Application of Conjoint Analysis and 5Ps Marketing Mix in Identifying Customer Preference of Alcohol Consumption among Youths in the Philippines.

Alcoholic beverages have long been one of the most popular commodities. They have been mass-produced worldwide because of their popularity and demand. On a survey by Statista in 2021, alcohol consumption is projected to increase in the Philippines. Thus, the popularity of numerous alcoholic beverages piqued the curiosity of consumers and researchers alike. This study used conjoint analysis that aims to have a better understanding of consumer preferences for alcohol consumption among youths. Additionally, the study considered the following attributes: (1) type of alcoholic beverage, (2) oral sensation, (3) flavor, (4) origin, (5) color, and (6) price. Results revealed that the product's price is the most crucial attribute influencing consumer preferences by 26.311%, followed by the type of alcoholic beverage with an importance score of 26.237%. The least considered attribute is the product's color, having an importance score of 7.790%. These were supported by two statistical tests, the Pearson's Correlation Test and Kendall's Tau Test, which both obtained a value higher than 0.8. Managerial implications were presented in the study to help provide strategies and development for alcoholic beverage distribution in the Philippines based on the findings of this study, which relate to young consumers.

Impact of patient handover structure on neonatal perioperative safety.

OBJECTIVE: To compare the incidence, severity, preventability, and contributing factors of non-routine events-deviations from optimal care based on the clinical situation-associated with team-based, nurse-to-nurse, and mixed handovers in a large cohort of surgical neonates. STUDY DESIGN: A prospective observational study and one-time cross-sectional provider survey were conducted at one urban academic children's hospital. 130 non-cardiac surgical cases in 109 neonates who received pre- and post-operative NICU care. RESULTS: The incidence of clinician-reported NREs was high (101/130 cases, 78%) but did not differ significantly across acuity-tailored neonatal handover practices. National Surgical Quality Improvement-Pediatric occurrences of major morbidity were significantly higher (p < 0.001) in direct team handovers than indirect nursing or mixed handovers. CONCLUSIONS: NREs occur at a high rate and are of variable severity in neonatal perioperative care. NRE rates and contributory factors were homogenous across handover types. Surveyed clinicians recommend structured handovers for all patients at every transfer point regardless of acuity.

Evaluating the effects of increasing surgical volume on emergency department patient access.

AIM: To determine how increases in surgical patient volume will affect emergency department (ED) access to inpatient cardiac services. To compare how strategies to increase cardiology inpatient throughput can either accommodate increases in surgical volume or improve ED patient access. METHODS: A stochastic discrete event simulation was created to model patient flow through a cardiology inpatient system within a US, urban, academic hospital. The simulation used survival analysis to examine the relationship between anticipated increases in surgical volume and ED patient boarding time (ie, time interval from cardiology admission request to inpatient bed placement). RESULTS: ED patients boarded for a telemetry and cardiovascular intensive care unit (CVICU) bed had a mean boarding time of 5.3 (median 3.1, interquartile range 1.5-6.9) h and 2.7 (median 1.7, interquartile range 0.8-3.0) h, respectively. Each 10% incremental increase in surgical volume resulted in a 37 and 33 min increase in mean boarding time to the telemetry unit and CVICU, respectively. Strategies to increase cardiology inpatient throughput by increasing capacity and decreasing length of stay for specific inpatients was compared. Increasing cardiology capacity by one telemetry and CVICU bed or decreasing length of stay by 1 h resulted in a 7-9 min decrease in average boarding time or an 11-19% increase in surgical patient volume accommodation. CONCLUSIONS: Simulating competition dynamics for hospital admissions provides prospective planning (ie, decision making) information and demonstrates how interventions to increase inpatient throughput will have a much greater effect on higher priority surgical admissions compared with ED admissions.

Organisational culture: variation across hospitals and connection to patient safety climate.

CONTEXT: Bureaucratic organisational culture is less favourable to quality improvement, whereas organisations with group (teamwork) culture are better aligned for quality improvement. OBJECTIVE: To determine if an organisational group culture shows better alignment with patient safety climate. DESIGN: Cross-sectional administration of questionnaires. Setting 40 Hospital Corporation of America hospitals. PARTICIPANTS: 1406 nurses, ancillary staff, allied staff and physicians. MAIN OUTCOME MEASURES: Competing Values Measure of Organisational Culture, Safety Attitudes Questionnaire (SAQ), Safety Climate Survey (SCSc) and Information and Analysis (IA). RESULTS: The Cronbach alpha was 0.81 for the group culture scale and 0.72 for the hierarchical culture scale. Group culture was positively correlated with SAQ and its subscales (from correlation coefficient r = 0.44 to 0.55, except situational recognition), ScSc (r = 0.47) and IA (r = 0.33). Hierarchical culture was negatively correlated with the SAQ scales, SCSc and IA. Among the 40 hospitals, 37.5% had a hierarchical dominant culture, 37.5% a dominant group culture and 25% a balanced culture. Group culture hospitals had significantly higher safety climate scores than hierarchical culture hospitals. The magnitude of these relationships was not affected after adjusting for provider job type and hospital characteristics. CONCLUSIONS: Hospitals vary in organisational culture, and the type of culture relates to the safety climate within the hospital. In combination with prior studies, these results suggest that a healthcare organisation's culture is a critical factor in the development of its patient safety climate and in the successful implementation of quality improvement initiatives.

