• The Journal of Asian Finance, Economics and Business
• /
• v.8 no.4
• /
• pp.735-740
• /
• 2021

The purpose of this study is to assess how accounting conservatism is practiced in the Jordanian pharmaceuticals and medical industry. It assesses the association between accounting conservatism and intellectual capital (IC) in this industry. This study measures IC performance using the market price per share less book value. Accounting conservatism is measured using the book-to-price ratio, and the data was collected from company annual reports and the Amman Stock Exchange (ASE) website. The data was collected for the period of six years (2014 to 2019). The sample was made up of four companies in the industry listed in the ASE. The data was analyzed using the SPSS program though the ordinary least squares regression model to assess how accounting conservatism is associated with IC. The findings indicate a negative association with companies having higher IC performance and reporting lower accounting conservatism. IC is applied more in these companies, although it might be lower than in other companies in other sectors. This study provides empirical evidence on how IC is applied in the industry and how it might be negatively associated with accounting conservatism. Findings indicate the need for more effective policies to promote recognition of intangible assets in the sector.

• The Journal of Asian Finance, Economics and Business
• /
• v.8 no.3
• /
• pp.1181-1191
• /
• 2021

This study aims to investigate the impact of workplace safety on doctors' retention and turnover intention along with job satisfaction as the mediator. A questionnaire-based survey was conducted with 394 medical doctors working in thirty-five hospitals in Pakistan using a structural equation modeling. Results of the study showed that: 1) workplace safety has a significant positive relationship with employee retention; 2) workplace safety has a significant negative relationship with turnover intention; 3) workplace safety has a significant positive relationship with job satisfaction; 4) job satisfaction has a significant positive relationship with employee retention; 5) job satisfaction has a significant positive relationship with turnover intentions; 6) job satisfaction mediates between workplace safety and employee retention; while 7) job satisfaction failed to mediate between workplace safety and turnover intentions. The findings of the study suggest that in a fear-free and safe environment, employees' chance to stay will increases. The study also suggests that dissatisfied employees do not need to leave the organization. There can be other factors that can be explored in future studies. This study also provides a practical implication for the doctors' low retention and high turnover, specifically in the healthcare sector of Pakistan by providing guidelines to the human resource executives to focus on the strategic implementation of workplace safety.

• KSII Transactions on Internet and Information Systems (TIIS)
• /
• v.16 no.7
• /
• pp.2225-2238
• /
• 2022

For advanced healthcare services, a variety of agents should maintain reliable connections with the manager and communicate personal health and medical information. The ISO/IEEE 11073 standards provide convenient interoperability and the optimized exchange protocol (OEP) supports efficient communication for devices. However, the standard does not specify secure communication, and sensitive personal information is easily exposed through attacks. Malicious attacks may lead to the worst results owing to service errors, service suspension, and deliberate delays. All possible attacks on the communication are analyzed in detail, and the damage is specifically identified. In this study, novel secure communication schemes over the 20601 OEP are proposed by introducing an authentication process while maintaining compatibility with existing devices. The agent performs a secure association with the manager for mutual authentication. However, communication with mutual authentication is not completely free from attacks. Message encryption schemes are proposed for concrete security. The authentication process and secure communication schemes between the secure registered agent (SRA) and the secure registered manager (SRM) are implemented and verified. The experimental analysis shows that the complexities of the SRA and SRM are not significantly different from those of the existing agent and manager.

• Journal of Chest Surgery
• /
• v.55 no.4
• /
• pp.325-331
• /
• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

• Journal of Biomedical Engineering Research
• /
• v.45 no.1
• /
• pp.1-9
• /
• 2024

Communication with others plays an important role in human social interaction and information exchange in modern society. However, some individuals have difficulty in communicating due to dysarthria. Therefore, it is necessary to develop effective diagnostic techniques for early treatment of the dysarthria. In the present study, we propose a mobile device-based methodology that enables to automatically classify dysarthria type. The light-weight CNN model was trained by using the open audio dataset of Korean patients with dysarthria. The trained CNN model can successfully classify dysarthria into related subtype disease with 78.8%~96.6% accuracy. In addition, the user-friendly mobile application was also developed based on the trained CNN model. Users can easily record their voices according to the selected inspection type (e.g. word, sentence, paragraph, and semi-free speech) and evaluate the recorded voice data through their mobile device and the developed mobile application. This proposed technique would be helpful for personal management of dysarthria and decision making in clinic.

