Submitted by Rafael Santana (rafael.silvasantana@ufpe.br) on 2017-07-14T17:36:21Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Tese - Edvan Aguiar.pdf: 4466098 bytes, checksum: 5dffe51268add65a59e22074a8f495e0 (MD5) / Made available in DSpace on 2017-07-14T17:36:21Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Tese - Edvan Aguiar.pdf: 4466098 bytes, checksum: 5dffe51268add65a59e22074a8f495e0 (MD5) Previous issue date: 2016-04-29 / CAPES, CNPQ, FACEPE / Esta tese aborda o papel da presença dos outros clientes sobre o comportamento do consumidor em ambiente varejista. Argumenta-se que os outros tendem a influenciar emoções individuais, determinando, em grande medida, a satisfação, as intenções de compra e o retorno à loja. À luz da Teoria do Impacto Social (LATANÉ, 1981) e do Paradigma Similaridade-Atração (BYRNE, 1971), este estudo propõe que a identificação do consumidor com os outros clientes que compartilham o mesmo ambiente de loja minimiza a influência do crowding nas respostas individuais (emoções, atitudes e comportamentos). Portanto, esta pesquisa objetivou investigar de modo a similaridade percebida modera a relação entre percepção de crowding e respostas do consumidor, em ambiente varejista com diferentes níveis de densidade humana, proximidade física e perfil dos outros consumidores (aparência física). A partir de um estudo de desenho experimental, as hipóteses de pesquisa e o modelo conceitual foram testados, e os resultados suportaram a proposta de tese defendida. A similaridade percebida contribui para que emoções e atitudes negativas sejam mitigadas, bem como comportamentos de afastamento, mesmo em situações crowding na loja. Esta variável impacta positivamente com a avaliação que o consumidor faz sobre o varejista, os produtos e sua própria experiência de compra. Os achados também indicam que a similaridade percebida influencia atitudes e comportamentos por meio das respostas emocionais (mediação). O estudo amplia o corpo teórico de conhecimento ao fornecer evidências de que a identificação social modera (interfere) em como o crowding é percebido e avaliado pelos consumidores. / This dissertation talks about the role of other customers‟ presence on consumer behavior in retail environment. It is argued that other customrs tend to influence indivudual emotions, determining, mostly, satisfaction, purchase intentions and return to store. Based on Social Impact Theory (LATANÉ, 1981) and Similarity-Attraction Paradigm (BYRNE, 1971), this study proposes that consumer identification toward other customers that share the same retail store, mitigate crowding influence on individual responses (emotions, attitudes and behaviors). Therefore, this research aimed to investigate how perceived similarity moderates the relationship between crowding perception and consumer responses, in retail environment with different levels of human density, physical proximity and other customers‟ profile (physical appearence). Drawing an experimental design methodology, the research hypotheses and the conceptual model have been tested, and the results have supported the argument defended. Perceived similarity contributes to mitigate negative emotions and attitudes, as well as avoidance behaviors, despite the store is crowded. This variable impacts positively the evaluation that consumers make about the retailer, products and their own shopping experience. The findings also indicate that perceived similarity influences attitudes and behaviors through emotional responses (mediation). The study expands the body of knowledge providing evidences that social identification moderates (interfers) on how crowding is perceived and evaluated by consumers.