Extracellular Wound Matrices: Novel Stabilization and Sterilization Method for Collagen-based Biologic Wound Dressings.

Biologic extracellular matrix (ECM)-based wound dressings offer promise in the treatment of chronic wounds. A variety of animal and human tissue derived dressings are currently available. These products are processed and/or sterilized by a range of chemical and mechanical processes, which will impact the final quality of the matrices--ultimately affecting the overall wound healing process. A novel method is described to prepare a sterile and biocompatible biological wound dressing. The advantages and the clinical implications of this wound dressing preparation are also discussed.

Relationship between patient complaints and surgical complications.

BACKGROUND: Patient complaints are associated with increased malpractice risk but it is unclear if complaints might be associated with medical complications. The purpose of this study was to determine whether an association exists between patient complaints and surgical complications. METHODS: A retrospective analysis of 16,713 surgical admissions was conducted over a 54 month period at a single academic medical center. Surgical complications were identified using administrative data. The primary outcome measure was unsolicited patient complaints. RESULTS: During the study period 0.9% of surgical admissions were associated with a patient complaint. 19% of admissions associated with a patient complaint included a postoperative complication compared with 12.5% of admissions without a patient complaint (p = 0.01). After adjusting for surgical specialty, co-morbid illnesses and length of stay, admissions with complications had an odds ratio of 1.74 (95% confidence interval 1.01 to 2.98) of being associated with a complaint compared with admissions without complications. CONCLUSIONS: Admissions with surgical complications are more likely to be associated with a complaint than surgical admissions without complications. Further research is necessary to determine if patient complaints might serve as markers for poor clinical outcomes.

A new structural class of selective and non-covalent inhibitors of the chymotrypsin-like activity of the 20S proteasome.

We describe the identification and in vitro characterization of a series of 2-aminobenzylstatine derivatives that inhibit non-covalently the chymotrypsin-like activity of the 20S proteasome. Our initial SAR data demonstrate that the 2-aminobenzylstatine core structure can effectively serve as the basis for designing potent, selective and non-covalent inhibitors of the chymotrypsin-like activity of the 20S proteasome.

Acoustical properties of speech as indicators of depression and suicidal risk.

Acoustic properties of speech have previously been identified as possible cues to depression, and there is evidence that certain vocal parameters may be used further to objectively discriminate between depressed and suicidal speech. Studies were performed to analyze and compare the speech acoustics of separate male and female samples comprised of normal individuals and individuals carrying diagnoses of depression and high-risk, near-term suicidality. The female sample consisted of ten control subjects, 17 dysthymic patients, and 21 major depressed patients. The male sample contained 24 control subjects, 21 major depressed patients, and 22 high-risk suicidal patients. Acoustic analyses of voice fundamental frequency (Fo), amplitude modulation (AM), formants, and power distribution were performed on speech samples extracted from audio recordings collected from the sample members. Multivariate feature and discriminant analyses were performed on feature vectors representing the members of the control and disordered classes. Features derived from the formant and power spectral density measurements were found to be the best discriminators of class membership in both the male and female studies. AM features emerged as strong class discriminators of the male classes. Features describing Fo were generally ineffective discriminators in both studies. The results support theories that identify psychomotor disturbances as central elements in depression and suicidality.

P27KiP1 overexpression inhibits the growth and doxorubicin sensitivity of HT29 human colon cancer cells in vivo.

We have previously shown that p27KiP1 plays a role in the tumor cell resistance of HT29 confluent monolayers to cytotoxic drugs in vitro. To determine whether p27KiP1 was a resistance factor to cytotoxic drugs in vivo we tested the effect of doxorubicin on p27KiP1-overexpressing HT29 tumors in nude mice. In this study we show that ectopic overexpression of p27KiP1 in HT29 human colon cancer cells decreases their tumorigenicity in vivo in nude mice. This decreased tumor growth was associated with increased p27KiP1 protein expression, studied by Western blotting in tumor extracts. Interestingly, the overexpressing-p27KiP1 tumors were significantly more resistant to intraveneous doxorubicin treatment than the control tumors. These results indicate that p27KiP1, which delays tumor growth could also increase tumor resistance to cytotoxic drugs in vivo.

