affymetrix microarrays. Results indicated that a total of 672 genes were differentially expressed (P < 0.01 and fold change >1.2) in the jejunum by MOS supplementation. Association analysis indicated that differentially expressed genes are involved in diverse biological functions including energy production, cell death, and protein translation. Expression of 77 protein synthesis-related genes was differentially regulated by MOS in the jejunum. Further pathway analysis indicated that 15 genes related to oxidative phosphorylation were upregulated in the jejunum, and expression of genes important in cellular stress response, such as peroxiredoxin 1, superoxide dismutase 1, and thioredoxin, were also increased by MOS. Differential expression of genes associated with cellular immune processes, including lysozyme, lumican, β 2-microglobin, apolipoprotein A-1, and fibronectin 1, were also observed in MOS-fed broilers. In summary, this study systematically identified biological functions and gene pathways that are important in mediating the biological effects of MOS in broilers.

A Patient Presents with Longstanding, Severe LV Dysfunction. Is There a Role for Additional Risk Stratification Before ICD?

Increased longevity of patients with systolic heart failure caused by the use of implantable cardioverter-defibrillators (ICDs) is one of the most successful achievements in contemporary medicine. During the last 2 decades, the scientific community has striven to increase the benefits of ICD usage by specifying indications for primary prevention ICD implantation. Left ventricular ejection fraction is neither highly specific nor is it a highly sensitive risk marker of sudden cardiac death. The authors discuss risk-stratification approaches in different patient populations with structural heart disease and systolic heart failure.

“BreastfeedingBasics”

The United States has not met the majority of the Centers for Disease Control and Prevention goals for breastfeeding duration. Studies have shown a lack of knowledge about breastfeeding by health care professionals and students (HCP/S). Web-based education can be a cost-effective manner of education for HCP/S. "BreastfeedingBasics" is an online free educational program available for use. This study compares information in "BreastfeedingBasics" to the breastfeeding knowledge competencies recommended by the US Breastfeeding Committee (USBC). It also evaluates usage of "BreastfeedingBasics" by users and health care professional faculty. Using anonymous information from Web site users, the authors compared mean pre-test and post-test scores of the modules as a measure of the knowledge gained by HCP/S users. They evaluated usage by demographic information and used a Web-based survey to assess benefits of usage of "BreastfeedingBasics" to faculty. Overall, 15 020 HCP/S used the Web site between April 1999 and December 2009. "BreastfeedingBasics" meets 8 of the 11 USBC knowledge competencies. Mean post-test scores increased (P < .001) for all modules. Faculty reported its benefits to be free, broad scope, and the ability to be completed on the students' own time; 84% of the faculty combined the use of "BreastfeedingBasics" with clinical work. Use of "BreastfeedingBasics" can help HCP/S meet the USBC core breastfeeding knowledge competencies and gain knowledge. Faculty are satisfied with its use. Wider use of "BreastfeedingBasics" to help improve the knowledge of HCP/S may help in improving breastfeeding outcomes.

A Comprehensive Review of Evidence and Current Recommendations Related to Pacifier Usage

Pacifier usage is controversial, and published recommendations are contradictory. The purposes of this literature review were to provide a comprehensive summary of risks and benefits of pacifier usage based upon the highest levels of evidence available and to provide a reference for nurses to utilize while assisting mothers in making an informed decision. Results indicated that benefits include reported ability to soothe/comfort, decreased risk of sudden infant death syndrome, and a probable synergistic role in adjunctive pain relief. Greatest risks are an increased incidence of acute otitis media, possible negative impact on breast-feeding, and dental malocclusion particularly if usage is greater than 2-3 years. The frequency, intensity, and duration of pacifier use are related to type and extent of all risks.

