bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of clinical competence – a longitudinal survey of nurse practitioner students
Authors: Taylor I. , Bing-Jonsson P. C. , Finnbakk E. , Wangensteen S. , Sandvik L. , Fagerström L.
Published: July 2021

Background

In order to achieve a sustainable standard of advanced clinical competence for nurse practitioners leading to a credible role, it is important to investigate the development of clinical competence among nurse practitioner students.

Aim

The aim of the present study is to analyse the development of nurse practitioner students’ self-assessed clinical competence from the beginning of their education to after completion of their clinical studies.

Design

The study involved the application of a longitudinal survey design adhering to STROBE guidelines.

Methods

The participants consisted of 36 registered nurses from a nurse practitioner programme at a Norwegian university. The Professional Nurse Self-Assessment Scale II was used for data collection during the period August 2015 to May 2020.

Results

The students developed their clinical competence the most for direct clinical practice. Our findings are inconclusive in terms of whether the students developed clinical competence regarding consultation, coaching and guidance, and collaboration. However, they do indicate a lack of development in some aspects of clinical leadership. The students with the lowest level of clinical competence developed their clinical competence regarding direct clinical practice significantly more than the students with the highest level of clinical competence. The differences between students with high and low levels of clinical competence were levelled out during their education. Thus, the students as a whole became a more homogenous group after completion of their clinical studies. Previous work experience in primary healthcare was a statistically significant, yet minor, predictor of the development of clinical competence.

Conclusion

Our findings indicate that the students developed their clinical competence for direct clinical practice in accordance with the intended learning outcomes of the university’s Master’s programme and international standards for nurse practitioners. It is imperative that the clinical field supports nurse practitioners by facilitating extended work-task fits that are appropriate to their newly developed clinical competence. We refrain from concluding with a recommendation that prior clinical work experience should be an entry requirement for nurse practitioner programmes. However, we recommend an evaluation of the nurse practitioner education programme with the aim of investigating whether the curriculum meets the academic standards of clinical leadership expected in advanced level of nursing.
Organisational and advance care planning program characteristics associated with advance care directive completion: a prospective multicentre cross-sectional audit among health and residential aged care services caring for older Australians
Authors: Detering Karen M. , Sinclair Craig , Buck Kimberly , Sellars Marcus , White Ben P. , Kelly Helana , Nolte Linda
Published: July 2021

Background

Advance care planning (ACP) and advance care directive (ACD) completion improve outcomes for patients, family, clinicians and the healthcare system. However, uptake remains low. Despite increasing literature regarding organisational-level ACP characteristics leading to success, there is a lack of data measuring the impact of these factors on ACD prevalence.

Methods

A prospective multi-centre, cross-sectional audit of health records among older Australians accessing general practices (GP), hospitals and residential aged care facilities (RACF) was undertaken to describe organisational and ACP-program characteristics across services, document ACD prevalence, and assess organisation-level predictors of ACD prevalence. Organisational-level data included general and ACP-program characteristics. Patient/resident data included demographics and presence of ACDs.

Results

One hundred organisations (GP = 15, hospitals = 27, RACFs = 58) participated, contributing data from 4187 patient/resident health records. Median prevalence of ACDs across organisations was 19.4%, (range = 0–100%). In adjusted models, organisational sector type was the strongest predictor of ACD prevalence, with higher rates in RACFs (unadjusted 28.7%, adjusted 20.6%) than hospitals (unadjusted 6.4%, adjusted 5.8%) or GPs (unadjusted 2.5%, adjusted 6.6%). RACFs in regional and rural/remote areas had higher prevalence than metropolitan organisations. Organisations supported by government funding and those that were Not For Profit had higher prevalence than those that were privately funded, and organisations with an ACP program that had been implemented at least 3 years before data collection had higher prevalence than those with either no program or a more recent program.

Conclusions

The median ACD prevalence was low, with substantial variation across organisations. Sector type was the strongest predictor, being highest in RACFs. Low prevalence rates, overall and in particular sectors, have implications for improvements. Further research into organisational factors associated with ACP/ACD completion is required.
Adapting to the COVID-19 pandemic on Building Research in Diet and Cognition (BRIDGE) trial
Authors: Fitzgibbon Marian , Blumstein Lara , Schiffer Linda , Antonic Mirjana A. , McLeod Andrew , Dakers Roxanne , Restrepo Leo , Boots Elizabeth A. , Sanchez-Flack Jennifer C. , Tussing-Humphreys Lisa , Lamar Melissa
Published: July 2021

Background

The COVID-19 pandemic has altered the research landscape for clinical trials, requiring thoughtful consideration regarding how to handle the risks and benefits of continuing them.

Design

This brief report describes the experience of adapting the Building Research in Diet and Cognition (BRIDGE) study, a randomized clinical trial examining the effects of the Mediterranean diet, with and without weight loss, on cognitive functioning in 185 older obese African American adults during the COVID-19 pandemic.

Measurement

The University of Illinois at Chicago (UIC) developed an expedited amendment process for research shifting to remote data collection. We conducted the study in three consecutive groups. For group 3, 14-month data collection period, we adapted our protocol to allow data collection via telephone and e-mail. We were unable to collect certain measures that required face-to-face contact.

Results

For measures that could be collected remotely, 14-month retention was similar for group 3 compared to groups 1 and 2: data were collected for 86.9% of group 3 (remote) and 87.9% of groups 1 and 2 (face to face), p = .84.

Conclusions

In order to preserve the integrity of our clinical trial and ensure the safety of our participants and staff during the COVID-19 pandemic, we had to carefully and efficiently adapt our data collection procedures. The procedures put in place allowed us to collect our primary outcomes and the majority of our secondary outcomes and will enable us to examine the role of dietary intake, with and without weight loss, on cognitive functioning in a vulnerable and high-risk population.

Trial registration

ClinicalTrials.gov NCT3129048. Registration Date: 4/17/2017.
Electrospun wound dressings containing bioactive natural products: physico-chemical characterization and biological assessment
Authors: Arampatzis Athanasios S. , Kontogiannopoulos Konstantinos N. , Theodoridis Konstantinos , Aggelidou Eleni , Rat Angélique , Willems Anne , Tsivintzelis Ioannis , Papageorgiou Vassilios P. , Kritis Aristeidis , Assimopoulou Andreana N.
Published: July 2021

Background

Current research on skin tissue engineering has been focusing on novel therapies for the effective management of chronic wounds. A critical aspect is to develop matrices that promote growth and uniform distribution of cells across the wound area, and at the same time offer protection, as well as deliver drugs that help wound healing and tissue regeneration. In this context, we aimed at developing electrospun scaffolds that could serve as carriers for the bioactive natural products alkannin and shikonin (A/S).

Methods

A series of polymeric nanofibers composed of cellulose acetate (CA) or poly(ε-caprolactone) (PCL) and varying ratios of a mixture of A/S derivatives, has been successfully fabricated and their physico-chemical and biological properties have been explored.

Results

Scanning electron microscopy revealed a uniform and bead-free morphology for CA scaffolds, while for PCL beads along the fibers were observed. The average diameters for all nanofibers ranged between 361 ± 47 and 487 ± 88 nm. During the assessment of physicochemical characteristics, CA fiber mats exhibited a more favored profile, while the assessment of the biological properties of the scaffolds showed that CA samples containing A/S mixture up to 1 wt.% achieved to facilitate attachment, survival and migration of Hs27 fibroblasts. With respect to the antimicrobial properties of the scaffolds, higher drug-loaded (1 and 5 wt.%) samples succeeded in inhibiting the growth of
Staphylococcus epidermidis and S. aureus
around the edges of the fiber mats. Finally, carrying out a structure-activity relationship study regarding the biological activities (fibroblast toxicity/proliferation and antibacterial activity) of pure A/S compounds – present in the A/S mixture – we concluded that A/S ester derivatives and the dimeric A/S augmented cell proliferation after 3 days, whereas shikonin proved to be toxic at 500 nM and 1 μM and alkannin only at 1 μM. Additionally, alkannin, shikonin and acetyl-shikonin showed more pronounced antibacterial properties than the other esters, the dimeric derivative and the A/S mixture itself.

Conclusions

Taken together, these findings indicate that embedding A/S derivatives into CA nanofibers might be an advantageous drug delivery system that could also serve as a potential candidate for biomedical applications in the field of skin tissue engineering.
Randomized Phase II Trial of MIBG Versus MIBG, Vincristine, and Irinotecan Versus MIBG and Vorinostat for Patients With Relapsed or Refractory Neuroblastoma: A Report From NANT Consortium
Authors: DuBois Steven G. , Granger M. Meaghan , Groshen Susan , Tsao-Wei Denice , Ji Lingyun , Shamirian Anasheh , Czarnecki Scarlett , Goodarzian Fariba , Berkovich Rachel , Shimada Hiroyuki , Villablanca Judith G. , Vo Kieuhoa T. , Pinto Navin , Mosse Yael P. , Maris John M. , Shusterman Suzanne , Cohn Susan L. , Goldsmith Kelly C. , Weiss Brian , Yanik Gregory A. , Twist Clare J. , Irwin Meredith S. , Haas-Kogan Daphne A. , Park Julie R. , Marachelian Araz , Matthay Katherine K.
Published: July 2021

PURPOSE

131I-metaiodobenzylguanidine (MIBG) is an active radiotherapeutic for neuroblastoma. The primary aim of this trial was to identify which of three MIBG regimens was likely associated with the highest true response rate.

PATIENTS AND METHODS

Patients 1-30 years were eligible if they had relapsed or refractory neuroblastoma, at least one MIBG-avid site, and adequate autologous stem cells. Patients received MIBG 18 mCi/kg on day 1 and autologous stem cell on day 15. Patients randomly assigned to arm A received only MIBG; patients randomly assigned to arm B received intravenous vincristine on day 0 and irinotecan daily on days 0-4; patients randomly assigned to arm C received vorinostat (180 mg/m2/dose) orally once daily on days 1 to 12. The primary end point was response after one course by New Approaches to Neuroblastoma Therapy criteria. The trial was designed with 105 patients to ensure an 80% chance that the arm with highest response rate was selected.

RESULTS

One hundred fourteen patients were enrolled, with three ineligible and six unevaluable, leaving 105 eligible and evaluable patients (36 in arm A, 35 in arm B, and 34 in arm C; 55 boys; and median age 6.5 years). After one course, the response rates (partial response or better) on arms A, B, and C were 14% (95% CI, 5 to 30), 14% (5 to 31), and 32% (18 to 51). An additional five, five, and four patients met New Approaches to Neuroblastoma Therapy Minor Response criteria on arms A, B, and C, respectively. On arms A, B, and C, rates of any grade 3+ nonhematologic toxicity after first course were 19%, 49%, and 35%.

CONCLUSION

Vorinostat and MIBG is likely the arm with the highest true response rate, with manageable toxicity. Vincristine and irinotecan do not appear to improve the response rate to MIBG and are associated with increased toxicity.
A Randomized, Multicenter, Open-Label, Blinded End Point, Phase 2, Feasibility, Efficacy, and Safety Trial of Preoperative Microvascular Protection in Patients Undergoing Major Abdominal Surgery
Authors: Yanase Fumitaka , Tosif Shervin H. , Churilov Leonid , Yee Ken , Bellomo Rinaldo , Gunn Kerry , Kim Chang , Krizhanovskii Camilla , Hahn Robert G. , Riedel Bernhard , Weinberg Laurence
Published: July 2021

BACKGROUND:

The endothelial glycocalyx, a carbohydrate-rich layer coating all endothelial surfaces, plays a fundamental role in the function of microcirculation. The primary aim of this study was to evaluate the feasibility of using dexamethasone and albumin to protect the endothelial glycocalyx in patients undergoing abdominal surgery. Secondary and exploratory outcomes included efficacy and safety.

METHODS:

We conducted a multicenter, open-label, blinded end point, phase 2, randomized trial. Patients undergoing colorectal, pancreas, or liver surgery were recruited and randomized to receive either intravenous dexamethasone (16 mg) and 20% albumin (100 mL) at induction of anesthesia, then 200 mL of 20% albumin with each subsequent 1000 mL of crystalloid administered (dexamethasone and albumin [Dex-Alb] group), or crystalloid fluid only with no dexamethasone (control group). Feasibility end points included patient recruitment and retention, consent rate, and successful study drug administration. The primary efficacy end point was the measurement of plasma syndecan-1 level on postoperative day (POD) 1, and secondary end points were heparan sulfate levels and inflammatory markers measured at 4 perioperative timepoints. Safety end points included errors in administration of the intervention, hyperglycemia, occurrence of postoperative complications, and patient retention.

RESULTS:

Seventy-two patients were randomized. All feasibility end points were achievable. There were no statistically significant differences observed in median (interquartile range) syndecan-1 levels on POD 1 (39 ng·mL−1 [20–97] in the Dex-Alb group versus 41 ng·mL−1 [19–84] in the control group; difference in medians −2.1, 95% confidence interval [CI], −13 to 8.6; P = .69). The Dex-Alb group had lower POD 1 heparan sulfate levels (319 ng·mL−1 [161–717] in the Dex-Alb group versus 1422 [670–2430] ng·mL−1 in the control group; difference in medians −1085, 95% CI, −1779 to −391) and C-reactive protein (CRP) levels on POD 1 (48 [29–77] mg·L−1 in the Dex-Alb group versus 85 mg·L−1 [49–133] in the control group; difference in medians −48, 95% CI, −75 to −21). Fewer patients had one or more postoperative complication in the Dex-Alb group than in the control group (6 [17%] vs 18 patients [50%]; odds ratio = 0.2, 95% CI, 0.06–0.6).

CONCLUSIONS:

Intravenous dexamethasone and albumin administration was feasible but did not reduce syndecan-1 on POD 1 in patients undergoing abdominal surgery. Given the clinically important CIs observed between the groups for heparan sulfate, CRP, and postoperative complications, a larger trial assessing the associations between dexamethasone and albumin administration and these outcomes is warranted.
Open Regionalism and the Pacific Alliance: The Case of the sura Group as a Private Sector Actor
Authors: Vargas-Alzate Luis Fernando , Amaya Alviar Ana María
Published: July 2021

Open regionalism is a dominant feature within the regional integration mechanism known as the Pacific Alliance. Its members seek to strengthen the economic ties between them and obtain favorable outcomes vis-à-vis the Asia Pacific region. The aim of this article is to demonstrate the private sector’s significance within the Pacific Alliance, while highlighting the role each one has played in the other’s success. To this end, the authors undertook an extensive literature review and conducted numerous interviews with representatives of the Colombian private sector to gather their estimations regarding the Pacific Alliance, its various stages of conception and implementation, and its real significance for the private sectors within and among members. Additionally, the focus was directed to the specific case of the sura Group, an international firm based in Colombia, to illustrate the objectives and benefits accruing to the private sector (and the sura Group itself) via this integration initiative.
Corrigendum: Greed Works—Online Algorithms for Unrelated Machine Stochastic Scheduling
Authors: Gupta Varun , Moseley Benjamin , Uetz Marc , Xie Qiaomin
Published: July 2021

This corrigendum fixes an incorrect claim in the paper Gupta et al. [Gupta V, Moseley B, Uetz M, Xie Q (2020) Greed works—online algorithms for unrelated machine stochastic scheduling. Math. Oper. Res. 45(2):497–516.], which led us to claim a performance guarantee of 6 for a greedy algorithm for deterministic online scheduling with release times on unrelated machines. The result is based on an upper bound on the increase of the objective function value when adding an additional job [Formula: see text] to a machine [Formula: see text] (Gupta et al., lemma 6). It was pointed out by Sven Jäger from Technische Universität Berlin that this upper bound may fail to hold. We here present a modified greedy algorithm and analysis, which leads to a performance guarantee of 7.216 instead. Correspondingly, also the claimed performance guarantee of [Formula: see text] in theorem 4 of Gupta et al. for the stochastic online problem has to be corrected. We obtain a performance bound [Formula: see text].
Integrating perspectives of patients, healthcare professionals, system developers and academics in the co-design of a digital information tool
Authors: Grynne Annika , Browall Maria , Fristedt Sofi , Ahlberg Karin , Smith Frida
Published: July 2021

Background

Patients diagnosed with cancer who are due to commence radiotherapy, often, despite the provision of a considerable amount of information, report a range of unmet information needs about the treatment process. Factors such as inadequate provision of information, or the stressful situation of having to deal with information about unfamiliar things, may influence the patient’s ability to comprehend the information. There is a need to further advance the format in which such information is presented. The composition of information should be tailored according to the patient’s individual needs and style of learning.

Method and findings

The PD methodology is frequently used when a technology designed artefact is the desired result of the process. This research is descriptive of its kind and provides a transparent description of the co-design process used to develop an innovative digital information tool employing PD methodology where several stakeholders participated as co-designers. Involving different stakeholders in the process in line with recommended PD activities enabled us to develop a digital information tool that has the potential to be relevant and user-friendly for the ultimate consumer.

Conclusions

Facilitating collaboration, structured PD activities can help researchers, healthcare professionals and patients to co-design patient information that meets the end users’ needs. Furthermore, it can enhance the rigor of the process, ensure the relevance of the information, and finally have a potential to employ a positive effect on the reach of the related digital information tool.
Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
Authors: Helle Kristina Barbara , Sadiku Arlinda , Zelleke Girma Mesfin , Ibrahim Toheeb Babatunde , Bouba Aliou , Tsoungui Obama Henri Christian , Appiah Vincent , Ngwa Gideon Akumah , Teboh-Ewungkem Miranda Ijang , Schneider Kristan Alexander
Published: July 2021

Background

Governments across the globe responded with different strategies to the COVID-19 pandemic. While some countries adopted measures, which have been perceived controversial, others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethical by the WHO Director-General. Inevitably, without proper control measures, viral diversity increases and multiple infectious exposures become common, when the pandemic reaches its maximum. This harbors not only a potential threat overseen by simplified theoretical arguments in support of herd immunity, but also deserves attention when assessing response measures to increasing numbers of infection.

Methods and findings

We extend the simulation model underlying the pandemic preparedness web interface CovidSim 1.1 (http://covidsim.eu/) to study the hypothetical effect of increased morbidity and mortality due to ‘multi-infections’, either acquired at by successive infective contacts during the course of one infection or by a single infective contact with a multi-infected individual. The simulations are adjusted to reflect roughly the situation in the USA. We assume a phase of general contact reduction (“lockdown”) at the beginning of the epidemic and additional case-isolation measures. We study the hypothetical effects of varying enhancements in morbidity and mortality, different likelihoods of multi-infected individuals to spread multi-infections and different susceptibility to multi-infections in different disease phases. It is demonstrated that multi-infections lead to a slight reduction in the number of infections, as these are more likely to get isolated due to their higher morbidity. However, the latter substantially increases the number of deaths. Furthermore, simulations indicate that a potential second lockdown can substantially decrease the epidemic peak, the number of multi-infections and deaths.

Conclusions

Enhanced morbidity and mortality due to multiple disease exposure is a potential threat in the COVID-19 pandemic that deserves more attention. Particularly it underlines another facet questioning disease management strategies aiming for herd immunity.
Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020
Authors: Zimmermann Ivan Ricardo , Sanchez Mauro Niskier , Frio Gustavo Saraiva , Alves Layana Costa , Pereira Claudia Cristina de Aguiar , Lima Rodrigo Tobias de Sousa , Machado Carla , Santos Leonor Maria Pacheco , Silva Everton Nunes da
Published: July 2021

Background

Almost 200,000 deaths from COVID-19 were reported in Brazil in 2020. The case fatality rate of a new infectious disease can vary by different risk factors and over time. We analysed the trends and associated factors of COVID-19 case fatality rates in Brazilian public hospital admissions during the first wave of the pandemic.

Methods

A retrospective cohort of all COVID-19-related admissions between epidemiological weeks 10–40 in the Brazilian Public Health System (SUS) was delimited from available reimbursement records. Smoothing time series and survival analyses were conducted to evaluate the trends of hospital case fatality rates (CFR) and the probability of death according to factors such as sex, age, ethnicity, comorbidities, length of stay and ICU use.

Results

With 398,063 admissions and 86,452 (21.7%) deaths, the overall age-standardized hospital CFR trend decreased throughout the period, varying from 31.8% (95%CI: 31.2 to 32.5%) in week 10 to 18.2% (95%CI: 17.6 to 18.8%) in week 40. This decreasing trend was observed in all sex, age, ethnic groups, length of stay and ICU admissions. Consistently, later admission (from July to September) was an independent protective factor. Patients 80+ year old had a hazard ratio of 8.18 (95% CI: 7.51 to 8.91). Ethnicity, comorbidities, and ICU need were also associated with the death risk. Although also decreasing, the CFR was always around 40–50% in people who needed an ICU admission.

Conclusions

The overall hospital CFR of COVID-19 has decreased in Brazilian public hospitals during the first wave of the pandemic in 2020. Nevertheless, during the entire period, the CFR was still very high, suggesting the need for improving COVID-19 hospital care in Brazil.
Percutaneous hepatic melphalan perfusion: Single center experience of procedural characteristics, hemodynamic response, complications, and postoperative recovery
Authors: Struck Manuel Florian , Kliem Peter , Ebel Sebastian , Bauer Alice , Gössmann Holger , Veelken Rhea , van Bömmel Florian , Dennecke Timm , Stehr Sebastian N. , Girrbach Felix F.
Published: July 2021

Background

Percutaneous hepatic melphalan perfusion (PHMP) for the selective treatment of hepatic metastases is known to be associated with procedural hypotension and coagulation disorders. Studies on anesthetic management, perioperative course, complications, and postoperative recovery in the intensive care unit (ICU) have not been published.

Methods

In a retrospective observational study, we analyzed consecutive patients who were admitted for PHMP over a 6-year period (2016–2021). Analyses included demographic, treatment, and outcome data with regard to short-term complications until ICU discharge.

Results

Fifty-three PHMP procedures of 16 patients were analyzed. In all of the cases, procedure-related hypotension required the median (range) highest noradrenaline infusion rate of 0.5 (0.17–2.1) μg kg min-1 and fluid resuscitation volume of 5 (3–14) liters. Eighty-four PHMP-related complications were observed in 33 cases (62%), of which 9 cases (27%) involved grade III and IV complications. Complications included airway constriction (requiring difficult airway management), vascular catheterization issues (which resulted in the premature termination of PHMP, as well as to the postponement of PHMP and to the performance of endovascular bleeding control after PHMP), and renal failure that required hemodialysis. Discharge from the ICU was possible after one day in most cases (n = 45; 85%); however, in 12 cases (23%), prolonged mechanical ventilation was required. There were no procedure-related fatalities.

Conclusions

PHMP is frequently associated with challenging cardiovascular conditions and complications that require profound anesthetic skills. For safety reasons, PHMP should only be performed in specialized centers that provide high-level hospital infrastructures and interdisciplinary expertise.
Repeatability and agreement of white-to-white measurements between slit-scanning tomography, infrared biometry, dual rotating Scheimpflug camera/Placido disc tomography, and swept source anterior segment optical coherence tomography
Authors: Buckenham Boyle Alexander , Namkung Soobin , Shew William , Gokul Akilesh , McGhee Charles N. J. , Ziaei Mohammed
Published: July 2021

Purpose

To assess the agreement and repeatability of horizontal visible iris diameter (HVID) or white-to-white (WTW) measurements between four imaging modalities; combination slit scanning elevation/Placido tomography, infrared biometry, dual rotating scheimpflug camera/Placido tomography, and swept source anterior segment optical coherence tomography (AS-OCT).

Methods

A prospective study of 35 right eyes of healthy volunteers were evaluated using the Orbscan IIz, IOL Master 700, Galilei G2, and DRI Triton OCT devices. The inter-device agreement and repeatability of HVID/WTW measurements for each device were analysed.

Results

Mean HVID/WTW values obtained by the Orbscan IIz, IOL Master 700, Galilei G2 and DRI Triton OCT were 11.77 ± 0.40 mm, 12.40 ± 0.43 mm, 12.25 ± 0.42 mm, and 12.42 ± 0.47 mm, respectively. All pairwise comparisons revealed statistically significant differences in mean HVID/WTW measurements (p = <0.01) except for the IOL Master 700—DRI OCT Triton pair (p = 0.56). Mean differences showed that the DRI Triton OCT produced the highest HVID/WTW values, followed by the IOL Master 700, Galilei G2 and Orbscan IIz, respectively. The limits of agreement were large on all device pairs. There was high repeatability for all devices (ICC ≥ 0.980). The highest repeatability was seen in the Galilei G2 (ICC = 0.995) and lowest in the Orbscan IIz (ICC = 0.980).

Conclusions

The four devices exhibit high repeatability, but should not be used interchangeably for HVID/WTW measurements in clinical practice.
Incidence, predictors, and outcomes of DAPT non-compliance in planned vs. ad hoc PCI in chronic coronary syndrome
Authors: Malik Jahanzeb , Yousaf Husnain , Abbasi Waleed , Hameed Nouman , Mohsin Muhammad , Shahid Abdul Wahab , Fatima Mahnoor
Published: July 2021

Objective

The disruption of dual antiplatelet therapy (DAPT) causes more adverse events after percutaneous coronary intervention (PCI). However, incidence and predictors of DAPT non-compliance are unknown in chronic coronary syndrome patients when compared between planned and ad hoc PCI.

Methods

This investigation was aimed to assess the incidence, predictors, outcomes, and primary mode of non-compliance of DAPT in patients with chronic coronary syndrome undergoing their first PCI. We analyzed the patients between planned (group 1) and ad hoc (group 2) PCI.

Results

There were a total of 628 participants in this investigation (370 were in planned PCI and 270 in the ad hoc PCI group). Out of 628 patients, by one month, 10% left DAPT in planned PCI group and 19.7% in ad hoc PCI group (aOR: 0.451, 95% CI: 0.285–0.713, p = 0.001). At 12 months, DAPT non-compliance was significantly more in ad hoc PCI group (52.7% vs. 47.8%; aOR: 0.647 95% CI: 0.470–0.891, p = 0.008). Age > 65 years (p < 0.001), low education status (p = 0.012), residents of rural areas (p < 0.001), ad hoc PCI group (p = 0.036), and angina class II (p = 0.038) were predictors for DAPT non-compliance in this cohort.

