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( Sarath Menon ),( Girish Ramteke ),( Dharmendra Jhavar ),( Manoj Gupta ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Endothelial dysfunction is regarded as an early marker for atherosclerosis & a precursor for future cardiovascular events. Objectives: Study was done to find out endothelial dysfunction (ED) in euglycemic & hyperglycemics. finding any endothelial dysfunction in high risk euglycemic & pre-diabetic individuals and compared degree of ED with different types of hyperglycemia, glycemic parameters & common cardio-vascular (CV) risk factors. MATERIAL & Methods: A cross-sectional, prospective study was done in subjects divided into two groups. First group included hyperglycemic individuals (80) Pre-diabetes( 20), Type1DM(20), Type2 DM (34), clinically labeled MODY(06) and second group included 40 euglycemic individuals. Body mass index, fasting lipid profile, FBS, PPBS, RBS, HbA1c were obtained. Endothelial dependent flow mediated dilatation was assessed with 7.5MHz high resolution ultrasound of brachial artery. A p-value of <0.05 was considered to be statistically significant. Results: Flow mediated dilatation was impaired with increase in age, BMI, lipid profile (p=0.04,0.02,0.02 respectively). FMD was seen inversely related to all glycemic parameters like FBS(r=.680,p=<0.001),PPBS(r=-.660,p=<0.001),RBS(r=.680,p=<0.001), HbA1c(r=-.820,p=<0.001).Flow mediated dilatation was impaired in Pre-diabetes, Type 1 DM,Type2 DM, Clinical MODY, but did not show significant difference between each other (9.03+0.73% vs 8.21+1.18% vs 6.95+2.14% vs 9.4+0.45%,p=0.20) but had significant difference when compared to euglycemics (14.01+3.06%,p=<0.001).FMD was impaired even in high-risk euglycemics(p=0.02) Conclusion: Results showed impaired endothelial function in hyperglycemics and endothelial dysfunction was seen even in Pre-diabetes and in high risk euglycemic individuals, thus showing endothelial damage in these early stages. Endothelial function declined with increase in the severity of glycemic parameters and common CV risk factors. Our study suggested FMD should be considered as a surrogate marker for future cardiovascular events.
The diversity of Fracture Risk Assessment Tool (FRAX)-based intervention thresholds in Asia
Sarath Lekamwasam 대한골다공증학회 2019 Osteoporosis and Sarcopenia Vol.5 No.4
Fracture Risk Assessment Tool (FRAX), introduced in 2008, is the most frequently used fracture risk calculator. Many Asian countries have developed own FRAX models to suit their country needs. Only a few Asian countries, however, have developed country-specific intervention thresholds to demarcate high-risk patients. A wide variation is seen in these intervention thresholds partly due to the different approaches used in developing the cutoff values. This paper discusses the diversity of the intervention thresholds in Asian countries and possible reasons. It also discusses the future directions for the countries in the Asian region.
Sarath C. Renjith,Kijung Park,Gül E. Okudan Kremer 한국정밀공학회 2020 International Journal of Precision Engineering and Vol.21 No.2
Additive manufacturing has emerged as an integral part of modern manufacturing because of its unique capabilities in various application domains. As efforts to effectively apply additive manufacturing, design for additive manufacturing (DfAM) has risen to provide a set of guidelines based on a practical design framework or a methodology during the product design process of additive manufacturing. However, most existing DfAM methods do not effectively consider the capabilities of extant additive manufacturing technologies in the early design stages, and therefore it is hard to map functional requirements from customer needs onto a product design for additive manufacturing. Moreover, available DfAM methods tend to rely on the direct application of a specific decision method rather than a systematic approach with appropriate deployment and transformation of available design decision methods considering the additive manufacturing environment. Consequently, existing DfAM methods lack suitability for use by additive manufacturing novices. To tackle these issues, this study develops a design framework for additive manufacturing through the integration of axiomatic design and theory of inventive problem-solving (TRIZ). This integrated approach is effective because the axiomatic design approach can be used to systematically define and analyze a design problem, while the TRIZ problem-solving approach combined with an additive manufacturing database can be used as an idea generation tool to generate innovative solutions for the design problem. A case study for a housing cover redesign is presented to apply and validate the proposed design framework.
Evaluating Integration Choices: The Case of Bolivia
( Sarath Rajapatirana ) 세종대학교 경제통합연구소 (구 세종대학교 국제경제연구소) 1997 Journal of Economic Integration Vol.12 No.3
Regional integration initiatives have surged in Latin America while many countries have undertaken unilateral trade liberalization and external market access prospects have improved with the successful conclusion of the Uruguay Round. This paper examines and ranks the integration choices faced by one such country: Bolivia. To the extent that different regional trade agreements follow World Trade Organization rules, these agreements could increase market access and allow the countries to realize gains beyond those provided by unilateral liberalization. In this sense, a regional trade arrangement is not inconsistent with multilateral free trade based on the most-favored-nation (MFN) principle. In the final analysis with Bolivia, regional integration is not merely a matter of economics but relates to domestic and regional politics. To this end, MFN trade with concessions from both MERCOSUR and ANDEAN Group ranks best among the choices facing Bolivia. (JEL Classification: F14, F15)
Sarath Lekamwasam,Madushani Karunanayaka,Vidumini Kaluarachchi,Manju Chandran,Hasanga Rathnayake,Sewwandi Subasinghe 대한골다공증학회 2020 Osteoporosis and Sarcopenia Vol.6 No.3
Objectives: We evaluated the ability of fracture risk assessment tool (FRAX) Sri Lanka to discriminate between women with a recent fracture and without a fracture, when trabecular bone score (TBS) is added to the calculation. Methods: We studied 394 women without previous fractures and 87 women who underwent dual energy X-ray absorptiometry within 3 months after the first fragility fracture. Fracture probabilities (FP) were estimated with and without TBS using Sri Lankan FRAX model and their ability to discriminate those with and without fracture was tested. Results: Women without fractures had higher bone mineral densities (BMDs) and lower FPs, compared to those with a recent fracture. Area under curves of receiver operating characteristic for FPs unadjusted were not different from those adjusted for TBS. The odd ratios of FPs unadjusted were not different from those of adjusted. The FPs estimated with TBS were higher, hence the intervention thresholds (ITs) were higher compared to FPs estimated without TBS. Thirty-two percent of women without previous fracture were above the ITs and the inclusion of TBS increased this to 36%. The integrated discriminatory index analysis showed a 8% increase in the discriminatory slope. Conclusions: The inclusion of TBS to Sri Lankan FRAX did not show an added advantage in discriminating between postmenopausal women with a recent fracture and without a fracture. TBS inclusion in fracture risk calculation among those without previous fractures, however, showed a marginal increase in the number of women above ITs.
Modelling Regional Demand for Domestic Leisure Tourism in Australia
Sarath Divisekera,Van Nguyen 한국호텔외식관광경영학회 2015 한국호텔외식경영학회 학술발표논문집 Vol.- No.-
This paper analyses the economic determinants of domestic demand for leisure tourism by Australians distinguished by the state of origin. A conceptual framework for the study is drawn from the neoclassical economic theory of consumer behaviour and a system of demand equations that represent key tourists’ consumption bundles—viz: food, accommodation, transportation, shopping, and entertainment—are developed. Nine demand systems were estimated, eight based on regional data representing the eight regions, and one aggregate (national) model based on a pooled sample. Estimated models are statistically significant and the derived elasticities are theoretically consistent and empirically plausible. The estimated own price elasticities across the eight states and territories reveal price inelastic demand for the five commodity aggregates. In contrast, income elasticities reveal relatively elastic demand for the commodity aggregates. Further, there are significant variations in the degree of income elasticity across the states and territories implying that tourists from different origins may have varying preferences for the tourism goods and services. The cross-price elasticities derived from all models reveal gross complementarity of demands. This implies that tourists’ overall utility depends on their joint consumption of a bundle of goods and services. The observed relatively price-inelastic demands, coupled with the apparent complementarity of demands, may reflect the possibility that a latent price sensitivity is associated with tourist demand.
Optimal Taxes and rent extraction form foreign tourist
Sarath Divisekera 한국호텔외식관광경영학회 2015 한국호텔외식경영학회 학술발표논문집 Vol.- No.-
This paper examines the issue of taxing foreign tourists. In the spirit of conventional optimum tariff theory, a model of optimal pricing is developed by incorporating interdependencies of demand for international tourism with its counterpart international travel. The analysis demonstrates that the issue of rent extraction from foreign tourists—as a means of maximising national gains—is a complex one. The complication arises from the inherent complementarity of tourism demand with its counterpart, international travel. Consequently, one has to consider not only the demand for and the existing market structure of the sector targeted for taxation, but also that of the complementary sector. If the prevailing market structure of the two sectors is competitive, one of the sectors may be targeted for taxation and the rents associated with unique tourism attributes may be extracted efficiently. Given the diversity of demand from tourists of different origins, and the inability to discriminate between locals and foreigners, the most appropriate sector to be targeted for taxation appears to be the international aviation sector. In conclusion, this study demonstrates the need for careful consideration of existing market structures and cross-demand relationships between travel and tourism. If these are ignored and the tourism industry is subject to increasing taxes, the very objective of maximising gains from foreign tourism could itself be detrimental to this most successful, growing industry.