During the past decade the effects of macromolecular crowding on reaction pathways is gaining in prominence. The stress is to move out of the realms of ideal solution studies and make conceptual modifications that consider non-ideality as a variable in our calculations. In recent years it has been shown that molecular crowding exerts significant effects on all in vivo processes, from DNA conformational changes, protein folding to DNA-protein interactions, enzyme pathways and signalling pathways. Both thermodynamic as well as kinetic parameters vary by orders of magnitude in uncrowded buffer system as compared to those in the crowded cellular milieu. Ignoring these differences will restrict our knowledge of biology to a “model system” with few practical understandings. The recent expansion of the genome database has stimulated a study on numerous previously unknown proteins. This has whetted our thirst to model the cellular determinants in a more comprehensive manner. Intracellular extract would have been the ideal solution to re-create the cellular environment. However, studies conducted in this solution will be contaminated by interference with other biologically active molecule and relevant statistical data cannot be extracted out from it. Recent advances in methodologies to mimic the cellular crowding include use of inert macromolecules to reduce the volume occupancy of target molecules and the use of immobilization techniques to increase the surface density of molecules in a small volumetric region. The use of crowding agents often results in non-specific interaction and side-reactions like aggregation of the target molecules with the crowding agents themselves. Immobilization of one of the interacting partners reduces the probability of aggregation and precipitation of bio-macromolecules by restricting their degrees of freedom. Covalent linkage of molecules on solid support is used extensively in research for creating a homogeneous surface of bound molecules which can be interrogated for their reactivity. However, when it comes to biomolecules, direct immobilization on solid support or use of organic linkers often results in denaturation. The use of bio-affinity immobilization techniques can help us overcome this problem. Since mild conditions are needed to regenerate such a surface, it finds universal applicability as bio-memory chips. This thesis focuses on our attempts to design a physiologically viable immobilization technique for following rotein-protein/protein-DNA interactions. The work explores the mechanism for biological interactions related to transcription process in E. coli. Chapter 1 deals with the literary survey of the importance and effects of molecular crowding on biological reactions. It gives a brief history of the efforts been made so far by experimentalists, to mimic macromolecular crowding and the methods applied. The chapter tries to project an all-round perspective of the pros and cons of different immobilization techniques as a means to achieve a high surface density of molecules and the advancements so far. Chapter 2 deals with the detailed technicality and applicability of the Langmuir-Blodgett method. It discusses the rationale behind our developing this technique as an alternate means of bio-affinity immobilization, under physiologically compatible conditions. It then goes on to describe our efforts to follow the sequence-specific and sequential assembly process of a functional RNA polymerase enzyme with one immobilized partner and also explore the role of omega subunit of RNAP in the reconstitution pathway. This chapter uses the assembly process of a multi-subunit enzyme to evaluate the efficiency of the LB system as a universal two-dimensional scaffold to follow sequence-specific protein-ligand interaction. Chapter 3 discusses the application of LB technique to quantitatively evaluate the kinetics and thermodynamics of promoter-RNA polymerase interaction under conditions of reduced dimensionality. Here, we follow the interaction of T7A1 phage promoter with Escherichia coli RNA polymerase using our Langmuir-Blodgett technique. The changes in mechanistic pathway and trapping of kinetic intermediates are discussed in detail due to the imposed restriction in the degrees of freedom of the system. The sensitivity of this detection method is compared vis-a-vis conventional immobilization methods like SPR. This chapter firmly establishes the universal application of LB technique as a means to emulate molecular crowding and as a sensitive assay for studying the effects of such crowding on vital biological reaction pathway. Chapter 4 describes the mechanistic pathway for the physical binding of MsDps1 protein with long dsDNA in order to physically protect DNA during oxidative stress. The chapter describes in detail the mechanism of physical sequestering of non-specific DNA strands and compaction of the genome under conditions where a kinetic bottleneck has been applied. The data obtained is compared with results obtained in the previous chapter for the sequence-specific DNA-protein interaction in order to understand the difference in recognition process between regulatory and structural proteins binding to DNA. Chapter 5 deals with the evaluation of the σ-competition model in E. coli for three different sigma factors (all belonging to the σ-70 family). Here again, we have evaluated the kinetic and thermodynamic parameters governing the binding of core RNAP with its different sigma factors (σ70, σ32and σ38) and performed a comparative study for the binding of each sigma factor to its core using two different non-homogeneous immobilization techniques. The data has been analyzed globally to resolve the discrepancies associated with establishing the relative affinity of the different sigma factors for the same core RNA polymerase under physiological conditions. Chapter 6 summarizes the work presented in this thesis. In the Appendix section we have followed the unzipping of promoter DNA sequence using Optical Tweezers in an attempt to follow the temporal fluctuations occurring in biological reactions in real time and at a single molecule level.