Conclusion

Approximately 5 out of 10 patients disrupt DAPT due to non-compliance. This investigation provides an insight on additional predictors of non-compliance to DAPT, helping us to identify and address specific patient-related factors for disruption.
Gráficos de controle fuzzy: a evolução e as tendências para pesquisas futuras nos últimos dez anos por meio de uma análise bibliométrica
Authors: Mendes Amanda dos Santos , Freitas Marcela Aparecida Guerreiro Machado de , Rocha Rizol Paloma M.S.
Published: July 2021

Os gráficos de controle fuzzy podem ser amplamente utilizados, apesar de serem uma ferramenta da qualidade relativamente nova. Este artigo relata uma análise e interpretação bibliométrica de dados de artigos relativos a gráficos de controle fuzzy de 2007 a 2017. A contribuição científica deste artigo é demonstrar indicadores bibliométricos e apresentar sugestões para futuras pesquisas. Com isso, incentiva-se as direções existentes neste campo de pesquisa e explora-se novos horizontes. Os resultados revelaram que Cengiz Kahraman é o autor mais citado no que se refere a gráficos de controle fuzzy e Istanbul Teknik Universitesi, é a instituição mais citada, colocando a Turquia como o país que mais se destaca em tal área de pesquisa. O artigo mais citado é “An alternative approach to fuzzy control charts: Direct fuzzy approach”, de Gulbay e Kahraman, publicado no periódico mais citado, Information Sciences. A principal tendência para pesquisas futuras observada foi a aplicação de conjuntos fuzzy type-2 nos gráficos de controle.
A importância de um escritório de gerenciamento de projetos em uma organização
Authors: Parolini Junior José Tadeu , Satller Thiago do Carmo , Pereira Andrey Gomes , Silva Letícia Cristina
Published: July 2021

As empresas encontram-se em constante transformação e necessitam a todo momento de inovação para conseguirem atender, de forma eficaz e eficiente, as demandas que surgem nas rotinas do seu dia a dia. Assim, a forma básica de controle para qualquer mudança que irá ocorrer dentro de uma organização, inicia-se através de um projeto. Entretanto, para que um projeto alcance o objetivo proposto é necessário que exista um gerenciamento para cada uma das fases que o compõe: iniciação, planejamento, execução, controle e monitoramento e encerramento. Desta forma, este artigo irá apresentar como um escritório de gerenciamento de projetos (Project Management Office – PMO) unificado pode ser importante para uma organização. Será realizado um levantamento bibliográfico sobre o tema abordado e em seguida, um estudo em uma mineradora para verificar como é o gerenciamento de projetos e o funcionamento dos escritórios de gerenciamento de projetos nesta organização. Após a realização do estudo foi possível concluir que o escritório de projetos é uma forma não só de unificar a gestão, mas também de aprimorar os resultados e melhorar de forma continuada os processos envolvidos.
Transição para servitização: uma revisão estruturada da literatura
Authors: Pedrinho Gustavo Canaver , Miguel Paulo A. Cauchick
Published: July 2021

Empresas típicas de manufatura vêm acrescentando serviços aos produtos com a finalidade de criar ofertas, bem como fortalecer o relacionamento com os clientes. Nesse contexto, o presente trabalho tem como objetivo investigar a literatura sobre servitização, destacando transição de empresas típicas de manufatura ocorrida nos últimos anos. O processo de seleção do conjunto de publicações para análise resultou em 50 artigos em consonância com o tema de pesquisa nas bases de dados Web of Science, Scopus e ScienceDirect. A análise bibliométrica identificou que os artigos foram escritos por 145 autores e coautores, publicados em 27 periódicos em um período de 10 anos (2009-2019) em 14 países resultando em um conjunto de 414 palavras-chave. A análise de conteúdo mostrou que em uma parte das publicações, o tema central está direcionado para a transição para servitização, incluindo também os desafios identificados para dar suporte a esta transição. Outro tema ainda pouco explorado, mas com grande potencial é a servitização digital, visto que, com o avanço da tecnologia, novas soluções podem surgir. Estes resultados indicam uma necessidade de estudos com este tema que exploram o uso de tecnologia para o desenvolvimento de novas soluções que fortaleçam as ofertas de serviços integrados aos produtos.
Reestruturação das equipes de manutenção em uma empresa de saneamento básico utilizando o roteirizador Geo-Rota web
Authors: Ramos Póvoa Carlos Leonardo , Keller Paula Daudt Grativol , Barcelos Ricardo de Souza Barreto
Published: July 2021

Este trabalho consiste no desenvolvimento de uma proposta de reestruturação de equipes de manutenção em uma empresa prestadora de serviços de saneamento básico. A pesquisa é justificada pela alta demanda de serviços, o que torna vital para o sucesso das operações o máximo aproveitamento da capacidade produtiva dos recursos disponíveis. Com o modelo de reestruturação proposto obteve-se um aumento na produtividade das equipes a partir da otimização dos roteiros de deslocamento, que permitiram reduzir o tempo total de rota e a quilometragem total percorrida. Como consequência, o número de equipes necessárias para atender uma mesma demanda de serviços foi reduzida. Ao aumentar a produtividade das equipes em campo é possível cumprir com prazos cada vez mais rigorosos de execução de serviços e fornecer um atendimento de maior qualidade, atendendo as exigências de clientes, investidores e órgãos reguladores. Uma nova formulação matemática para o Problema de Roteirização de Ordens de Serviço (SOVRP) é proposta, bem como testes computacionais do modelo.
Estudo ergonômico da carga mental e de sintomas osteomusculares relacionados ao trabalho em um Tribunal Judiciário Federal
Authors: Silva Aleson Belo da , Marques Amanda Braga , Macedo Thiago Allan Marques de , Cabral Marco Antonio Leandro , Souza Ricardo Pires de
Published: July 2021

