Assessment of Social Sustainability for the Construction Workforce

Minimal research has focused on the social dimension of sustainability in the built environment especially as it relates to the construction workforce. As a result, there are few to no tools available to industry stakeholders to holistically assess and improve the social sustainability of the construction workforce. Given the high employee turnover rates and shortage of skilled workers in the construction industry, there is a paramount need to develop reliable and practical tools to assess and improve the social sustainability of the construction workforce. Being able to frequently assess and improve social sustainability at the workforce level will assist construction organizations, and ultimately the entire construction industry, develop, attract, and retain skilled workers. The overreaching goal of this research is to enable assessing and improving social sustainability in construction at the workforce level. To achieve the research goal, the attributes, indicators, and metrics influencing the social sustainability of the construction workforce were identified, categorized, and quantified. By integrating the identified attributes, indicators, and metrics into an evaluation procedure, a practical tool to assess and improve social sustainability of the construction workforce was developed. The developed tool is referred to as the workforce sustainability assessment tool (W-SAT). The present research contributes to the body of knowledge by fulfilling the industry need for an instrument to assess and improve the social attributes of the construction workforce

Measuring and Evaluating Safety Maturity of Construction Contractors: Multicriteria Decision-Making Approach

Evaluating the safety maturity of construction contractors before awarding the contract is an effective strategy that many owners have started to implement. Given the importance of workplace safety, awarding the contract to safer contractors can enhance project performance outcomes in terms of safety, quality, cost, and schedule. Safety maturity is one quality of a construction organization encompassing interdependent factors that can be used to evaluate expected safety performance. However, there is no formal decision-making framework available in literature that owners can use to evaluate contractor safety maturity. The present study aims to bridge this gap in safety knowledge by proposing a decision-making framework that can be used to evaluate the safety maturity of construction contractors. Development of the decision-making framework included two tasks. First, an integrative literature review to identify influential safety maturity factors and their potential indicators was performed. The result of the review revealed seven factors (safety leading indicators, safety lagging indicators, safety and supervisory personnel, system maturity and resiliency, preconstruction services, technology and innovation, and safety culture) that influence the safety maturity of construction contractors. Second, the identified factors, and their indicators, were integrated into a formal multicriteria decision-making method, referred to as Choosing by Advantages, to evaluate the safety maturity of five construction contractors on a selected case study project. The proposed framework is expected to provide practical and theoretical directions on how to evaluate contractor safety maturity using relevant evaluation factors and sound decision-making methods

ROLE OF TARGETED THERAPY IN THE COMBINATION TREATMENT OF PATIENTS WITH KIDNEY CANCER AND METASTATIC BRAIN INVOLVEMENT

In patients with kidney cancer (KC), the rate of metastatic brain involvement is 2-11%, is steadily growing, and is one of the important reasons for treatment failures in these patients. Surgery and radiotherapy, including radiosurgery, must be considered as optimal treatments for patients with KC and brain metastases. Systemic drug therapy has recently played a more and more increasing role in the treatment of patients with a progressive brain tumor process. At the same time, there are no exact pharmacokinetic data on drugs registered for the treatment of disseminated KC in respect to their concentration in the human central nervous when they are used in therapeutic doses. On the basis of the data of the literature review and the results of the authors’ studies, it may be concluded that while none of the target agents has still shown any significant advantage over others in treating KC patients with brain metastases. All the drugs have demonstrated their ability to achieve a clinical and X-ray verified objective effect (as stabilizations in most cases) in treating brain metastases. The most data are available on the therapeutic efficacy of sunitinib and sorafenib. In case of progressive brain tumor process, drug treatment should be individually discussed in each situation in accordance with standard approaches to treating patients with disseminated KC

COMBINED CHEMOTHERAPY INCLUDING PROCARBAZINE (NATULAN) IN THE TREATMENT OF ANAPLASTIC OLIGODENDROGLIOMAS

Our investigation has demonstrated the high efficiency of combined chemotherapy (CT) including procarbazine + lomustine or procarbazine + lomustine + vincristine in patients with anaplastic oligodendrogliomas. Postoperative CT has been recently recommended for patients with deletion of chromosomes 1p and 19q, by taking into account the good prognosis of a therapeutic effect, better parameters of time till progression in this patient group, and a risk for cognitive impairments after brain radiotherapy