Submitted by Adriana Alves Rodrigues (aalves@espm.br) on 2017-11-23T14:59:03Z No. of bitstreams: 1 ANDREA SILVIA SECURATO.pdf: 2258702 bytes, checksum: ce8b47f8b0a7a37dd282aa762c8f1a49 (MD5) / Approved for entry into archive by Adriana Alves Rodrigues (aalves@espm.br) on 2017-11-23T15:01:08Z (GMT) No. of bitstreams: 1 ANDREA SILVIA SECURATO.pdf: 2258702 bytes, checksum: ce8b47f8b0a7a37dd282aa762c8f1a49 (MD5) / Approved for entry into archive by Ana Cristina Ropero (ana@espm.br) on 2017-12-01T11:21:36Z (GMT) No. of bitstreams: 1 ANDREA SILVIA SECURATO.pdf: 2258702 bytes, checksum: ce8b47f8b0a7a37dd282aa762c8f1a49 (MD5) / Made available in DSpace on 2017-12-01T11:23:10Z (GMT). No. of bitstreams: 1 ANDREA SILVIA SECURATO.pdf: 2258702 bytes, checksum: ce8b47f8b0a7a37dd282aa762c8f1a49 (MD5) Previous issue date: 2017-03-29 / The store environmental factors and their influences on consumption are current and relevant themes, dealt with by much of the academic literature. These factors, divided into auditory, visual, olfactory, tactile, tasteful and social, are presented as the focus of managerial strategies, do to the interferences in the dynamics of attention at the point of sale. This paper seeks to clarify this dynamic, in face of three factors: auditory, visual and social. For that, the variables of music, lighting and crowding and their influences on consumer attention in a simulated supermarket environment were considered. The analysis was carried out in the Retail Lab of the School of Advertising and Marketing with the use of EyeTracking technology to identify the visual attention in front of six varied scenarios. The results point to a positive impact of music of moderate height (ambient sound), as well as influences of the high and natural lighting and acceleration of the decisions of purchase by the density of individuals (crowding). Such results contribute to the academic and managerial knowledge in marketing, with indication of proposals for future studies. / Os fatores ambientais de loja, e suas influências sobre o consumo são temas atuais e relevantes, tratados por grande parte da literatura acadêmica. Estes fatores, divididos em auditivos, visuais, olfativos, táteis, degustativos e sociais apresentam-se como foco das estratégias gerenciais, apresentada as interferências nas dinâmicas de atenção no ponto de venda. Este trabalho busca aclarar esta dinâmica, diante de três dos fatores: auditivo, visual e social. Para tanto, foram consideradas as variáveis de música, iluminação e crowding, e suas influências na atenção do consumidor em ambiente simulado de supermercado. A análise foi realizada no Retail Lab da Escola Superior de Propaganda e Marketing, com o uso da tecnologia Eye Tracking para identificação a atenção visual, diante de seis cenários variados. Os resultados apontam para um impacto positivo de músicas, de altura moderada (som ambiente), bem como influências da iluminação alta e natural, e aceleração das decisões de compra pela densidade de indivíduos, crowding. Tais resultados contribuem para o conhecimento acadêmico e gerencial em marketing, com indicação de propostas para estudos futuros.

Made available in DSpace on 2010-04-20T21:00:48Z (GMT). No. of bitstreams: 3 joaomarceloferreiraturma2003.pdf.jpg: 14925 bytes, checksum: df498c91cdb430c463307b2d17171402 (MD5) joaomarceloferreiraturma2003.pdf: 341537 bytes, checksum: 05d5e2e600196fc209a92cab8cd98d1b (MD5) joaomarceloferreiraturma2003.pdf.txt: 138094 bytes, checksum: 9b39a668792a751b0cf2901bddcc8005 (MD5) Previous issue date: 2006-02-06T00:00:00Z / Empirical studies on the determinants of private investments in development countries, including several studies in Brazil, have shown that there is a negative impact of high inflation on private investments. However, the recent Brazilian experience shows clearly that stabilization by itself is not sufficient to generate higher investments ratios. The main goal of this thesis is to find empirical evidence that explains why private investment and the investment ratio did not recover after the Real-plan, even though inflation was under control in the 1995-2004 period. In order to achieve this goal econometric estimations were done for long-term private investiments and also of the crowding-out effect of public investments in other areas than infrastructure on private investments. In order to find empirical evidence of the negative impact of both increased government revenues as well as the increase of relative prices of capital goods on private investments since 1995 a model using quarterly data for 1995-2004 was estimated. A more datailed analysis of the Brazilian tax burden and its composition has shown that the tax burden is, not only ever high but also not optimally allocated. Tax revenue comes mainly from taxing production (goods and services) and less from taxing income and property. Moreover, although tax revenue has increased over the last ten years, government spending has become more inefficient, largely in the form of low or non-productive spending while productive government expediture, including government spending on infrastructure, has fallen. / Estudos empíricos sobre os determinantes de investimentos privados em países em desenvolvimento, incluindo vários estudos para o Brasil, mostraram o impacto negativo de elevadas taxas de inflação sobre os investimentos privados. No entanto, a experiência brasileira recente mostra claramente que a estabilização por si só não é capaz de fazer com que as taxas de investimento se recuperem. Este trabalho objetiva a busca de respostas em evidências empíricas sobre quais teriam sido os principais fatores responsáveis pela não recuperação dos investimentos no Brasil pós-plano Real, apesar do controle inflacionário, no período 1995-2004. Para isso, foi estimado um modelo de investimento privado em nível de longo prazo (1970-2003) com dados anuais. Estas estimações mostram evidência empírica de crowding-in dos investimentos públicos em infra-estrutura sobre os investimentos privados e do efeito de crowding-out dos demais investimentos públicos (que não são em infra-estrutura) sobre os investimentos privados. Para obter evidências empíricas do impacto negativo da carga tributária e dos preços relativos dos bens de capital sobre as taxas de investimento foi estimado um modelo trimestral com dados de 1995-2004. Uma análise mais detalhada sobre a carga tributária brasileira e sua composição mostrou ainda que, além de sua magnitude elevada, a carga tributária brasileira tem uma alocação desfavorável ao investimento privado, pois seu peso é muito maior sobre o setor produtivo do que sobre renda e patrimônio. Além disso, a despeito da arrecadação crescente nos últimos 10 anos, os gastos do governo têm se concentrado em gastos pouco ou não produtivos e tem diminuído a participação relativa dos investimentos públicos em infra-estrutura, que são gastos produtivos e estimuladores de investimentos privados (efeito de crowding-in).

Bakgrund: Crowding är ett fenomen som innebär en stor ansamling av personer på en och samma plats. På akutmottagningar blir crowding en utmaning då antalet patienter överskrider antalet sjuksköterskor. Under sitt arbetspass träffar sjuksköterskan många patienter men för patienterna är besöket på en akutmottagning något utöver det vardagliga. Därför är det viktigt att sjuksköterskan sätter den enskilda patienten i centrum. Syfte: Att undersöka vilka erfarenheter sjuksköterskor och patienter har av crowding på akutmottagningar. Metod: Magisterarbetet är en integrativ litteraturstudie. Databaserna Cinahl och Pubmed har använts i studien. Totalt omfattar resultatet 16 artiklar och både patienter och sjuksköterskor har inkluderats i undersökningen. Resultat: Sex huvudkategorier framkom i resultatet. "Svårt att upprätta patientsäkerhet", "stressig arbetsmiljö påverkar arbetstillfredsställelsen", "att känna sig otillräcklig", "ökad teamkänsla vid samarbete", "påverkan på vårdrelationen" och "när omgivningen blir icke-vårdande". Slutsats: Crowding medför en påverkan på vårdrelationen, patientsäkerheten, sjuksköterskors arbetsmiljö och patienternas vårdmiljö. Vidare forskning av erfarenheter av crowding behövs för att belysa problemet och minska dess negativa konsekvenser för sjuksköterskor och patienter. / Background: Crowding is a phenomenon that involves a large gathering of people in one place. In emergency departments, crowding becomes a challenge as the number of patients exceeds the number of nurses. During the work shift, the nurse meets many patients. But for the patients the visit to an emergency department is something out of the ordinary. Therefore, it is important that the nurse puts the individual patient at the center.  Aim: To investigate what experiences nurses and patients have of crowding in emergency rooms.   Method: An integrative literature study. The Cinahl and Pubmed databases were used in this study. A total of 16 articles were included in the survey. Experiences of both patients and nurses have been included in the study.   Result: Six main categories were identified in the result. "Difficult to establish patient safety", "stressful work environment affects job satisfaction", "feeling inadequate", "increased team spirit in collaboration", "impact on the care relationship", and "when the environment becomes non-caring".  Conclusion: Crowding has an impact on the care relationship, patient safety, nurses´ work environment and patients´ care environment. Further research on crowding experiences is needed to shed light on the problem and reduce its negative consequences for nurses and patients.

