The Recruitment of Intuitive Managers

French scientist, Alexis Carrel said, “All great men are gifted with intuition. They know without reasoning or analysis, what they need to know.” Studies among leaders confirm this and underscore the value of developing intuition. Business is all about rational, orderly systems for strategic planning, decision-making, forecasts, operations, budgeting, supervision and control, production and practically every other facet of an organisation. Under rising pressure and ambiguity, rational thinking may not perform satisfactorily. In the context of management decision-making, research conducted by Nutt (1999) reveals that rational/logic based strategies struggle to reach the fifty percent success mark. Business leaders the world over are acknowledging that many important decisions, and career choices are increasingly based on intuition or gut feel. The recruitment of highly intuitive managers can enable organisations to tackle contexts and issues thrown up by the challenges of this century. To identify managers with high levels of intuition is, therefore, a necessary step. Validated and reliable tests are available to measure intuition in managers. The paper further suggests ways to fine tune the process to recruit intuitive managers. Keywords: Intuition, Recruitment, Management, Intuitive thinking, Intuitive decision making, CSI, REI

I2RS Architecture in SDN and its Use Cases

With the introduction of virtualization and software defined networking, the way network functions has been completely revolutionized. These days, one controller is required to control and monitor hundreds of devices, a job which usually required a human administrator. This process is fast and simple, but still the way the controller interacts with the router or any networking device is still not fully optimized in terms of the ease, the speed at which new policies are implemented over the networking device. It can further be evolved with the help of I2RS protocol. I2RS protocol can utilize existing protocols to inject routes directly into the local routing information base of a networking device. With the help of topology manager, it can provide full-fledged view of the network topology. This can be helpful in taking decisions regarding the network. With the access to local RIB the feedback loop between sensing the network and implementing new policies can be significantly tight. This can make the network completely real time. (As cited in abstract.) *Publication date not found

Interdisciplinary handover between obstetric nursing and neonatal physician teams: An observational study

Objective: We investigated the content and quality of communication of interservice interprofessional handover between obstetric nurses and neonatal physicians for high-risk deliveries. Design: Observational study. Setting: Labour and delivery unit at a tertiary care hospital. Method: We audio-recorded handovers between obstetric and neonatal teams (n=50) and conducted clinician interviews (n=29). A handover content framework was developed and used to qualitatively code missing core and ancillary content and their potential for adverse events. Results: 26 (52%) handovers missed one or more clinical content elements; a third of the handovers missed at least one core clinical content element. Increase in the number of missed clinical content elements increased the odds of potential adverse events by 2.39 (95% CI1.18 to 5.37). Both residents and nurses perceived handovers to be of low quality and inconsistent and attributed it to the lack of a structured handover process. Conclusion: Streamlining handover processes by instituting standardisation approaches for both information organisation and communication can improve the quality of neonatal handovers

Role of Silver Diamine Fluoride in Permanent Tooth Caries Management: A Narrative Review

Introduction: Silver Diamine Fluoride is vastly used in preventive and therapeutic management of deciduous dentition. It includes its utilization as a fissure sealant, for arresting carious lesions and as a pulp capping agent. However, its use in permanent dentition is limited. Hence, the present narrative review has been conducted in order to assess SDF use in permanent dentition. Methodology: Present review was conducted to evaluate role of SDF in permanent tooth caries management. A rigorous literature search was conducted utilizing various databases suchas PubMed, Scopus, Web of Science, Cochrane Database, and CTRI (Clinical Trial Registry - India). The search period was defined to be last 10 years, that is, from 1st January 2012 to 31st December 2021. Terminologies "Silver Diamine Fluoride," "SDF," "Permanent Dentition” were included. The terminologies were combined using Boolean Operations "AND" and "OR". Results:  7 studies were identified after following inclusion and exclusion criteria. The included studies were evaluated for study design, nature of trial along with its type, materials compared and procedure performed along with the results. Various uses of SDF were identified such as fissure sealant, in root caries management, in proximal or occlusal caries management along with its use as indirect pulp capping agent.  Conclusion: Although SDF use in primary dentition is widely acknowledged. Its use in permanent dentition is still limited. Hence more clinical trials need to be carried out for better understanding of this material

Role of Silver Diamine Fluoride in Permanent Tooth Caries Management: A Narrative Review