Evaluación del índice de pulsatilidad relacionado con la biometría fetal en fetos pequeños para la edad gestacional / Evaluation of doppler index related to the fetal biometry is small fetus according to the gestational age

Objetivos: 1)Establecer límites de referencias para los índices Doppler obtenidos de los vasos fetales respecto a los diferentes parámetros biométricos. 2) Evaluar los modelos más adecuados para testear la eficacia de los nuevos nomogramas desarrollados con respecto de aquellos basados en la edad gestacional en una población de fetos pequeños para la edad gestacional. Material y Métodos: se consideraron 153 fetos adecuados para la edad gestacional y 90 fetos pequeños para la edad gestacional examinados durante el último año entre las 20 y 40 semanas de edad gestacional. Resultados: los fetos normales mostraron una relación lineal negativa entre el IP de todos los vasos investigados y todo los parámetros biométricos considerados. Si bien el DBP se relacionó mejor con el IP de arteria umbilical y de arteria renal, y el diámetro transverso cerebeloso con el IP de ACM, no se encontraron diferencias significativas entre las variables testeadas. Conclusión: en los fetos pequeños para la edad gestacional los nomogamas de DBP, CA y LF subestimaron significativamente los valores de IP en todos los vasos estudiados cuando se compararon con los nomogramas basados en edad gestacional y diámetro cerebeloso transverso. Estos nuevos nomogramas basados en diámetro tranverso cerebeloso pueden resultar útiles en la evaluación de los índices Doppler en fetos con edad gestacional incierta

Voluntary movement strategies of individuals with unilateral peripheral vestibular hypofunction.

This study compared voluntary movement strategies of patients with unilateral peripheral vestibular hypofunction with those of age-matched healthy control subjects. All subjects performed three voluntary movement tasks with their dominant upper extremity: a forward flexion arm movement through 90 degrees, a reach to an overhead target, and a reach to a side target. Subjects performed the movement tasks sitting and standing (Body Position), and under precued and choice reaction time (RT) conditions (Task Certainty). Measures of motor planning and movement execution included RT and movement time (MT), respectively. Statistical analysis included separate Group x Task Certainty x Body Position ANOVA calculations for each task. Across tasks, results suggested no between group differences for RT. A Task Certainty main effect for the side and overhead tasks indicated that the choice RT situation resulted in longer RTs as compared to the precued RT condition. Movement time differed between the two groups. Across all three voluntary movement tasks, vestibular impaired subjects moved more slowly than control subjects. Providing vestibular subjects with a precue did not bring MT performance to the level of controls. Body position influenced MT for the side task only. Across both groups of subjects, MT for the side task was longer when performed in the standing position. The results of this study suggest that individuals with unilateral peripheral vestibular hypofunction initiate voluntary movement responses with similar timing as control subjects, but require more time to complete the movement. Vestibular rehabilitation should include goal-directed movement and should address issues of movement speed.

Structural and conformational requirements for high-affinity binding to the SH2 domain of Grb2(1).

Following earlier work on cystine-bridged peptides, cyclic phosphopeptides containing nonreducible mimics of cystine were synthesized that show high affinity and specificity toward the Src homology (SH2) domain of the growth factor receptor-binding protein (Grb2). Replacement of the cystine in the cyclic heptapeptide cyclo(CYVNVPC) by D-alpha-acetylthialysine or D-alpha-lysine gave cyclo(YVNVP(D-alpha-acetyl-thiaK)) (22) and cyclo(YVNVP(D-alpha-acetyl-K)) (30), which showed improved binding 10-fold relative to that of the control peptide KPFYVNVEF (1). NMR spectroscopy and molecular modeling experiments indicate that a beta-turn conformation centered around YVNV is essential for high-affinity binding. X-ray structure analyses show that the linear peptide 1 and the cyclic compound 21 adopt a similar binding mode with a beta-turn conformation. Our data confirm the unique structural requirements of the ligand binding site of the SH2 domain of Grb2. Moreover, the potency of our cyclic lactams can be explained by the stabilization of the beta-turn conformation by three intramolecular hydrogen bonds (one mediated by an H2O molecule). These stable and easily accessible cyclic peptides can serve as templates for the evaluation of phosphotyrosine surrogates and further chemical elaboration.

Cholesterol 7alpha-hydroxylase influences the expression of hepatic apoA-I in two inbred mouse strains displaying different susceptibilities to atherosclerosis and in hepatoma cells.