The hospital emergency department (ED) is a critical source for health care amid a complex healthcare system in the United States. It is the gateway to care for a broad range of people, arriving from a variety of locations. With this wide reaching net and a decreasing trend in hospital beds, EDs throughout the United States are experiencing overcrowding. ED crowding has various tactical and strategic facility management impacts ranging from facility occupancy issues to adverse health outcomes. Among other factors, recent research has cited the sharp increase in ED visits over the years and ED patient boarding as key contributors to crowding. Home hospital care is a model in which health care is delivered at an individual’s home as a substitute for hospital-level inpatient short-term acute care. Clinical research has shown home hospital to be an effective care model for select illnesses presenting frequently to EDs, such as congestive heart failure, community acquired pneumonia, chronic obstructive pulmonary disease, and cellulitis. While there exist distinct clinical and social criteria for which delineate eligible individuals, home hospital care models have been linked with the potential to free inpatient beds. The overarching objective of this study is to investigate the relationship between home hospital care and ED crowding. To achieve this objective, the study examined the relationship between home hospital care and ED crowding, specific to ED boarding performance at a large, urban, teaching hospital facility. A methodology for identification of potential home hospital patients was used through clinical and social criteria, and a scale for the range of clinical eligibility rates was established for the five suitable illnesses. The study modeled patient flow and bed demand, and utilized computer simulation modeling to assess the impact of home hospital care on ED boarding performance. Various models were simulated to represent different home hospital intervention types. The models incorporated home hospital through an ED Referral program, Inpatient-Transfer Referral program, Community Referral program, and a fully integrated home hospital program. Three scenarios were run for each model to assess practical possibilities for the utilization of the freed bed hours from a home hospital program. This research contributes insight and understanding of home hospital’s impacts on ED crowding. The insight from this study quantifies the effects of a home hospital program on ED boarding and inpatient bed demand. The modeling study is contributes an analytical understanding of the impacts that home hospital could potentially have on crowding, which could prove useful in the struggle against ED congestion. This understanding helps to provide a more thorough understanding of home hospital, and could aid in an organization’s decision-making process of whether to implement a program. The presented modeling methodology for analyzing home hospital and ED crowding can also be used as a model format for researchers and practitioners for analytical purposes in future studies.

The study of crowding effects on particle diffusion is a large subject with implications in many scientific areas. The studies span from pure theoretical calculations to experiments actually measuring the movement of proteins diffusing in a cell. Even though the subject is important and has been studied heavily there are still aspects not fully understood.   This report describes a Monte Carlo simulation approach (Gillespie algorithm) to study the effects of crowding on particle diffusion in a quasi one-dimensional system. With quasi meaning that the particles diffuses on a one-dimensional lattice but has the possibility to disassociate from the lattice and then rebind at a latter stage. Different binding strategies are considered: rebinding to the same location and randomly choosing the binding location. The focus of the study is how these strategies affects the mobility (diffusion coefficient) of a tracer particle. The main result of this thesis is a graph showing the diffusion coefficient as a function of the binding rate for different binding strategies and particle densities. We provide analytical estimates for the diffusion coefficient in the unbinding rate limits which show good agreement with the simulations. / Hur "trängsel" (från engelskans "crowding" t ex molecular crowding) påverkar diffusionsprocesser är viktigt inom många olika vetenskapliga områden. Forskningen som för tillfället utförs sträcker sig från rent teoretiska beräkningar till experiments där man kan följa enskilda proteiners rörelse i en cell. Även fast ämnet är viktig och väl undersökt finns det fortfarande många aspekter som man inte förstår till fullo. I det här examensarbetet beskrivs en Monte Carlo metod (Gillespie algoritmen) för att studera hur trängsel påverkar en partikel som diffunderar i ett "nästan" en-dimensonellt system. Det är nästan en-dimensionellt i det avsedde att partiklarna diffunderar på ett gitter men kan binda av från gittret och binda tillbaka i ett senare skedde. Olika metoder för hur partiklarna binder till gittret undersöks: Återbinding till avbindingsplatsen och slumpmässigt vald återbindingsplats. Fokus ligger på att förklara hur dessa påverkar mobiliteten (diffusionskonstanten) av en spårningspartikel (tracer particle). Resultatet är en graf som visar diffusionskonstanten för spårningspartikeln som en funktion av avbindingsfrekvens för olika bindingstrategier och partikeldensiteter. Vi ger också analytiska resultat i gränsvärdet för höga och låga avbindingstakter vilka stämmer bra överens med simuleringar.