СRANIAL AND INTRACRANIAL METASTASES OF THYROID CANCER

Thyroid cancer metastasis to the brain is rare and little-studied pathology. Problems of their diagnosis and treatment remain to be solved. Features of this group is a metastatic lesion of the brain and bones of the cranial vault with extra- and intracranial growth. The paper details the clinical picture, X-ray, morphological diagnosis and treatment of patients with intracranial metastases thyroid cancer

ХИРУРГИЧЕСКИЙ ЭТАП В КОМПЛЕКСНОМ ЛЕЧЕНИИ ПАЦИЕНТОК С ЦЕРЕБРАЛЬНЫМИ МЕТАСТАЗАМИ РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ

Brain metastases of breast cancer are severe complication of oncological process. Despite the spreading of the process, many patients receive treatment and live for years in contrast to patients with cerebral metastases of other cancers (lung cancer, melanoma, renal cell carcinoma). At different stages of metastatic disease in these patients may be offered different types of treatment: chemotherapy, hormonal therapy, targeted therapy, radiotherapy, radiosurgery, surgical treatment. However, there are no standards that define the indications for surgical treatment of cerebral metastases of breast cancer. This article describes the surgical techniques and defines indications and contraindications for surgical treatment.Церебральные метастазы рака молочной железы являются грозным осложнением онкологического процесса. Несмотря на диссеминацию процесса многие пациентки живут и получают лечение годами, в отличие от пациентов с церебральными метастазами других злокачествен- ных опухолей (рак легкого, меланома, почечноклеточный рак). И на разных этапах метастатической болезни этим пациенткам могут быть предложены различные виды лечения: химиотерапия, гормонотерапия, таргетная терапия, лучевая терапия, радиохирургия, хирургическое лечение. Однако стандартов определяющих показания к хирургическому лечения при церебральных метастазах рака молочной железы в настоящее время нет. В статье описываются хирургические методики, определяются показания и противопоказания к хирургическому лечению

ЛЕКАРСТВЕННАЯ ТЕРАПИЯ БОЛЬНЫХ РАКОМ МОЛОЧНОЙ ЖЕЛЕЗЫ C МЕТАСТАТИЧЕСКИМ ПОРАЖЕНИЕМ ГОЛОВНОГО МОЗГА

The Blokhin RCRC the effectiveness of various schemes of drug therapy in breast cancer patients with brain metastases was evaluated.When using the schemes with anthracyclines (CAF, AC) among 26 patients objective response in the brain (full and partial regression) was registered in 16 (62%) patients (previously untreated patients). Median survival was 12 months. In the group of patients received monotherapy (30 patients), capecitabine was administered at a dose of 2000 mg/m2/day per os the 1 to 14 days every 3 weeks. Partial effect in the brain was registered in 9 patients (30%). Median survival was 15.1 months. In the combination therapy group (capecitabine + radiotherapy) among 30 patients overall effect in the brain was registered in 4 patients (13%), partial response - 18 (60%). Median survival was 22 months. The effectiveness of chemotherapy scheme gemcitabine and cisplatin in 30 breast cancer patients with metastases in the brain, previously treated with I-III line of chemotherapy and radiation therapy in the area of the brain was evaluated. In 4 cases (13.3%) complete regression of metastases in the brain was achieved. In 12 patients (40.0%) a partial regression of metastases in the brain was achieved. Median survival was 10 months. Twenty-three breast cancer patients with overexpression of Her2/neu, and with metastatic brain lesions received capecitabine + lapatinib. Complete response in the brain was achieved in 2 cases (8.7%), partial regression - in 9 cases (39.1%) and stabilization of the disease - in 10 cases (43.5%). Median overall survival was 16 months. Nine patients with breast cancer with overexpression of Her2/neu, and with metastatic brain lesions received therapy with capecitabine + trastuzumab. In 2 cases (22.2%) complete regression of metastases in the brain was achieved, in 4 cases (44.4%) - partial response, in 2 cases (22.2%) - stabilization. The median overall survival was 15.5 months.Thus, the results of this study have shown high efficiency of drug therapy in the treatment of breast cancer patients with metastases in the brain.В РОНЦ им Н. Н. Блохина РАМН изучалась эффективность  различных схем лекарственной  терапии у больных с метастазами рака молочной железы в головном мозге.При применении схем с антрациклинами (CAF, AC) у 26 больных объективный эффект в мозге (полные и частичные регрессии) зарегистрирован  у 16 (62%) пациенток (ранее нелеченые больные). Медиана выживаемости больных составила 12 месяцев. В группе пациентов, получавших монотерапию (30 человек), капецитабин назначался  в дозе 2000 мг/м2/сутки внутрь с 1 по 14 дни, каждые 3 недели.  Частичный эффект в головном мозге зарегистрирован  у 9 пациенток (30%). Медиана выживаемости составила 15,1 месяца. В группе комбинированной  терапии (капецитабин + лучевая терапия) из 30 пациентов полный эффект в головном мозге зарегистрирован у 4 пациенток (13%), частичный эффект — у 18 (60%). Медиана выживаемости составила 22 месяца. Проводилось исследование  по изучению эффективности химиотерапии по схеме гемцитабин + цисплатин у 30 больных раком молочной железы с метастазами в головном мозге,  ранее  получавших I–III линии химиотерапии  и лучевую терапию на область головного мозга. В 4 случаях (13,3%) достигнута полная регрессия  метастазов в головном мозге. У 12 больных (40,0%) достигнута частичная регрессия  метастазов в головном мозге. Медиана общей выживаемости составила 10 мес. 23 больным раком молочной железы с гиперэкспрессией Her-2/neu и c метастатическим поражением головного мозга проводилась терапия по схеме капецитабин + лапатиниб.  В 2 случаях (8,7%) достигнута полная регрессия  в головном мозге, в 9 случаях (39,1%) — частичная регрессия, в 10 случаях (43,5%) — стабилизация болезни. Медиана общей выживаемости составила 16 месяцев. 9 больным раком молочной железы с гиперэкспрессией Her-2/neu и c метастатическим поражением головного мозга проводилась терапия по схеме капецитабин + трастузумаб.  В 2 случаях (22,2%) зарегистрирована  полная регрессия  метастазов в головном мозге, в 4 случаях (44,4%) — частичная регрессия,  в 2 случаях (22,2%) — стабилизация. Медиана общей выживаемости составила 15,5 месяцев.Таким образом,  результаты проведенных исследований показали высокую эффективность лекарственной терапии в лечении больных раком молочной железы с метастазами в головном мозге

Process Mining for Six Sigma

Process mining offers a set of techniques for gaining data-based insights into business processes from event logs. The literature acknowledges the potential benefits of using process mining techniques in Six Sigma-based process improvement initiatives. However, a guideline that is explicitly dedicated on how process mining can be systematically used in Six Sigma initiatives is lacking. To address this gap, the Process Mining for Six Sigma (PMSS) guideline has been developed to support organizations in systematically using process mining techniques aligned with the DMAIC (Define-Measure-Analyze-Improve-Control) model of Six Sigma. Following a design science research methodology, PMSS and its tool support have been developed iteratively in close collaboration with experts in Six Sigma and process mining, and evaluated by means of focus groups, demonstrations and interviews with industry experts. The results of the evaluations indicate that PMSS is useful as a guideline to support Six Sigma-based process improvement activities. It offers a structured guideline for practitioners by extending the DMAIC-based standard operating procedure. PMSS can help increasing the efficiency and effectiveness of Six Sigma-based process improving efforts. This work extends the body of knowledge in the fields of process mining and Six Sigma, and helps closing the gap between them. Hence, it contributes to the broad field of quality management

The health status of the Russian pediatric population exposed to radiation from the Chernobyl accident: Results of a 29-year follow-up of the Children's Research and Practical Center for Anti-Radiation Protection

The paper presents the results of a long-term follow-up of the health status of children exposed to radiation from the 1986 Chernobyl accident. Five reference cohorts have been identified, each of which has individual features of the development of radiation-induced diseases. A cohort of babies irradiated in utero, a cohort of the children of Chernobyl accident liquidators, and a cohort of mI-irradiated children born in 1969-1986 are considered