Hospital mortality is associated with ICU admission time

Previous studies have shown that patients admitted to the intensive care unit (ICU) after "office hours" are more likely to die. However these results have been challenged by numerous other studies. We therefore analysed this possible relationship between ICU admission time and in-hospital mortality in The Netherlands. This article relates time of ICU admission to hospital mortality for all patients who were included in the Dutch national ICU registry (National Intensive Care Evaluation, NICE) from 2002 to 2008. We defined office hours as 08:00-22:00 hours during weekdays and 09:00-18:00 hours during weekend days. The weekend was defined as from Saturday 00:00 hours until Sunday 24:00 hours. We corrected hospital mortality for illness severity at admission using Acute Physiology and Chronic Health Evaluation II (APACHE II) score, reason for admission, admission type, age and gender. A total of 149,894 patients were included in this analysis. The relative risk (RR) for mortality outside office hours was 1.059 (1.031-1.088). Mortality varied with time but was consistently higher than expected during "off hours" and lower during office hours. There was no significant difference in mortality between different weekdays of Monday to Thursday, but mortality increased slightly on Friday (RR 1.046; 1.001-1.092). During the weekend the RR was 1.103 (1.071-1.136) in comparison with the rest of the week. Hospital mortality in The Netherlands appears to be increased outside office hours and during the weekends, even when corrected for illness severity at admission. However, incomplete adjustment for certain confounders might still play an important role. Further research is needed to fully explain this differenc

Deterrence in Cyberspace: An Interdisciplinary Review of the Empirical Literature

The popularity of the deterrence perspective across multiple scientific disciplines has sparked a lively debate regarding its relevance in influencing both offenders and targets in cyberspace. Unfortunately, due to the invisible borders between academic disciplines, most of the published literature on deterrence in cyberspace is confined within unique scientific disciplines. This chapter therefore provides an interdisciplinary review of the issue of deterrence in cyberspace. It begins with a short overview of the deterrence perspective, presenting the ongoing debates concerning the relevance of deterrence pillars in influencing cybercriminals’ and cyberattackers’ operations in cyberspace. It then reviews the existing scientific evidence assessing various aspects of deterrence in the context of several disciplines: criminology, law, information systems, and political science. This chapter ends with a few policy implications and proposed directions for future interdisciplinary academic research

Pharmacokinetic-Pharmacodynamic Modeling in Pediatric Drug Development, and the Importance of Standardized Scaling of Clearance.

Pharmacokinetic/pharmacodynamic (PKPD) modeling is important in the design and conduct of clinical pharmacology research in children. During drug development, PKPD modeling and simulation should underpin rational trial design and facilitate extrapolation to investigate efficacy and safety. The application of PKPD modeling to optimize dosing recommendations and therapeutic drug monitoring is also increasing, and PKPD model-based dose individualization will become a core feature of personalized medicine. Following extensive progress on pediatric PK modeling, a greater emphasis now needs to be placed on PD modeling to understand age-related changes in drug effects. This paper discusses the principles of PKPD modeling in the context of pediatric drug development, summarizing how important PK parameters, such as clearance (CL), are scaled with size and age, and highlights a standardized method for CL scaling in children. One standard scaling method would facilitate comparison of PK parameters across multiple studies, thus increasing the utility of existing PK models and facilitating optimal design of new studies

The effect of dietary antioxidant supplementation in a vertebrate host on the infection dynamics and transmission of avian malaria to the vector.

Host susceptibility to parasites is likely to be influenced by intrinsic factors, such as host oxidative status determined by the balance between pro-oxidant production and antioxidant defences. As a result, host oxidative status acts as an environmental factor for parasites and may constrain parasite development. We evaluated the role of host oxidative status on infection dynamics of an avian malarial parasite by providing canaries (Serinus canaria) with an antioxidant supplementation composed of vitamin E (a lipophilic antioxidant) and olive oil, a source of monounsaturated fatty acids. Another group received a standard, non-supplemented food. Half of the birds in each group where then infected with the haemosporidian parasite, Plasmodium relictum. We monitored the parasitaemia, haematocrit level, and red cell membrane resistance, as well as the transmission success of the parasite to its mosquito vector, Culex pipiens. During the acute phase, the negative effect of the infection was more severe in the supplemented group, as shown by a lower haematocrit level. Parasitaemia was lower in the supplemented group during the chronic phase only. Mosquitoes fed on supplemented hosts were more often infected than mosquitoes fed on the control group. These results suggest that dietary antioxidant supplementation conferred protection against Plasmodium in the long term, at the expense of a short-term negative effect. Malaria parasites may take advantage of antioxidants, as shown by the increased transmission rate in the supplemented group. Overall, our results suggest an important role of oxidative status in infection outcome and parasite transmission

Do agile managed information systems projects fail due to a lack of emotional intelligence?

YesAgile development methodologies (ADM) have become a widely implemented project management approach in Information Systems (IS). Yet, along with its growing popularity, the amount of concerns raised in regard to human related challenges caused by applyingADMare rapidly increasing. Nevertheless, the extant scholarly literature has neglected to identify the primary origins and reasons of these challenges. The purpose of this study is therefore to examine if these human related challenges are related to a lack of Emotional Intelligence (EI) by means of a quantitative approach. Froma sample of 194 agile practitioners, EI was found to be significantly correlated to human related challenges in agile teams in terms of anxiety, motivation, mutual trust and communication competence. Hence, these findings offer important new knowledge for IS-scholars, project managers and human resource practitioners, about the vital role of EI for staffing and training of agile managed IS-projects

The Association Between Information Security and Reward Processing

Insider threat represents a significant source of violations of information security within corporations and government entities. Therefore, gaining a clearer understanding of the factors that moderate insider threat is important for the information systems community. The current study builds upon previous behavioral research demonstrating that an imbalance between one’s sensitivity to gains and losses may contribute to violations of information security by using event-related brain potentials (ERPs) to examine the association between information security decision-making and the neural correlates of the processing of gains and losses. The ERP data revealed that the amplitude of differences in neural activity between gains and losses was greater in individuals who were more likely to endorse violating information security, and that this association was observed regardless of whether gains or losses resulted from an active choice or were outside of the control of the individual

It’s Not Easy Being Agile: Unpacking Paradoxes in Agile Environments

Abstract In this paper, we outline inherent tensions in Agile environments, which lead to paradoxes that Agile teams and organizations have to navigate. By taking a critical perspective on Agile frameworks and Agile organizational settings the authors are familiar with, we contribute an initial problematization of paradoxes for the Agile context. For instance, Agile teams face the continuous paradox of ‘doing Agile’ (= following an established Agile way of working) versus ‘being Agile’ (= changing an established Agile way of working). One of the paradoxes that organizations face is whether to start their Agile journey with a directed top-down (and therefore quite un-Agile) ‘big bang’ or to allow an emergent bottom-up transformation (which may be more in-line with the Agile spirit but perhaps not be able to overcome organizational inertia). Future research can draw on our initial problematization as a foundation for subsequent in-depth investigations of these Agile paradoxes. Agile teams and organizations can draw on our initial problematization of Agile paradoxes to inform their learning and change processes