As the United States becomes increasingly urbanized, the importance of federally designated wilderness areas as places of reflection and refuge from city life becomes even more apparent. These wilderness areas provide visitors with opportunities for solitude, recreation, and connecting with nature. Wilderness has long been important to American society, influencing the likes of John Muir, Theodore Roosevelt, and Henry David Thoreau. With the passage of the Wilderness Act of 1964, the assurance that these areas would remain protected in perpetuity for the enjoyment of the American people was enshrined into law. While these wilderness areas remain protected by Federal law, increasing visitation rates and changing social norms may begin to threaten the so-called "wilderness experience," making it difficult for visitors to enjoy and experience the conditions set forth in the Wilderness Act. Wilderness managers must therefore seek to understand the attitudes, preferences, and motivations of wilderness visitors using these areas to ensure that management conditions provide for a high-quality wilderness experience. This study uses quantitative survey methods to explore differences in management preferences, wilderness conditions, and crowding perceptions between overnight and day visitors to wilderness areas. Visitors were surveyed at 30 trailheads throughout the Olympic National Park Wilderness during the summer of 2012. While wilderness visitors held many similar opinions on management preferences and wilderness conditions, there were differences in the degree to which they agreed or disagreed. Overnight visitors tended to be more sensitive to crowding than day visitors, both on hiking trails and at attraction sites, and were more supportive of management policies that limited access in favor of increasing opportunities for solitude experiences. This study supports the use of a management by objectives framework that incorporates indicators and standards of quality to ensure that certain conditions are met. Findings from this study can aid in the development of standards for crowding and the establishment of other management policies in Olympic National Park Wilderness to ensure that all visitors are provided with the opportunity for a high-quality wilderness experience.

Emergency department (ED) crowding is a patient safety concern that has been increasing for more than a decade. Increased visits have resulted in ED crowding, longer wait times, ambulance diversions, and boarding of admitted patients (Hing & Bhuiya, 2012). Numerous factors affect ED crowding. Once various extraneous issues are resolved and a bed is available for a patient, it becomes the responsibility of nurses across unit boundaries to coordinate the patient transfer. This study applies Relational Coordination Theory (RCT) as a framework to provide nurses insight into the relational aspects of their work in the transfer of ED patients to inpatient beds. Relational coordination is a mutually reinforcing process of interaction between communication and relationships that is carried out for the purpose of task interaction. It is useful for coordinating work that is highly interdependent, uncertain, and time constrained (Gittell, 2002). Nurses work during ED transfers requires task interaction as they coordinate their efforts. This study, guided by RCT, will examine relational and communication dynamics among nurses within their own units and across unit boundaries as they interact during ED transfers. A cross-sectional, descriptive design will explore the seven dimensions of Relational Coordination (RC) during ED admissions and explain nurses relational and communication dimensions that may influence ED boarding times. The results of this study provide new information and a sound theoretical model on which to base future research.

Healthcare industry in United States of America is facing a big paradox. Although US is a leader in the industry of medical devices, medical practices and medical researches, however there isnt enough satisfaction and quality in performance of US healthcare operations. Despite the big investments and budgets associated with US healthcare, there are big threats to US healthcare operational side, that reduces the quality of care. In this research study, a step by step Systems Engineering approach is applied to improve healthcare delivery process in an Emergency Department of a hospital located in Indianapolis, Indiana. In this study, different type of systems engineering tools and techniques are used to improve the quality of care and patients satisfaction in ED of Eskenazi hospital. Having a simulation model will help to have a better understanding of the ED process and learn more about the bottlenecks of the process. Simulation model is verified and validated using different techniques like applying extreme and moderate conditions and comparing model results with historical data. 4 different what if scenarios are proposed and tested to find out about possible LOS improvements. Additionally, those scenarios are tested in both regular and an increased patient arrival rate. The optimal selected what-if scenario can reduce the LOS by 37 minutes compared to current ED setting. Additionally, by increasing the patient arrival rate patients may stay in the ED up to 6 hours. However, with the proposed ED setting, patients will only spend an additional 106 minutes compared to the regular patient arrival rate.<br>