Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

The complete genome sequence of Chromobacterium violaceum reveals remarkable and exploitable bacterial adaptability

Chromobacterium violaceum is one of millions of species of free-living microorganisms that populate the soil and water in the extant areas of tropical biodiversity around the world. Its complete genome sequence reveals (i) extensive alternative pathways for energy generation, (ii) ≈500 ORFs for transport-related proteins, (iii) complex and extensive systems for stress adaptation and motility, and (iv) wide-spread utilization of quorum sensing for control of inducible systems, all of which underpin the versatility and adaptability of the organism. The genome also contains extensive but incomplete arrays of ORFs coding for proteins associated with mammalian pathogenicity, possibly involved in the occasional but often fatal cases of human C. violaceum infection. There is, in addition, a series of previously unknown but important enzymes and secondary metabolites including paraquat-inducible proteins, drug and heavy-metal-resistance proteins, multiple chitinases, and proteins for the detoxification of xenobiotics that may have biotechnological applications

Measuring and Evaluating Organizational Innovation Capacity and Performance from Systemic and Sustainability-Oriented Perspective

In the last decades, several multidimensional models for measuring and evaluating the innovation capacity and performance of organisations have been designed by researchers and consulting firms and adopted by established innovative organisations worldwide. However, the topic of measurement and evaluation models that are designed for sustainability-oriented innovation management has remained underexplored by researchers and practitioners. From this perspective, this work proposes a conceptual model for measuring and evaluating the sustainability-oriented innovation capacity (SOIC) and performance (SOIP) of established organisations, guided by the following principles: a multidimensional structure, stakeholder goal orientation, interdependence and feedback loop analyses, innovation process orientation and ease of implementation and use. In line with these principles, the proposed model combines the balanced scorecard (BSC) framework with a hybrid multicriteria methodological approach. Furthermore, it considers the interdependencies between the key innovation indicators (KIIs), which are classified according to four perspectives of an adapted BSC framework. The proposed conceptual model, and the empirical results that demonstrate its applicability in an organisational context, may contribute to improving the current practices for measuring and evaluating the SOIC and SOIP, which could help organisations to adjust their strategies to create sustainable value for the new era of business

Desarrollo del pensamiento lógico y rendimiento académico de los estudiantes

El estudio del desarrollo pensamiento lógico y su incidencia en el rendimiento académico de los estudiantes del Instituto Tecnológico Superior Vicente Rocafuerte involucra el desarrollo psicológico y evolutivo del ser humano a través de los distintos aportes de los teóricos de la psicología cognitiva para desarrollo del pensamiento lógico. Con el fin de lograr competencias para razonar, procesar y retener información y lograr un aprendizaje natural, contextual y dirigido pueden ayudar a mejorar el desarrollo intelectual del sujeto y como resultado elevar el nivel académico de los estudiantes. Finalmente se desea identificar y relacionar la importancia de las variables y diseñar un módulo de estrategias para el desarrollo del pensamiento lógico y con la aplicación del mismo promover las habilidades para resolver problemas, conflictos, aprender de manera autónoma , tomar decisiones, regular impulsos emocionales y con ello superar el nivel de aprovechamiento académico, logrando la aprobación de los cursos del año lectivo con éxito, el desarrollo del pensamiento lógico debe ser aprovechado en todos los programas de educación superior como en cualquier área de la vida del estudiante que sin dudar beneficiará en su ejercicio profesional como aporta a la sociedad

The Impact of Human Factors on the Software Testing Process: The Importance of These Factors in a Software Testing Environment

Software testing is a key process that ensures a reliable quality product, and like other activities in the development process, have a wide range of tools available, but still requires a lot of human work, where the final quality of the software can be impacted directly by several factors. In this sense, this study aims to identify the human factors (cognitive, operational and organizational) present in the test process and to define the influence of these factors during their execution. Thus, the article presents a study with quantitative methods and techniques of the survey type, in which 112 professionals from the test area participated in 17 Brazilian states. The results provide a set of human factors that correlate with the final quality of a software product or service

Boodlea composita (Harv.) F.Brand (Chlorophyta) no litoral nordeste do Brasil

Este estudo relata a primeira ocorrência de Boodlea composita (Harv.) F.Brand (Chlorophyta) para o litoral nordeste do Brasil e o segundo registro para o litoral brasileiro. O material foi coletado ao longo do litoral da Bahia (08º20'07"-18º20'07''S e 30º20'37"-46º36'59"W). A distribuição de B. composita foi ampliada no litoral do Brasil, uma vez que esta era conhecida apenas para a região sudeste, especificamente para Cabo Frio, Rio de Janeiro. No Atlântico Americano, B. composita apresenta limite norte de distribuição nas Bermudas e limite sul, no Rio de Janeiro