Towards Design Principles for Data-Driven Decision Making: An Action Design Research Project in the Maritime Industry

Data-driven decision making (DDD) refers to organizational decision-making practices that emphasize the use of data and statistical analysis instead of relying on human judgment only. Various empirical studies provide evidence for the value of DDD, both on individual decision maker level and the organizational level. Yet, the path from data to value is not always an easy one and various organizational and psychological factors mediate and moderate the translation of data-driven insights into better decisions and, subsequently, effective business actions. The current body of academic literature on DDD lacks prescriptive knowledge on how to successfully employ DDD in complex organizational settings. Against this background, this paper reports on an action design research study aimed at designing and implementing IT artifacts for DDD at one of the largest ship engine manufacturers in the world. Our main contribution is a set of design principles highlighting, besides decision quality, the importance of model comprehensibility, domain knowledge, and actionability of results

Near Elimination of Ventricular Pacing in SafeR Mode Compared to DDD Modes: A Randomized Study of 422 Patients

Aims:SafeR performance versus DDD/automatic mode conversion (DDD/AMC) and DDD with a 250-ms atrioventricular (AV) delay (DDD/LD) modes was assessed toward ventricular pacing (Vp) reduction. Methods:After a 1-month run-in phase, recipients of dual-chamber pacemakers without persistent AV block and persistent atrial fibrillation (AF) were randomly assigned to SafeR, DDD/AMC, or DDD/LD in a 1:1:1 design. The main endpoint was the percentage of Vp (%Vp) at 2 months and 1 year after randomization, ascertained from device memories. Secondary endpoints include %Vp at 1 year according to pacing indication and 1-year AF incidence based on automatic mode switch device stored episodes. Results:Among 422 randomized patients (73.2 ± 10.6 years, 50% men, sinus node dysfunction 47.4%, paroxysmal AV block 30.3%, bradycardia-tachycardia syndrome 21.8%), 141 were assigned to SafeR versus 146 to DDD/AMC and 135 to DDD/LD modes. Mean %Vp at 2 months was 3.4 ± 12.6% in SafeR versus 33.6 ± 34.7% and 14.0 ± 26.0% in DDD/AMC and DDD/LD modes, respectively (P < 0.0001 for both). At 1 year, mean %Vp in SafeR was 4.5 ± 15.3% versus 37.9 ± 34.4% and 16.7 ± 28.0% in DDD/AMC and DDD/LD modes, respectively (P < 0.0001 for both). The proportion of patients in whom Vp was completely eliminated was significantly higher in SafeR (69%) versus DDD/AMC (15%) and DDD/LD (45%) modes (P < 0.0001 for both), regardless of pacing indication. The absolute risk of developing permanent AF or of remaining in AF for >30% of the time was 5.4% lower in SafeR than in the DDD pacing group (ns). Conclusions:In this selected patient population, SafeR markedly suppressed unnecessary Vp compared with DDD modes. PACE 2012; 35:392–402

Single-chamber Versus Dual-chamber Implantable Cardioverter Defibrillators: Do We Need Physiologic Pacing in The Course?

Background: Many patients with ICD receive different antiarrhythmic drugs (e.g. sotalol, amiodarone, β-blockers) because of ventricular or atrial tachycardias. These drugs can cause AV-block or chronotropic incompetence resulting in a higher percentage of ventricular pacing. Methods: We analyzed in a retrospective study the impact of DDD(R) versus VVI(R) mode on subjective (NYHA classification) and objective parameters [brain natriuretic peptide (BNP), 6 minute walk test, echocardiography] in 12 of 120 patients (age 60.2 ± 11.2 years; 10 males, 2 females) who needed an upgrading of a single to a dual chamber ICD. The ICD had to be upgraded because of chronotropic incompetence in all patients with signs of progressing heart failure. Data were collected in VVI(R)-pacing and after 6 and 12 months in DDD(R)-pacing with a long AV-interval and AV hysteresis to reduce ventricular pacing. Results: The 6 minute walk test (392.4 ± 91.4 vs. 324.6 ± 93.3 m, P < 0.001), NYHA-classification (1.4 ± 0.3 vs. 2.6 ± 0.8, P < 0.0001), BNP (234.1 ± 73.5 vs. 410.4 ± 297.0 pg/ml, P < 0.001), left ventricular ejection fraction (49.8 ± 9.6 vs. 36.5 ± 10.9 %, P < 0.0001) and A-wave (73.6 ± 13.7 vs. 41.0 ± 14.0 cm/sec, P < 0.0001) improved with DDD(R)-pacing after 12 months. The ventricular pacing decreased (84.2 ± 18.1 vs. 1.1 ± 1.7 %, P < 0.0001) after 12 months by DDD(R)-pacing with long AV-interval (220.0 ± 10.4 ms) and AV hysteresis. Conclusion: Our data show a superiority of DDD(R) mode versus VVI(R) mode regarding subjective and objective parameters as NYHA-classification, BNP, 6 minute walk test, left ventricular ejection fraction and left ventricular endsystolic volume after 12 months. The improvements seem to depend on the reduction of ventricular pacing with advanced atrial contraction. But only a small number of patients needed the upgradation

Resource evaluation of geothermal power plant under the conditions of carboniferous deposits usage in the Dnipro-Donetsk depression

The objective of the work is to substantiate the actualization of the problem of obtaining geothermal energy from oil and gas wells of oil and gas production facilities in the central-eastern part of the Dnieper- Donetsk Depression (DDD). The research methodology is based on the collection and statistical processing geophysical data of the DDD oil and gas deposits, the use of balance equations for energy and substance matter. The main result of the work is that the principal technological scheme of the geothermal system has been developed and the geothermal potential of oil and gas wells in the experimental zone has been analyzed. There have been considered the technological and ecological aspects of geothermal heat usage from depleted deposits of the DDD wells, which were disclosed into сarboniferous deposits productive horizons

Protein structure and phenotypic analysis of pathogenic and population missense variants in STXBP1

Background: Syntaxin-binding protein 1, encoded by STXBP1, is highly expressed in the brain and involved in fusing synaptic vesicles with the plasma membrane. Studies have shown that pathogenic loss-of-function variants in this gene result in various types of epilepsies, mostly beginning early in life. We were interested to model pathogenic missense variants on the protein structure to investigate the mechanism of pathogenicity and genotype–phenotype correlations. Methods: We report 11 patients with pathogenic de novo mutations in STXBP1 identified in the first 4293 trios of the Deciphering Developmental Disorder (DDD) study, including six missense variants. We analyzed the structural locations of the pathogenic missense variants from this study and the literature, as well as population missense variants extracted from Exome Aggregation Consortium (ExAC). Results: Pathogenic variants are significantly more likely to occur at highly conserved locations than population variants, and be buried inside the protein domain. Pathogenic mutations are also more likely to destabilize the domain structure compared with population variants, increasing the proportion of (partially) unfolded domains that are prone to aggregation or degradation. We were unable to detect any genotype–phenotype correlation, but unlike previously reported cases, most of the DDD patients with STXBP1 pathogenic variants did not present with very early-onset or severe epilepsy and encephalopathy, though all have developmental delay with intellectual disability and most display behavioral problems and suffered seizures in later childhood. Conclusion: Variants across STXBP1 that cause loss of function can result in severe intellectual disability with or without seizures, consistent with a haploinsufficiency mechanism. Pathogenic missense mutations act through destabilization of the protein domain, making it prone to aggregation or degradation. The presence or absence of early seizures may reflect ascertainment bias in the literature as well as the broad recruitment strategy of the DDD study

Evaluasi Penggunaan Obat Antihipertensi Dengan Metode Atc/Ddd Pada Pasien Stroke Rawat Inap Rsud Dr. Moewardi Tahun 2010 Dan 2011

Stroke adalah penyakit penurunan fungsi sistem saraf pusat secara tibatiba yang berlangsung selama 24 jam dan diperkirakan berasal dari pembuluh darah. Pada penderita stroke yang mempunyai latar belakang hipertensi memerlukan penanganan antihipertensi dengan tepat agar diperoleh hasil yang optimal. Penelitian ini bertujuan untuk mengetahui antihipertensi apa saja yang digunakan pada pasien stroke serta bagaimana mengevaluasi kuantitas penggunaannya di instalasi rawat inap RSUD Dr. Moewardi pada tahun 2010 dan 2011. Jenis penelitian ini merupakan penelitian observasional dengan pengambilan data secara retrospektif, berupa data yang didapat dari lembar rekam medik pasien yang didiagnosis menderita stroke di instalasi rawat inap RSUD Dr. Moewardi. Teknik pengambilan sampel menggunakan cara purposive sampling. Pengolahan data dilakukan dengan menghitung kuantitas penggunaan antihipertensi menggunakan metode ATC/DDD. Hasil penelitian menunjukkan jumlah penggunaan antihipertensi tiga terbanyak untuk pasien stroke rawat inap di RSUD Dr. Moewardi pada tahun 2010 adalah Captopril (36,502 DDD/100 Pasien-hari), Furosemid (14,730 DDD/100 Pasien-hari) dan Nifedipin (9,780 DDD/100 Pasien-hari). Sedangkan pada tahun 2011 adalah Captopril (33,248 DDD/100 Pasien-hari), Amlodipin (9,145 DDD/100 Pasien-hari), dan Furosemid (8,250 DDD/100 Pasien-hari). Selama periode tahun 2010 dan 2011, penggunaan antihipertensi untuk pasien stroke di RSUD Dr. Moewardi tidak mengalami begitu banyak perubaha

Stable Atrial Sensing on Long-Term Follow Up of VDD Pacemakers

Background: The hemodynamic advantages of maintaining AV synchrony through AV synchronous pacing are widely known as compared to single chamber pacing. DDD pacemaker implantation entails higher cost and is technically more challenging than the VDD pacemaker. Methods: Seventy one patients underwent VDD lead (Biotronik GmbH, St. Jude Medical and Medtronic Inc.) implantation at KEM hospital, Mumbai during a period of 3 years through subclavian, axillary and cephalic routes for degenerative, post-surgical or congenital high grade atrioventricular or complete heart block. They were followed up regularly for ventricular threshold and P wave amplitude of the floating atrial dipole. Results: Follow up data of almost 95% of patients is available for a period of 15.8 ± 6.7 months. P wave amplitude at implant was 2.1 ± 0.7mV and at follow up 1.1 ± 0.6mV with mean ventricular threshold of <0.5V at implant and <1V at follow-up. Conclusion: Implantation of a single lead VDD pacemaker is possible in all patients with symptomatic AV block and intact sinus node function without any technical complications. P wave sensing is reliable and consistent with floating atrial lead at an average follow up of 15.8 months, providing an excellent alternative to DDD pacemaker implantation