Este estudo tem o objetivo de avaliar as condições ergonômicas dos servidores que atuam em serviços processuais do Tribunal Judiciário Federal, com sede no Rio Grande do Norte/Brasil, por meio da aplicação de ferramentas de avaliação de carga mental e de percepção de dores osteomusculares no contexto laboral. Com investigação focada nos domínios da ergonomia cognitiva e física por meio da demanda da organização que possui alto índice de absenteísmos ocasionados por fatores ergonômicos. Ademais, o estudo também investiga o regime do teletrabalho, realizado por mais de 50% dos servidores do quadro. A pesquisa foi desenvolvida por meio da aplicação do questionário NASA TLX, para avaliação de carga mental de trabalho no domínio da ergonomia cognitiva, e do questionário Nórdico para avaliação de sintomas osteomusculares, no domínio da ergonomia física. Os resultados revelam a necessidade de intervenção ergonômica e melhorias nas condições de trabalho para minimizar os impactos da atividade laboral nos colaboradores por meio de ações e programas de qualidade de vida no trabalho. Revelam também a necessidade de acompanhamento das atividades realizadas por meio do teletrabalho, com definição clara de processos e ações ergonômicas visando garantir o bem estar dos servidores presencialmente e em teletrabalho.
United States security cooperation with Kenya in the second decade of the 21st century
Authors: Jureńczyk Rafał
Published: July 2021

The subject of the paper is the cooperation of the United States with Kenya in the area of security in the second decade of the 21st century. The introduction contains the methodological assumptions of the paper and a synthetic historical background. The first section of the paper covers the theoretical framework. The second section outlines the increase of the United States’ strategic involvement in Africa, including East Africa, in the 21st century. The third section discusses the joint efforts of the US and Kenya in combating terrorism and piracy. The fourth section is devoted to US training and development assistance for the Kenyan security sector. The considerations are carried out within the framework of the postcolonial current of the theory of international relations. During the research, the method of analyzing text sources was used. The main thesis of the paper assumes that although Africa, including Kenya, was not a particularly important area of strategic interest of the United States, these countries had significant common security interests and undertook cooperation to implement them. First of all, it concerned counteracting international terrorism, but also the general stabilization of East Africa. In the future, the importance of East Africa in American politics might systematically increase, both in the area of economy and security, which will entail further strengthening of cooperation between the US and Kenya.
Territorial development in today’s Romania: the strenuous quest for a European patterned regionalization
Authors: Dan Horaţiu , Maniu Mircea
Published: July 2021

The rationale of this paper would be extracted from the fact that a regional policy, in the full European patterned comprehensive sense, was never thoroughly pursued in Romania since joining EU in 2007. Our research try to evaluate if there are any preliminary historical assets in order to ease the process of modern regionalization and further on to investigate the policies that were officially implemented in order to comply with the overall EU territorial developmental framework. Last but not least we investigate the ad-hoc approaches of several of the local public administrators in the country, innovative approaches conceived in order to mend the evident lack of consistency of governmental public policies in this area. Within this respect our endeavor is to benchmark the overall progress of the country towards genuine regional development to some recently taken steps by some local administrative bodies, steps that already proved to be lucrative for a few counties in North-Western Romania.
Czy Polacy są za uniwersalizmem świadczeń – badanie społeczności lokalnej po wprowadzeniu Programu „Rodzina 500 Plus”. Raport z badań – region koniński
Authors: Nowiak Wojciech
Published: July 2021

Od 2016 roku realizowany jest w Polsce program „Rodzina 500 Plus”, stanowiący istotny element polityki rodzinnej. W artykule przedstawiono wyniki badania, dotyczącego stosunku wyodrębnionej grupy mieszkańców do programu oraz stopnia poparcia dla jego uniwersalnego charakteru, na poszczególnych etapach realizacji. Pierwsze badanie nastąpiło po prawie roku funkcjonowania programu. Jego celem była wstępna ocena dotycząca realnego odbioru przez społeczeństwo pierwszych miesięcy realizacji Programu 500+, zarówno z punktu widzenia beneficjentów, jak i obserwatorów. Badanie z roku 2017 pozwoliło na szczegółową analizę, ocenę z punktu widzenia uniwersalnego charakteru świadczeń, stopnia akceptacji programu oraz postulowanych zmian. Studia zostały przeprowadzone metodą wywiadów bezpośrednich. We wszystkich badanych grupach widoczny jest brak zrozumienia i akceptacji uniwersalnego charakteru świadczenia. Badania z roku 2017 ukazują krytyczne wnioski wszystkich grup do uniwersalnych rozwiązań o charakterze pieniężnym, mankamenty tej formy są widoczne na konkretnych przykładach.
Inkluzja społeczeństwa obywatelskiego w procesy podejmowania decyzji na poziomie lokalnym: wpływ projektów międzynarodowych
Authors: Atnazheva Liliia
Published: July 2021