Introduction: Silver Diamine Fluoride is vastly used in preventive and therapeutic management of deciduous dentition. It includes its utilization as a fissure sealant, for arresting carious lesions and as a pulp capping agent. However, its use in permanent dentition is limited. Hence, the present narrative review has been conducted in order to assess SDF use in permanent dentition. Methodology: Present review was conducted to evaluate role of SDF in permanent tooth caries management. A rigorous literature search was conducted utilizing various databases suchas PubMed, Scopus, Web of Science, Cochrane Database, and CTRI (Clinical Trial Registry - India). The search period was defined to be last 10 years, that is, from 1st January 2012 to 31st December 2021. Terminologies "Silver Diamine Fluoride," "SDF," "Permanent Dentition” were included. The terminologies were combined using Boolean Operations "AND" and "OR". Results:  7 studies were identified after following inclusion and exclusion criteria. The included studies were evaluated for study design, nature of trial along with its type, materials compared and procedure performed along with the results. Various uses of SDF were identified such as fissure sealant, in root caries management, in proximal or occlusal caries management along with its use as indirect pulp capping agent.  Conclusion: Although SDF use in primary dentition is widely acknowledged. Its use in permanent dentition is still limited. Hence more clinical trials need to be carried out for better understanding of this material

A comparative study of granisetrone, dexamethasone and combination of granisetrone-dexamethasone as prophylaxis for postoperative nausea vomiting during laparoscopic surgeries

Background: In laparoscopic surgeries, insufflation with carbon dioxide triggers vagal afferents on the bowel and peritoneum which induces emesis by activating the vomiting center. It is hypothesized that combined antiemetics with different sites of activity would be more effective than one drug alone for the prophylaxis against PONV. So, the present study was planned to compare the efficacy of granisetron, dexamethasone and combination of granisetron with dexamethasone to prevent PONV.Methods: This randomized prospective double-blind study was performed on 120 patients, aged between 18 and 58 years of ASA physical status I and II of either sex undergoing laparoscopic surgeries under general anesthesia. Patients were randomized in three groups, group I (granisetrone 2 mg I.V.), group II (dexamethasone) 8 mg I.V., group III (granisetrone+dexamethasone) 2 mg+8 mg I.V. with 40 patients in each group. Complete response, incidence of nausea, vomiting, and rescue antiemetic were recorded at specified intervals.Results: A complete response (defined as no PONV and no need for another rescue antiemetic) was achieved in 75% of the patients given granisetron, 70% in dexamethasone and in 92.5% of the patients given granisetron plus dexamethasone (P <0.05). The overall cumulative incidences (0-24 hours) of PONV were 10 (25%) in the granisetron, 12 (30%) in the dexamethasone and 3 (7.5%) in the combination group. No difference in adverse events were observed in any of the groups.Conclusions: The prophylactic therapy of granisetron 2 mg plus dexamethasone 8 mg just before induction of anaesthesia is significantly effective in prevention of PONV in patients undergoing laparoscopic surgeries

Exploration of Molecular Factors Impairing Superoxide Dismutase Isoforms Activity in Human Senile Cataractous Lenses

PURPOSE. To explore different molecular factors impairing the activities of superoxide dismutase (SOD) isoforms in senile cataractous lenses. METHODS. Enzyme activity of SOD isoforms, levels of their corresponding cofactors copper (Cu), manganese (Mn), zinc (Zn), and expression of mRNA transcripts and proteins were determined in the lenses of human subjects with and without cataract. DNA from lens epithelium (LE) and peripheral blood was isolated. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) followed by sequencing was carried out to screen somatic mutations. The impact of intronic insertion/deletion (INDEL) variations on the splicing process and on the resultant transcript was evaluated. Genotyping of IVS4þ42delG polymorphism of SOD1 gene was done by PCR-restriction fragment length polymorphism (RFLP). RESULTS. A significant decrease in Cu/Zn-and Mn-SOD activity (P &lt; 0.001) and in Cu/Zn-SOD transcript (P &lt; 0.001) and its protein (P &lt; 0.05) were found in cataractous lenses. No significant change in the level of copper (P ¼ 0.36) and an increase in the level of manganese (P ¼ 0.01) and zinc (P ¼ 0.02) were observed in cataractous lenses. A significant positive correlation between the level of Cu/Zn-SOD activity and the levels of Cu (P ¼ 0.003) and Zn (P ¼ 0.005) was found in the cataractous lenses. DNA sequencing revealed three intronic INDEL variations in exon4 of SOD1 gene. Splice-junction analysis showed the potential of IVS4þ42delG in creating a new cryptic acceptor site. If it is involved in alternate splicing, it could result in generation of SOD1 mRNA transcripts lacking exon4 region. Transcript analysis revealed the presence of complete SOD1 mRNA transcripts. Genotyping revealed the presence of IVS4þ42delG polymorphism in all subjects. CONCLUSIONS. The decrease in the activity of SOD1 isoform in cataractous lenses was associated with the decreased level of mRNA transcripts and their protein expression and was not associated with either modulation in the level of enzyme cofactors or with INDEL variations

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation