The evaluation of the level of knowledge of nurses participating in the Regional Program of Workshops for Diabetic Education — initial report

Wstęp. W systemie opieki diabetologicznej w Polsceodpowiedzialność za edukację pacjenta spoczywagłównie na pielęgniarkach. Problemem jest brakszkoleń dostępnych dla większego grona pielęgniarek,które w swojej codziennej praktyce mają stycznośćz pacjentami diabetologicznymi. Celem pracy była analiza poziomu wiedzy pielęgniarek z zakresu diabetologiiuczestniczących w Regionalnym ProgramieWarsztatów Edukacji Diabetologicznej.Materiał i metody. Badaniem objęto 272 pielęgniarkiz województwa kujawsko-pomorskiego, które wzięłyudział w Warsztatach Edukacji Diabetologicznej. Wiedzępielęgniarek przed szkoleniem i po nim ocenianona podstawie identycznego testu diagnostycznegozłożonego z 12 pytań, dotyczącego tematyki poruszanejw czasie warsztatów.Wyniki. Po określeniu granicy zdawalności testu na 60%poprawnych odpowiedzi wykazano, że początkowy testzdało 10% pielęgniarek z oddziałów szpitalnych (grupa A)oraz 18% pielęgniarek pracujących w placówkach podstawowejopieki zdrowotnej (grupa B). Końcowy testzaś zdało 96% pielęgniarek z grupy A oraz 93% pielęgniarekz grupy B. Średnia punktacja uzyskana w teściepoczątkowym przez pielęgniarki grupy A i grupy B się nieróżniła (4,88 ± 2,04 vs 4,67 ± 2,3 punktów; p = 0,46),natomiast w teście końcowym była istotnie wyższaw grupie A w porównaniu z grupą B (10,3 ± 1,26 vs9,41 ± 1,54 punktów, p < 0,0001).Wnioski. Przed warsztatami znajomość zagadnieńz zakresu diabetologii była w obu grupach pielęgniarekniedostateczna. Warsztaty Edukacji Diabetologicznejpodniosły poziom wiedzy obu grup pielęgniarek.Dlatego też istnieje potrzeba prowadzenia szkoleńz zakresu diabetologii dla pielęgniarek.Introduction. In the Polish health care system, responsibilityfor the education of diabetic patients lies solelyon unspecialised nurses. A signifi cant problem is thelack of courses available to those nurses, who havecontact with diabetic patients in their daily practice.The aim of this study was to evaluate the nurses’ knowledgeconcerning diabetes.Material and methods. The study involved 272 nurses,who participated in the The Regional Program of Workshopsfor Diabetic Education. The level of knowledgewas evaluated before and after the workshops via thetest consisting of 12 questions.Results. After determining the passing percentage ofthe test as 60%, only 10% in group A — nurses workingin the clinics — and 18% in group B — nurses workingin the outpatients departments — passed the initialtest. The fi nal test was passed by 96% and 93% ofnurses, respectively. The average scores obtained inthe initial test by group A and group B didn’t differ(4.88 ± 2.04 vs 4.67 ± 2.3 points, p = 0.46), while inthe fi nal test it was signifi cantly higher in group A comparedwith group B (10.3 ± 1.26 vs 9.41 ± 1.54 points,p < 0.0001).Conclusions. Nurses working in outpatients departments,as well as nurses working in hospitals, didnot present a satisfactory level of knowledge aboutdiabetology. The Workshops for Diabetic Educationincreased the level of knowledge of both groups. Thereis a need for better education for nurses in the fi eld ofdiabetology

Deep Learning Algorithm for Differentiating Patients with a Healthy Liver from Patients with Liver Lesions Based on MR Images

The problems in diagnosing the state of a vital organ such as the liver are complex and remain unresolved. These problems are underscored by frequently published studies on this issue. At the same time, demand for imaging diagnostics, preferably using a method that can detect the disease at the earliest possible stage, is constantly increasing. In this paper, we present liver diseases in the context of diagnosis, diagnostic problems, and possible elimination. We discuss the dataset and methods and present the stages of the pipeline we developed, leading to multiclass segmentation of the liver in multiparametric MR image into lesions and normal tissue. Finally, based on the processing results, each case is classified as either a healthy liver or a liver with lesions. For the training set, the AUC ROC is 0.925 (standard error 0.013 and a p-value less than 0.001), and for the test set, the AUC ROC is 0.852 (standard error 0.039 and a p-value less than 0.001). Further refinements to the proposed pipeline are also discussed. The proposed approach could be used in the detection of focal lesions in the liver and the description of liver tumors. Practical application of the developed multi-class segmentation method represents a key step toward standardizing the medical evaluation of focal lesions in the liver

Lean & Green, how to encourage industries to establish pro-environmental behaviour

Research has shown that mangers in the manufacturing industry are not motivated to implement improvement activities aimed at reducing negative impact on the environment. They concentrate their efforts on improving business indicators as they believe that ecological improvement is associated with costly investments. The Eco Lean Compass method that is presented in the paper, allows the identification of those areas of organizational improvement that do not require significant investments although simultaneously supports business and environmental benefits. This paper presents the main components of the method including Eco Orbit View, Eco-A3 Report and Energy Consumption Study, as well as the results achieved during the practical application in polish company

Regulation of the MID1 protein function is fine-tuned by a complex pattern of alternative splicing

Clinical features of Opitz BBB/G syndrome are confined to defects of the developing ventral midline, whereas the causative gene, MID1, is ubiquitously expressed. Therefore, a non-redundant physiological function of the MID1 product appears to be developmentally restricted. Here, we report the identification of several alternative MID1 exons in human, mouse and fugu. We show that splice variants of the MID1 gene that are comparable in terms of function occur in the three organisms, suggesting an important role in the regulation of the MID1 protein function. Accordingly, we observed differential MID1 transcript patterns in a tissue-specific manner by Northern blot and RT-PCR. The identified splice variants cause loss-of-function effects via several mechanisms. Some introduce a stop codon followed by a novel poly(A+) tail, leading to the formation of C-terminally truncated proteins. Dominant negative effects through altered binding to the MID1-interacting protein agr4 in vitro could be demonstrated in a couple of cases. Others carry premature termination codons without poly(A+) tails. These are degraded by nonsense mediated mRNA decay (NMD). Our data reveal a mechanism conserved in human, mouse and fugu that regulates developmentally restricted MID1 activity and suggest NMD to be critical in the translational regulation of a ubiquitously transcribed mRNA

Towards Industry 4.0: efficient and sustainable manufacturing leveraging MTEF – MTEF-MAESTRI total efficiency framework

An overview of the work under development within the EU-funded collaborative project MAESTRI is presented in this chapter. The project provides a framework of new Industrial methodology, integrating several tools and methods, to help industries facing the fourth industrial revolution. This concept, called the MAESTRI Total Efficiency Framework (MTEF), aims to advance the sustainability of manufacturing and process industries by providing a management system in the form of a flexible and scalable platform and methodology. The MTEF is based on four pillars: a) an effective management system targeted at continuous process improvement; b) Efficiency assessment tools to support improvements, optimization strategies and decision-making support; c) Industrial Symbiosis paradigm to gain value from waste and energy exchange; d) an Internet-of-Things infrastructure to support easy integration and data exchange among shop-floor, business systems and MAESTRI tools

Vemurafenib for Refractory Multisystem Langerhans Cell Histiocytosis in Children: An International Observational Study

International audiencePURPOSE:Off-label use of vemurafenib (VMF) to treat BRAFV600E mutation-positive, refractory, childhood Langerhans cell histiocytosis (LCH) was evaluated.PATIENTS AND METHODS:Fifty-four patients from 12 countries took VMF 20 mg/kg/d. They were classified according to risk organ involvement: liver, spleen, and/or blood cytopenia. The main evaluation criteria were adverse events (Common Terminology Criteria for Adverse Events [version 4.3]) and therapeutic responses according to Disease Activity Score.RESULTS:LCH extent was distributed as follows: 44 with positive and 10 with negative risk organ involvement. Median age at diagnosis was 0.9 years (range, 0.1 to 6.5 years). Median age at VMF initiation was 1.8 years (range, 0.18 to 14 years), with a median follow-up of 22 months (range, 4.3 to 57 months), whereas median treatment duration was 13.9 months (for 855 patient-months). At 8 weeks, 38 complete responses and 16 partial responses had been achieved, with the median Disease Activity Score decreasing from 7 at diagnosis to 0 (P < .001). Skin rash, the most frequent adverse event, affected 74% of patients. No secondary skin cancer was observed. Therapeutic plasma VMF concentrations (range, 10 to 20 mg/L) seemed to be safe and effective. VMF discontinuation for 30 patients led to 24 LCH reactivations. The blood BRAFV600E allele load, assessed as circulating cell-free DNA, decreased after starting VMF but remained positive (median, 3.6% at diagnosis, and 1.6% during VMF treatment; P < .001) and was associated with a higher risk of reactivation at VMF discontinuation. None of the various empirical therapies (hematopoietic stem-cell transplantation, cladribine and cytarabine, anti-MEK agent, vinblastine, etc) used for maintenance could eradicate the BRAFV600E clone.CONCLUSION:VMF seemed safe and effective in children with refractory BRAFV600E-positive LCH. Additional studies are needed to find effective maintenance therapy approaches