Clicking for a Cause: Using Social Media Campaigns to Drive Awareness for Golf Tournaments and Charitable Organizations

Sport industry leaders have recognized the popularity of social media; however, some have struggled with quantifying the benefits of such usage (Fisher, 2009). This case explores the potential opportunities social media sites can provide to sport organizations. Golf tournament organizer TampaTourneys, LLC created an administrative Facebook page to keep its Facebook users informed about events. The organization also used the page to promote a cause related marketing campaign benefitting a charitable fundraiser. Partnering with Blackhawk Computers, TampaTourneys initiated a week-long campaign, which encouraged the tournament organizer’s Facebook fans to tell their respective Facebook friends about the fundraiser and become fans of the TampaTourneys Facebook page. In turn, the organization made a monetary donation on behalf of its current and new fans. Based on the campaign’s success, TampaTourneys decided to initiate a second and longer fundraising effort. The case asks students to analyze data collected from the first fundraising campaign and develop a new campaign for the tournament organizer.

Helicopter transport

Traumatic injury continues to be a significant cause of morbidity and mortality in the year 2011. In addition, the healthcare expenditures and lost years of productivity represent significant economic cost to the affected individuals and their communities. Helicopters have been used to transport trauma patients for the past 40 years, but there are conflicting data on the benefits of helicopter emergency medical service (HEMS) in civilian trauma systems. Debate persists regarding the mortality benefit, cost-effectiveness, and safety of helicopter usage, largely because the studies to date vary widely in design and generalizability to trauma systems serving heterogeneous populations and geography. Strict criteria should be established to determine when HEMS transport is warranted and most likely to positively affect patient outcomes. Individual trauma systems should conduct an assessment of their resources and needs in order to most effectively incorporate helicopter transport into their triage model. Research suggests that HEMS improves mortality in certain subgroups of trauma patients, both after transport from the scene of injury and following interfacility transport. Studies examining the cost-effectiveness of HEMS had mixed results, but the majority found that it is a cost-effective tool. Safety remains an issue of contention with HEMS transport, as helicopters are associated with significant safety risk to the crew and patient. However, this risk may be justified provided there is a substantial mortality benefit to be gained. Recent studies suggest that strict criteria should be established to determine when helicopter transport is warranted and most likely to positively affect patient outcomes. Individual trauma systems should conduct an assessment of their resources and needs in order to most effectively incorporate HEMS into their triage model. This will enable regional hospitals to determine if the costs and safety risks associated with HEMS are worthwhile given the potential benefits to patient morbidity and mortality.

An Empirical Model of Optimal Capital Structure1

The authors provide a reasonably user‐friendly and intuitive model for arriving at a company's optimal, or value‐maximizing, leverage ratio that is based on the estimation of company‐specific cost and benefit functions for debt financing. The benefit functions are downward‐sloping, reflecting the drop in the incremental value of debt with increases in the amount used. The cost functions are upward‐sloping, reflecting the increase in costs associated with increases in leverage. The cost functions vary among companies in ways that reflect differences in corporate characteristics such as size, profitability, dividend policy, book‐to‐market ratio, and asset collateral and redeployability.The authors use these cost and benefit functions to produce an estimate of a company's optimal amount of debt. Just as equilibrium in economics textbooks occurs where supply equals demand, optimal capital structure occurs at the point where the marginal benefit of debt equals the marginal cost. The article illustrates optimal debt choices for companies such as Barnes &amp; Noble, Coca‐Cola, Six Flags, and Performance Food Group. The authors also estimate the net benefit of debt usage (in terms of the increase in firm or enterprise value) for companies that are optimally levered, as well as the net cost of being underleveraged for companies with too little debt, and the cost of overleveraging for companies with too much. One critical insight of the model is that the costs associated with overleveraging appear to be significantly higher, at least for some companies, than the costs of being underleveraged.

Adoption Intention and Benefits of E-Commerce Usage in Business: An Exploratory Study

The adoption of internet for e-commerce in business in developing countries grows slower than in developed countries. This research seeks to identify the reason that causing such business to adopt e-commerce (adoption intentions) and the benefits they are realizing. Beside it, this study also want to know the differences of intention adoption and the benefits of usage between corporations which have domestic markets and those which have global markets.Research conducted in east Java and involved 64 companies as samples. By Using exploratory factor analysis it can be concluded that there are five factor in terms of intention to adopt e-commerce for business, e.i: 1) to maintain the activity with the suppliers and business partnership, 2) to keep and satisfy the customer, 3) to access to the market, 4) to build image, and 5) to recruit staff online. Further analysis concludes that there is significant different in intention adoption, especially in factor to access to the market between corporations which have domestic markets and those which have global markets. Corporations which have global markets have stronger intention in factor to- access to the market than those which domestic markets. Beside it, there is no differences significantly in benefits after adopted e-commerce for business process.The implication of the result is indicate that e-commerce have many strategic benefits for every business corporation. It is not only to improve internal and external business process but also give the equal benefits with the cost.

Optimal Capital Structure

We study optimal capital structure by first estimating firm-specific cost and benefit functions for debt. The benefit functions are downward sloping reflecting that the incremental value of debt declines as more debt is used. The cost functions are upward sloping, reflecting the rising costs that occur as a firm increases its use of debt. The cost functions vary by firm to reflect the firm’s characteristics such as asset collateral and redeployability, asset size, the book-to-market ratio, profitability, and whether the firm pays dividends. We use these cost and benefit functions to produce a firm-specific recommendation of the optimal amount of debt that a given company should use. In textbook economics, equilibrium occurs where supply equals demand. Analogously, optimal capital structure occurs where the marginal benefit equals the marginal cost of debt. We illustrate optimal debt choices for specific firms such as Barnes & Noble, Coca-Cola, Six Flags, and Performance Food Group, among others. We also calculate the cost of being underlevered for companies that use too little debt, the cost of being overlevered for companies that use too much debt, and the net benefit of debt usage for those that are correctly levered. Finally, we provide formulas that can be easily used to approximate the cost of debt function, and in turn to determine the optimal amount of debt, for any given firm. van Binsbergen is from the Kellogg Graduate School of Management, Northwestern University, and the Graduate School of Business, Stanford University, and NBER; Graham is from the Fuqua School of Business, Duke University, and NBER; and Yang is from the McDonough School of Business, Georgetown University. This paper updates our paper “The Cost of Debt” published in the Journal of Finance (December 2010), with a particular focus on a practitioner audience.

Textbook websites: user technology acceptance behaviour

Compared with course management software (e.g. Blackboard and WebCT), the content and technology offered by a textbook website (TBW) is relatively costless to universities and professors, and is a potentially valuable tool that can be leveraged to help students learn course material. The present study uses the extended Technology Acceptance Model (TAM2) and structural equation modelling to examine characteristics associated with the voluntary usage behaviour (UB) of TBW by students in entry-level accounting courses. Analysing survey data from 231 participants, our results indicate that perceptions of usefulness, the ability to demonstrate or explain the benefits of usage and peer usage of the TBW are all positively associated with UB. However, our findings also suggest that notwithstanding the potential benefits accruing to students, faculty encouragement is a critical enabling factor for use of the TBW. Because of persistent concerns on the part of students, educators, administrators, textbook publishers, and legislators regarding the cost and quality of higher education, we discuss the implications of our results for these stakeholders.

The benefit of smart phone usage in liver organ procurement

A 56-year-old man was on the transplant list with end-stage liver disease secondary to hepatitis C when a donor liver became available at a location 545 km away. The procurement team, consisting of a senior and junior fellow, went on the retrieval, while the staff surgeon remained in the hospital with the recipient. At the time of organ procurement, a suspicious lesion was identified in the left lateral lobe. The transplant fellows took intraoperative pictures of the lesion with a smart phone and sent them to the staff surgeon for advice. A teleconsultation, facilitated by images sent from the smart phone, took place over the next 22 min. The decision was made to proceed with the transplant, as it was felt that the lesion could be resected from the liver allograft. Had the fellows not been able to interact with the staff surgeon in real-time during the surgery, there is a high likelihood that the organ would have been rejected by the staff surgeon due to the unexpected finding. The patient's postoperative course was relatively uneventful with no evidence of infection. The patient was discharged from hospital and continues to do well. We expect that the role of smart phones in remote consultation will continue to expand in future.

