Quantifying Insurance Agency Channel Dynamics Using Premium Sales Big Data and External Factors.

In insurance business, product sales can be realized over a variety of channels such as independent agencies, or bank branches. In 2017, 55% of premium production was generated over insurance agencies in Turkey making independent agency evaluation prominent in the domain. Unfortunately lacking attention from the scientific community, agency evaluation problem is usually tackled in the industry by utilizing internal business dynamics data. To incorporate the external facts to the agency evaluation process, we propose a computational approach to model behavior traits reflecting insurance agency channel dynamics based on not only premium sales big data but also external facts. We demonstrate how we translate these behavior traits into useful features, namely, utilization, response, and governance, so that each agency can be positioned in a space whose dimensions are determined by these features allowing easy visual detection of segments. Utilization model suggests that each agency has a potential based on its location, determined by several local socioeconomic factors, and it explains the capability of converting potential to profit. To compute utilization scores, we adapt point-of-interest data as a parameter to the segmentation model, a novel approach not only in the insurance business but also in the literature. The response model suggests that a responsive agency must follow overall profit trends of the company. Finally, the governance model explains agency/company cooperation in terms of premium production. All together, we propose a segmentation-based agency evaluation model providing understanding of insurance agency behavior that could be explained and formulated along these three dimensions. Based on the findings from a year-long case study and a proceeding implementation period of our models on an actual analytic system of the insurance company donating the data, we reflect on the performance and usability of our behavioral models that were fit on premium sales big data comprising 127 million transactions. Our results suggest that (1) our approach is quite efficient in extracting features from production logs, (2) behavioral models are quite intuitive resulting in straightforward application steps, and (3) the adoption of behavior models in agency segmentation and evaluation processes is an improvement over commonplace approaches in which premium production is used as the sole metric.

Healing Status of Pressure Injuries Among Critically Ill Patients in a Turkish Hospital: A Descriptive, Retrospective Study.

Evaluating the healing status of pressure injuries is important to planning medical and nursing care. PURPOSE: A descriptive, retrospective study was conducted to determine the healing status of pressure injuries among critically ill immobile patients. METHODS: Data were obtained via medical record review of all patients admitted to a Turkish university hospital's anesthesiology intensive care unit (ICU) between January 2008 and December 2015. Demographic (age, gender), medical (comorbidities, diagnosis, length of ICU stay), and pressure injury characteristics (number, location, stage, healing status, length, width, exudate amount, tissue type) were evaluated along with Pressure Ulcer Scale for Healing (PUSH) Tool scores. Data from all patients >18 years of age with an ICU stay >24 hours who had a pressure injury and whose records were complete were included in the study. Data were expressed as number, percentage, and mean and median values. Wilcoxon test, Spearman's correlation analysis, and chi-square test were performed as appropriate. Pressure injuries were considered healed when the PUSH score equaled zero. RESULTS: The study sample comprised 359 patients (60.97 ± 19.31 [range 19-95] years, 217 men, median length of stay 25 [range 1-363] days) with 672 pressure injuries. Most pressure injuries were located on the coccyx (278 [41.4%]), and 153 (22.8%) healed during ICU stay. Older age (r = 0.167; P = .002) and length of ICU stay (r = 0.238; P = .0001) were significantly correlated with having multiple pressure injuries. There was a statistically significant relationship between pressure injury location and stage and healing status (χ2 = 28.993, P = .0001; and χ2 = 60.200, P = .001, respectively). The lowest percentage of injuries healed were on the coccyx and were stage 4 and unstageable. Overall, the mean first PUSH score was significantly higher than the last assessment score (8.99 ± 3.82 to 7.28 ± 5.22, respectively; z = -10.807; P = .0001). CONCLUSION: Many immobile ICU patients had multiple pressure injuries, especially patients who were older and who had a longer length of stay. Healing scores for pressure injuries were better at discharge or transfer and 22% of injuries were healed. Prospective studies comparing all factors that may contribute to pressure injury healing are warranted. .

Effect of patient position on endotracheal cuff pressure in mechanically ventilated critically ill patients.

BACKGROUND: Endotracheal tube cuff pressure must be maintained within 20-30mH2O to prevent complications. There is limited literature reporting the impact of nursing care on endotracheal cuff pressure. However, few studies have reported the effect of nursing care on endotracheal cuff pressure. OBJECTIVES: This study was performed to investigate the effects of body position on endotracheal cuff pressure. METHODS: Twenty-five patients receiving mechanical ventilatory therapy were placed in a baseline position (semirecumbent position with the head of the bed elevated at 30° and head in a neutral position) with endotracheal tube cuff was adjusted to 25cmH2O. The patients were moved into 16 different positions: anteflexion of the head; hyperextension of the head; left lateral flexion of the head; right lateral flexion of the head; rotation of the head to the left; rotation of the head to the right; semirecumbent position with 45° elevation of the head of the bed; recumbent position with 10° elevation of the head of the bed; supine position; trendelenburg position 10°; left lateral position at 30°, 45°, and 90°; and right lateral position at 30°, 45°, and 90°. The endotracheal tube cuff pressure was measured and recorded after each position change. RESULTS: Among the 400 endotracheal tube cuff pressure measurements (25 patients×16 positions) 10 (2.5%) were lower than 20cmH2O; 201 (50.3%) were between 20-30cmH2O and 189 (47.3%) were higher than 30cmH2O. Mean endotracheal tube cuff pressure increased from 25 to 32.59±4.08cmH2O after changing the patients' position. Friedman test indicated a statistically significant deviation in the ETCP across the 16 positions (X2: 122.019, p: 0.0001). CONCLUSIONS: Body positioning during daily nursing care effected the endotracheal tube cuff pressure, suggesting that endotracheal tube cuff pressure should be measured after changing a patient's position and adjusted within the recommended range.