C57BL/6 mice are susceptible to diet-induced atherosclerosis, whereas BALB/c mice are resistant. The susceptibility of C57BL/6 mice has been linked to decreased plasma HDL cholesterol in response to a diet containing fat, cholesterol, and cholic acid. Feeding C57BL/6 mice a diet consisting of fat and cholesterol, but no cholic acid, increased plasma high density lipoprotein (HDL) cholesterol. The increase in HDL was associated with increases in both plasma apolipoprotein (apo)A-I and hepatic apoA-I mRNA. Supplementation of the cholesterol-rich diet with cholic acid inhibited the stimulatory effect of cholesterol on hepatic apoA-I mRNA expression, resulting in similar hepatic apoA-I mRNA levels compared to chow-fed mice. Atherosclerosis-resistant BALB/c mice were also resistant to diet-induced changes in plasma HDL, apoA-I, and hepatic apoA-I mRNA levels. Previous studies showed that the diets changed both the activity and mRNA encoding the liver specific enzyme 7alpha-hydroxylase (1993.J. Lipid Res. 34: 923-931). In both strains of mice, hepatic expression of apoA-I and 7alpha-hydroxylase mRNA varied in parallel. Whereas susceptible C57BL/6 mice also showed a significant correlation between HDL cholesterol and expression of 7alpha-hydroxylase, no such correlation was observed in BALB/c mice, suggesting that genetic differences in HDL metabolism, not hepatic apoA-I synthesis, are responsible for the strain specific differences in plasma HDL levels. The finding that lecithin: cholesterol acyltransferase (LCAT) activity was significantly decreased in C57BL/6 mice, but not in BALB/ c mice fed the atherogenic diet, further supports this conclusion. Additional studies show that McArdle hepatoma cells stably expressing plasmid-derived rat 7alpha-hydroxylase recapitulated the parallel linear relationship between 7alpha-hydroxylase and apoA-I mRNA expression observed in both strains of mice. These data link hepatic apoA-I mRNA expression to hepatic cholesterol/bile acid metabolism.

Functional reach and single leg stance in patients with peripheral vestibular disorders.

The purpose of this study was to compare functional reach distance and right single leg stance time in patients who had peripheral vestibular disease. Twenty-eight patients (15 female, 13 male) between the ages of 35 and 84 were asked to perform 3 trials each of functional reach (FR) and right single leg stance (SLS). SLS times were measured by a Kistler static force platform on line with a Caspar personal computer. FR distance was measured by using a free-standing 147-cm rule. In addition, each subject filled out the Dizziness Handicap Inventory (DHI). Trials were randomized to prevent fatigue or practice effects. A Pearson product-moment correlation was performed between FR and SLS (r = 0.59, P = 0.001). Post hoc analyses of the first, the best, and the average scores highlighted the importance of using means for comparison in a population as variable as the vestibularly impaired. Post hoc analyses showed no correlation between the DHI score and either functional reach distance or single leg stance time. However, when the subjects were divided into groups based on DHI score (group 1 with DHI < or = 49/100, group 2 with DHI > or = 50/100) and a pooled two-sample t-test was performed, a significant difference (P = 0.05) was found in functional reach distance; the subjects who reported less perception of handicap reached farther than those who reported more perception of handicap. No difference was found between the two DHI groups in single leg stance time. Post hoc correlations of functional reach and single leg stance time. Post hoc correlations of functional reach and single leg stance within the two DHI groups showed a higher correlation in group 1 (DHI < or = 49/100), with r equals 0.65 (P < or = 0.01), than in group 2 (DHI > or = 50/100), with r equals 0.38 (P = 0.20). The study found a highly significant, moderate correlation between functional reach distance and single leg stance times in patients with peripheral vestibular disease. These results support the use of FR as an additional assessment tool with patients who have peripheral vestibular disease.

Functional outcome of vestibular rehabilitation in patients with abnormal sensory-organization testing.

A goal of vestibular rehabilitation is to improve the functional status of patients with balance disorders. Despite the focus of vestibular rehabilitation on function, few objective data describe the outcome of vestibular rehabilitation in terms of balance function. In this prospective observational study, we tested a well-defined patient cohort (n = 67) with abnormal pretreatment sensory-organization testing who were undergoing vestibular rehabilitation. Patient outcomes were determined by using objective and subjective measures of function before and after rehabilitation. Overall, 60% of patients showed objective improvement of balance function; 25% of patients improved to normal. Analysis of success and failure of vestibular rehabilitation is important as an aid to appropriate patient counseling and efficient use of rehabilitation resources.