• Tuberculosis and Respiratory Diseases
• /
• v.67 no.1
• /
• pp.21-26
• /
• 2009

Background: Non-invasive positive pressure ventilation (NPPV) ensures adequate gas exchange during bronchoscopy in spontaneously breathing, hypoxemic patients, thus avoiding endotracheal intubation. However, in some patients, endotracheal intubation is eventually required after bronchoscopy. This study investigated the incidence of intubation and predictors of a need for emergency intubation prior to NPPV bronchoscopy initiation. Methods: On a retrospective basis, we reviewed the medical records of 36 patients (median age, 55 years; interquartile range [IQR], 43~65 years) with acute hypoxemic respiratory failure who required NPPV during bronchoscopy between January 2005 and October 2007. Results: All patients were hypoxemic (median $PaO_2/FiO_2$ ratio 155; IQR 90~190), but tolerated bronchoscopy with NPPV support. SOFA score and SAPS II score immediately before NPPV initiation were 4 (3~7) and 36 (30~42), respectively. Seventeen (47%) patients needed endotracheal intubation at a median time of 22 (2~50) hours after bronchoscopy. Patients who needed intubation after bronchoscopy had a higher in-hospital mortality (11 [65%] vs. 4 [21%], p=0.017). Upon multiple logistic regression analysis, the need for intubation after bronchoscopy was independently associated with a $P_aO_2/FiO_2$ ratio (OR, 0.961; 95% CI, 0.924~0.999; p=0.047) immediately before NPPV initiation for bronchoscopy. Conclusion: The severity of the hypoxemia immediately prior to NPPV initiation for bronchoscopy was associated with the need for intubation after bronchoscopy in patients with hypoxemic respiratory failure.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.5
• /
• pp.645-653
• /
• 1999

Introduction : Although myocardial ischemia tends to occur more frequently than can he documented in ventilated patients, it has not been well studied on the factors related to the occurrence of the ischemia. Methods : To investigate the related factors to ischemia development, a prospective study was done in 95 cases with consecutive 73 patients who had received mechanical ventilation(MV) in MICU. In addition to 24 h holter monitoring, echocardiogram, electrolytes, cardiac enzymes, hemodynamic, and gas exchange measurements were done within 24 h after initiation of MV in 69 cases. The measurements were repeated at weaning period in 26 cases. The ischemia was defined by the ST segment changes; up-sloping depression more than 1.5 mm or down-sloping or horizontal depression more than 1.0 mm from isoelectric baseline for 80 ms following J point. Results : Twelve patients(12.6% in 95 cases) developed ischemia in total. The incidence of ischemia development showed an increased tendency in the initial 24 hr after MV (15.9%) and in patients with left-sided heart failure found by echocardiogram (18.2%) compared with that of the weaning period (3.8%) and patients without heart failure (10.9%) (P=0.12, P=0.09, in each). There were no differences in APACHE III score, baseline ECG findings, electrolytes abnormalities, use of inotropics or bronchodilators, presence of sepsis or shock, mode of ventilation, and survival rate according to the development of ischemia. Maximal heart rates and mean arterial pressure also were not different between patients with ($137.2{\pm}30.9/min$, $82.5{\pm}15.9$ mm Hg) and without ischemia ($l29.5{\pm}29.7/min$, $83.8{\pm}17.6$ mm Hg). Conclusion : Although the incidence of myocardial ischemia was 12.6% in total, there were no clinically predictable factors to the development of ischemia during mechanical ventilation.

• Clinical and Experimental Pediatrics
• /
• v.46 no.8
• /
• pp.777-783
• /
• 2003

Purpose : The aim of this study was to evaluate the effect of inhaled nitric oxide(iNO) on gas exchange, hemodynamics and pulmonary inflammation in newborn piglets with E. coli induced septic lung. Methods : Twenty three instrumented and ventilated piglets were randomized into three groups : CON(n=6), PCON(n=9), and PNO(n=8). In the piglets of the PCON and PNO groups, E. coli septic lung was induced by endotracheal instillation of E. coli. Ten ppm iNO was given continuously in the PNO group after endotracheal instillation of E. coli. All animals were mechanically ventilated for six hour with a peak inspiratory pressure of 30 $cmH_2O$, frequency of 25 breaths/min, $FiO_2$ 1.0 and a positive end-expiratory pressure of 4 $cmH_2O$. All measurements were made at one hour intervals during the experiment. At the end of the experiment, lung tissue was harvested for the analysis of myeloperoxidase activity, indicative of lung inflammation. Results : All piglets with pulmonary instillation of E. coli developed E. coli sepsis. Piglets in the PCON group developed progresseve pulmonry hypertension, hypoxemia and hypercarbia compared to the CON group due to increased pulmonary vascular resistance, intrapulmonary shunt fraction and physiologic dead space fraction. iNO did not reverse pulmonary hypertension in the PNO group. However iNO significantly improved oxygenation, which was attributed to marked improvement of venous admixture and partial attenuation of increase in dead space fraction. Increased myeloperoxidase activity in PCON compared to CON was significantly attenuated in PNO. Conclusion : iNO improves oxygenation and lung inflammation in newborn piglets with E. coli induced septic lung.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.4
• /
• pp.500-512
• /
• 2000