Celem artykułu jest wyodrębnienie czynników, które mają bezpośredni wpływ na poziom uczestnictwa mieszkańców w procesach administracyjnych, oraz opracowanie propozycji, które zapewnią systematyczne stosowanie mechanizmów włączenia społeczności lokalnej do podejmowania decyzji. Obecnie na Ukrainie trwają procesy decentralizacji, które mają na celu podwyższenie poziomu zarządzania, w związku z czym odbyło się łączenie rad miejskich i wiejskich. Znaczący wpływ na te procesy mają projekty międzynarodowe, pomagające nowoutworzonym hromadom (jednostka podziału administracyjnego) wprowadzać lepsze praktyki zarządzania, zwłaszcza poprzez włączenie społeczeństwa obywatelskiego do podejmowania decyzji na poziomie lokalnym. Problem polega na tym, że mieszkańcy z jednej strony nie wiedzą, jakie istnieją mechanizmy uczestnictwa w procesach administracyjnych, a z drugiej strony – władze lokalne niewystarczająco informują o możliwościach włączenia społeczeństwa do podejmowania decyzji. W niniejszej pracy zastosowano dwie główne techniki badawcze: wywiad i ankietowanie. Analiza została przeprowadzona na przykładzie nowoutworzonych hromad, które uczestniczyły w Programie „Decentralizacja przynosi lepsze wyniki i efektywność” (DOBRE), realizowanym przez międzynarodową organizację Global Communities i finansowanym ze środków Agencji Stanów Zjednoczonych ds. Rozwoju Międzynarodowego (USAID). Ustalono, że mieszkańcy nie są wystarczająco zorientowani w mechanizmach umożliwiających im uczestnictwo w procesach podejmowania decyzji na szczeblu lokalnym oraz możliwości ich wykorzystania. Ponadto stwierdzono, że istnieje związek wzajemny: im wyższy poziom wiedzy społeczeństwa obywatelskiego (jak otrzymać dostęp do informacji o usługach, za które odpowiadają władze lokalne), tym wyższy poziom jego zadowolenia z uczestnictwa w podejmowaniu decyzji. Potencjalnym zagrożeniem po zakończeniu projektów międzynarodowych może być cofnięcie w przemianach, które zostały wprowadzone w hromadach. W celu uniknięcia takiej sytuacji może być zaproponowane stworzenie w strukturze jednostek samorządowych osobnego wydziału odpowiadającego za wdrożenie przemian w hromadach albo przegląd funkcji już istniejących wydziałów, ich reformowanie i wprowadzenie „dobrych praktyk” dla monitoringu, analizy, zbioru danych oraz stworzenie warunków dla wewnętrznej koordynacji kierunków rozwoju.
Risk Evaluation Factor of Health Promotion Medical Insurance: An Analysis Focusing on Cost of Telematics and Policyholder’s Coverage Selection
Authors: Suzawa Yoshihiko
Published: July 2021

This study aims to demonstrate the effect of the cost of telematics and loss ratio improvement on the coverage demand for health promotion medical insurance. Real-time monitoring via telematics is expected to alleviate moral hazard of insured persons through the “analogical experience rating system,” resulting in a decreased claim cost and an improved loss ratio. In reality, however, the real-time monitoring on a continuous basis imposes a cost burden on insurers and thus, certain expense loadings apply to insurance premiums. The analysis based on the modified separating market equilibrium model reveals that people tend to opt for partial insurance coverage, and high-risk individuals even stay uninsured unless the expense loadings are not excessive. This result implies that the demand for health promotion medical insurance can decrease, and may conduce a market shrinkage, unless the improvement of loss ratio sufficiently surpasses the cost of telematics utilization.
Relationship of Gensini score with retinal vessel diameter and arteriovenous ratio in senile CHD
Authors: Wang Ning , Liang Changsen
Published: July 2021

Background

This study aimed to find the correlation of Gensini score with retinal vessel diameter and arteriovenous ratio in elderly patients with coronary heart disease (CHD).

Methods

This study included 120 senile CHD patients as the CHD group and 100 healthy individuals as the normal group (NG). Gensini score was used to evaluate the severity of coronary artery lesions. Central retinal artery equivalents (CRAE), central retinal venular equivalents (CRVE), and arteriovenous ratio (AVR) were measured.

Results

CHD group has lower CRAE and AVR than NG, while higher CRVE was observed in NG. CRAE and AVR in UAP (unstable angina pectoris) and AMI (acute myocardial infarction) groups showed reduction (stable angina pectoris); however, enhanced CRVE and Gensini scores in UA and AMI groups were observed as compared to the SAP group. CRAE and AVR in moderate and severe groups were reduced to a greater extent compared to the mild groups, while enhanced CRVE and Gensini scores were observed more often in the severe group than the mild group. CRAE and AVR were negatively correlated with the Gensini score; however, CRVE was positively correlated with the Gensini score.

Conclusion

AVR is expected to be a noninvasive index to diagnose and predict senile CHD, which has a certain evaluation value. Diabetes, smoking history, and TC are independent risk factors of senile CHD.
Sulfoquinovose metabolism in marine algae
Authors: Scholz Sabine , Serif Manuel , Schleheck David , Sayer Martin D.J. , Cook Alasdair M. , Küpper Frithjof Christian
Published: July 2021

This study aimed to survey algal model organisms, covering phylogenetically representative and ecologically relevant taxa. Reports about the occurrence of sulfonates (particularly sulfoquinovose, taurine, and isethionate) in marine algae are scarce, and their likely relevance in global biogeochemical cycles and ecosystem functioning is poorly known. Using both field-collected seaweeds from NW Scotland and cultured strains, a combination of enzyme assays, high-performance liquid chromatography and matrix-assisted laser-desorption ionization time-of-flight mass spectrometry was used to detect key sulfonates in algal extracts. This was complemented by bioinformatics, mining the publicly available genome sequences of algal models. The results confirm the widespread presence of sulfonates and their biosynthetic pathways in macro- and microalgae. However, it is also clear that catabolic pathways, if present, must be different from those documented from the bacterial systems since no complete cluster of gene homologues of key genes could be detected in algal genomes.