説得納得ゲームを用いた風力発電の科学技術コミュニケ–ション―風力発電による便益と問題点の双方の理解をめざして―

説得納得ゲームを用いた風力発電の科学技術コミュニケ–ション―風力発電による便益と問題点の双方の理解をめざして―

The risks and benefits of long‐term use of hydroxyurea in sickle cell anemia: A 17.5 year follow‐up

A randomized, controlled clinical trial established the efficacy and safety of short-term use of hydroxyurea in adult sickle cell anemia. To examine the risks and benefits of long-term hydroxyurea usage, patients in this trial were followed for 17.5 years during which they could start or stop hydroxyurea. The purpose of this follow-up was to search for adverse outcomes and estimate mortality. For each outcome and for mortality, exact 95% confidence intervals were calculated, or tests were conducted at alpha = 0.05 level (P-value <0.05 for statistical significance). Although the death rate in the overall study cohort was high (43.1%; 4.4 per 100 person-years), mortality was reduced in individuals with long-term exposure to hydroxyurea. Survival curves demonstrated a significant reduction in deaths with long-term exposure. Twenty-four percent of deaths were due to pulmonary complications; 87.1% occurred in patients who never took hydroxyurea or took it for <5 years. Stroke, organ dysfunction, infection, and malignancy were similar in all groups. Our results, while no longer the product of a randomized study because of the ethical concerns of withholding an efficacious treatment, suggest that long-term use of hydroxyurea is safe and might decrease mortality.

SUTIL – Network selection based on utility function and integer linear programming

This work presents SUTIL, a mechanism for network selection in the context of next generation networks (NGN). SUTIL selection mechanism prioritizes networks with higher relevance to the application and lower energy consumption and it enables full and seamless connectivity to mobile user devices and applications. Consequently, SUTIL contributes to realize the vision of ubiquitous computing, in which services, devices, and sensor-enriched environments interact anytime, anywhere to accomplish human designed tasks. The provided solution is based on utility function and integer linear programming and it aims at: (i) maximizing the user satisfaction while meeting application QoS and (ii) minimizing the energy consumption of devices when connecting to a target network. The solution is global since it considers for a given base station all devices that are simultaneously candidate for handoff. Simulation results showed the benefits of SUTIL usage in NGN environments.

Assessing the Costs and Benefits of EV or HEV Usage Using Pattern Recognition and Vehicle Simulation

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The effect of surrounding temperature on liquefied petroleum gas behaviour during exhaustion process

Liquefied petroleum gas (LPG) is considered to be a cleaner fuel because it has less impact on air quality. However, the potential benefit of LPG usage in domestic or residential sectors in Malaysia is hampered by LPG residue in cylinder. A few critical factors, such as LPG composition, exhaustion rate and surrounding temperature, have been identified to significantly contribute to the LPG residue problem. The present study will only report the effect of surrounding temperature on the behaviour of LPG inside the storage cylinder during exhaustion process. The investigation was experimentally carried out at the surrounding temperature of 10°C to 35°C. The results show that LPG exhaustion operation at the surrounding temperature of 25°C or higher exhibited significant temperature and pressure profiles which explained a considerable reduction of the LPG residue. Radial and axial thermal distribution analysis inside the cylinder indicates that sensible heat needed for evaporation process was derived mainly in the axial direction at the regions adjacent to the internal wall. [Received: January 28, 2009; Accepted: December 8, 2009]