Background : To evaluate the efficacy of two methods of obtaining lung recruitment to reduce ventilator-induced lung injury(VILI). Methods : Fifteen New-Zealand white rabbits were ventilated in the pressure-controlled mode while maintaining constant tidal volume(10 ml/kg) and fixed respiration rate. Lung injury was induced by repeated saline lavage (PaO2<100 mmHg), and the pressure-volume curve was drawn to obtain Pflex. The animals were then randomly assigned to three groups and ventilated for 4 hours. In the control group(n=5), positive end-expiratory pressure(PEEP) less than that of Pflex by 3 mmHg was applied throughout the study. In the recruitment maneuver(RM) group(n=5), RM(CPAP of 22.5 mmHg, for 45 seconds) was performed every 15 minutes in addition to PEEP level less than Pflex by 3 mmHg This phrase is unclear. In the Pflex group, PEEP of Pflex was given without RM. Gas exchange, lung mechanics, and hemodynamics parameters as well as pathology were examined. Results : 1) Both the control and RM groups showed decreasing tendency in PaO2 with time. There was significantly decreased PaO2 at 4 hr compared to Ihr(p<0.05). But in the Pflex group, PaO2 did not decrease with time(p<0.05 vs other groups at 3, 4 hr). PaCO2 did not show significant difference among the three groups. 2) There was no significant difference in static compliance and plateau pressure. Mean blood pressure and heart rate also did not show any significant difference among the three groups. 3) The pathologic exam showed significantly less neutrophil infiltration in the Pflex group than in the control group(p<0.05). There was borderline significant difference in hyaline membrane score among the groups (p= 0.0532). Conclusion : Although recruitment maneuver of the injured lung may be important in decreasing VILI, it alone may not be sufficient to minimize VILI.

• Journal of Chest Surgery
• /
• v.39 no.3 s.260
• /
• pp.201-207
• /
• 2006

Background: Percutaneous cardiopulmonary support (PCPS) provides passive support of gas exchange and perfusion, allowing the use of other methods of care for organ recovery, and saves lives of patients with severe cardiopulmonary failure in a wide variety of clinical settings with a minimal risk of bleeding and need for chest re~ exploration. We summarized a single center's experiences with PCPS in patients with cardiogenic shock or cardiac arrest due to the ischemic heart disease. Material and Method: Among the 20 consecutive patients with cardiogenic shock or cardiac arrest from May 1999 to June 2005, Biopump (Medtronic, Inc, Minneapolis, MN) was used in 7 patients and the self-priming, heparin-coated circuit of EBS (Terumo, Japan) was applied to remaining 13 patients. Most of cannulations were performed percutaneously via femoral arteries and veins. The long venous cannulas of DLP (Medtronic inc. Minneapolis, MN) or the RMI (Edwards's lifescience LLC, Irvine, CA) were used with the arterial cannulae from 17 Fr to 21 Fr and the venous cannula from 21 Fr to 28 Fr. Result: The 20 consecutive patients who were severely compromised and received PCPS for the purpose of resuscitation were comprised of 13 cardiac arrests and 7 cardiogenic shocks in which by-pass surgery was performed in 11 patients and 9 ongoing PCls under the cardiopulmonary support. The mean support time on the PCPS was 38$\pm$42 hours. Of the 20 patients implanted with PCPS, 11 patients ($55\%$) have had the PCPS removed successfully; overall, 8 of these patients ($40\%$) were discharged from the hospital in an average surviving time for 27$\pm$17 days after removing the PCPS and survived well with 31$\pm$30 months of follow-up after the procedure. Conclusion: The use of PCPS appears to provide the hemodynamic restoration, allowing the survival of patients in cardiac arrest or cardiogenic shock who would otherwise not survive, and patients receiving PCPS had a relatively long-term survival.