Designing Progressive and Interactive Analytics Processes for High-Dimensional Data Analysis.

In interactive data analysis processes, the dialogue between the human and the computer is the enabling mechanism that can lead to actionable observations about the phenomena being investigated. It is of paramount importance that this dialogue is not interrupted by slow computational mechanisms that do not consider any known temporal human-computer interaction characteristics that prioritize the perceptual and cognitive capabilities of the users. In cases where the analysis involves an integrated computational method, for instance to reduce the dimensionality of the data or to perform clustering, such non-optimal processes are often likely. To remedy this, progressive computations, where results are iteratively improved, are getting increasing interest in visual analytics. In this paper, we present techniques and design considerations to incorporate progressive methods within interactive analysis processes that involve high-dimensional data. We define methodologies to facilitate processes that adhere to the perceptual characteristics of users and describe how online algorithms can be incorporated within these. A set of design recommendations and according methods to support analysts in accomplishing high-dimensional data analysis tasks are then presented. Our arguments and decisions here are informed by observations gathered over a series of analysis sessions with analysts from finance. We document observations and recommendations from this study and present evidence on how our approach contribute to the efficiency and productivity of interactive visual analysis sessions involving high-dimensional data.

Purification, recovery, and characterization of chick pea (Cicer arietinum) ß-galactosidase in single step by three phase partitioning as a rapid and easy technique.

In this study chick pea ß-galactosidase was first time purified and recovered in single step by three phase partitioning (TPP). Optimal purification parameters for TPP were 60% ammonium sulfate saturation (w/v) with 1:0.5 (v/v) ratio of crude extract:t-butanol at pH 6.8, which gave 10.1 purification fold with 133% recovery of ß-galactosidase. SDS-PAGE analysis showed that protein has two subunits with molecular masses of 48 and 38kDa, respectively. Characterization of enzyme showed that optimal pH of purified enzyme was 2.8 and optimal temperature was 50°C. Enzyme was further characterized by the Arrhenius activation energy and Michael-Menten kinetic constants. Activation energy (Ea) was calculated by using Arrhenius equation and determined to be 15.52kcalmol(-1). Km value of purified enzyme was estimated for the o-nitrophenyl ß-d galactopyranoside (ONPG) substrate as 1.09mM, while its maximum velocity, Vm was 0.90U/mL/min at 37°C. TPP improved substrate affinity of enzyme by the increased flexibility during the partitioning. TPP is simple, easy and economic technique for purification and recovery of ß-galactosidase from chick pea, and has a big potential use for industrial applications.

Three-phase partitioning as a rapid and easy method for the purification and recovery of catalase from sweet potato tubers (Solanum tuberosum).

Three-phase partitioning (TPP) was used to purify and recover catalase from potato crude extract. The method consists of ammonium sulfate saturation, t-butanol addition, and adjustment of pH, respectively. The best catalase recovery (262 %) and 14.1-fold purification were seen in the interfacial phase in the presence of 40 % (w/v) ammonium sulfate saturation with 1.0:1.0 crude extract/t-butanol ratio (v/v) at pH 7 in a single step. The sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis of the enzyme showed comparatively purification and protein molecular weight was nearly found to be 56 kDa. This study shows that TPP is a simple, economical, and quick method for the recovering of catalase and can be used for the purification process.

Treatment of nonsyndromic dentigerous cysts in primary dentition.

OBJECTIVE: Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They usually occur singly and are located in the mandible. Nonsyndromic bilateral dentigerous cysts (NSBDC) are rarely seen during childhood. The aim of this study was to determine the long-term effects of the marsupialization technique in growing children with NSBDC. STUDY DESIGN: Seven patients with NSBDC (4 female, 3 male) ranging in age from 7 to 9 years (mean 8.35 years) were involved in the study. All the individuals were treated by marsupialization. Space-maintaining appliances were applied during permanent teeth eruption. Intraoral photographs, and panoramic and periapical films were taken before surgery and during healing. RESULTS: The NSBDC were successfully treated by the marsupialization technique and rapid healing period was observed in the growing patients, without any loss of permanent teeth. No recurrence was seen in the long-term follow-up period (3-10 years). CONCLUSION: Our clinical and radiological results revealed that using the marsupialization technique in children with NSBDC provided safe healing of permanent teeth around the dentigerous cysts in a short period. However, treatment planning and regular clinical follow-ups are necessary to ensure clinical success.

Immediate provisional restoration fabrication for immediate implant loading using a modified technique: a clinical report.

This article describes the immediate fabrication and placement of a provisional restoration, using a modified method for impressionmaking. An impression was made before surgery and provisional acrylic temporary restorations with composite resin frameworks were prepared on the solid-screw implant abutments. This article demonstrates this simple method and discusses the benefits of immediate provisionalization after surgery.