Workforce analysis using data mining and linear regression to understand HIV/AIDS prevalence patterns

<p>Abstract</p> <p>Background</p> <p>The achievement of the Millennium Development Goals (MDGs) depends on sufficient supply of health workforce in each country. Although country-level data support this contention, it has been difficult to evaluate health workforce supply and MDG outcomes at the country level. The purpose of the study was to examine the association between the health workforce, particularly the nursing workforce, and the achievement of the MDGs, taking into account other factors known to influence health status, such as socioeconomic indicators.</p> <p>Methods</p> <p>A merged data set that includes country-level MDG outcomes, workforce statistics, and general socioeconomic indicators was utilized for the present study. Data were obtained from the Global Human Resources for Health Atlas 2004, the WHO Statistical Information System (WHOSIS) 2000, UN Fund for Development and Population Assistance (UNFDPA) 2000, the International Council of Nurses "Nursing in the World", and the WHO/UNAIDS database.</p> <p>Results</p> <p>The main factors in understanding HIV/AIDS prevalence rates are physician density followed by female literacy rates and nursing density in the country. Using general linear model approaches, increased physician and nurse density (number of physicians or nurses per population) was associated with lower adult HIV/AIDS prevalence rate, even when controlling for socioeconomic indicators.</p> <p>Conclusion</p> <p>Increased nurse and physician density are associated with improved health outcomes, suggesting that countries aiming to attain the MDGs related to HIV/AIDS would do well to invest in their health workforce. Implications for international and country level policy are discussed.</p

Variation in care and outcome for fragile hip fracture patients: a European multicentre study benchmarking fulfilment of established quality indicators

PURPOSE Despite the availability of clinical guidelines for hip fracture patients, adherence to these guidelines is challenging, potentially resulting in suboptimal patient care. The goal of this study was (1) to evaluate and benchmark the adherence to recently established quality indicators (QIs), and (2) to study clinical outcomes, in fragile hip fracture patients from different European countries. METHODS This observational, cross-sectional multicenter study was performed in 10 hospitals from 9 European countries including data of 298 consecutive patients. RESULTS A large variation both within and between hospitals were seen regarding adherence to the individual QIs. QIs with the lowest overall adherence rates were the administration of systemic steroids (5.4%) and tranexamic acid (20.1%). Indicators with the highest adherence rates (above 95%) were pre-operative (99.3%) and post-operative haemoglobin level assessment (100%). The overall median time to surgery was 22.6 h (range 15.7-42.5 h). The median LOS was 9.0 days (range 5.0-19.0 days). The most common complications were delirium (23.2%) and postsurgical constipation (25.2%). CONCLUSION The present study shows large variation in the care for fragile patients with hip fractures indicating room for improvement. Therefore, hospitals should invest in benchmarking and knowledge-sharing. Large quality improvement initiatives with longitudinal follow up of both process and outcome indicators should be initiated

Assessment of Minimal Residual Disease in Standard-Risk AML

BACKGROUND: Despite the molecular heterogeneity of standard-risk acute myeloid leukemia (AML), treatment decisions are based on a limited number of molecular genetic markers and morphology-based assessment of remission. Sensitive detection of a leukemia-specific marker (e.g., a mutation in the gene encoding nucleophosmin [NPM1]) could improve prognostication by identifying submicroscopic disease during remission. METHODS: We used a reverse-transcriptase quantitative polymerase-chain-reaction assay to detect minimal residual disease in 2569 samples obtained from 346 patients with NPM1-mutated AML who had undergone intensive treatment in the National Cancer Research Institute AML17 trial. We used a custom 51-gene panel to perform targeted sequencing of 223 samples obtained at the time of diagnosis and 49 samples obtained at the time of relapse. Mutations associated with preleukemic clones were tracked by means of digital polymerase chain reaction. RESULTS: Molecular profiling highlighted the complexity of NPM1-mutated AML, with segregation of patients into more than 150 subgroups, thus precluding reliable outcome prediction. The determination of minimal-residual-disease status was more informative. Persistence of NPM1-mutated transcripts in blood was present in 15% of the patients after the second chemotherapy cycle and was associated with a greater risk of relapse after 3 years of follow-up than was an absence of such transcripts (82% vs. 30%; hazard ratio, 4.80; 95% confidence interval [CI], 2.95 to 7.80; P<0.001) and a lower rate of survival (24% vs. 75%; hazard ratio for death, 4.38; 95% CI, 2.57 to 7.47; P<0.001). The presence of minimal residual disease was the only independent prognostic factor for death in multivariate analysis (hazard ratio, 4.84; 95% CI, 2.57 to 9.15; P<0.001). These results were validated in an independent cohort. On sequential monitoring of minimal residual disease, relapse was reliably predicted by a rising level of NPM1-mutated transcripts. Although mutations associated with preleukemic clones remained detectable during ongoing remission after chemotherapy, NPM1 mutations were detected in 69 of 70 patients at the time of relapse and provided a better marker of disease status. CONCLUSIONS: The presence of minimal residual disease, as determined by quantitation of NPM1-mutated transcripts, provided powerful prognostic information independent of other risk factors. (Funded by Bloodwise and the National Institute for Health Research; Current Controlled Trials number, ISRCTN55675535.)

My IoT Puzzle: Debugging IF-THEN Rules Through the Jigsaw Metaphor

End users can nowadays define applications in the format of IF-THEN rules to personalize their IoT devices and online services. Along with the possibility to compose such applications, however, comes the need to debug them, e.g., to avoid unpredictable and dangerous behaviors. In this context, different questions are still unexplored: which visual languages are more appropriate for debugging IF-THEN rules? Which information do end users need to understand, identify, and correct errors? To answer these questions, we first conducted a literature analysis by reviewing previous works on end-user debugging, with the aim of extracting design guidelines. Then, we developed My IoT Puzzle, a tool to compose and debug IF-THEN rules based on the Jigsaw metaphor. My IoT Puzzle interactively assists users in the debugging process with different real-time feedback, and it allows the resolution of conflicts by providing textual and graphical explanations. An exploratory study with 6 participants preliminary confirms the effectiveness of our approach, showing that the usage of the Jigsaw metaphor, along with real-time feedback and explanations, helps users understand and fix conflicts among IF-THEN rules

A certified plasmid reference material for the standardisation of BCR-ABL1 mRNA quantification by real-time quantitative PCR

Serial quantification of BCR–ABL1 mRNA is an important therapeutic indicator in chronic myeloid leukaemia, but there is a substantial variation in results reported by diff

Production of hydrogen by methane dry reforming: A study on the effect of cerium and lanthanum on Ni/MgAl2O4 catalyst performance

Hydrogen production from dry reforming of methane (DRM) was investigated on different Nickel based catalysts deposited on MgAl2O4. MgAl2O4 spinel was prepared using Alumina supplied from different manufacturers (Sigma Aldrich, Alfa Aesar and Degussa) with low and high specific surface area. Moreover, the influence of different parameters on the catalytic activity on methane dry reforming was studied such as the effect of Ni content, the effect of commercial alumina and the effect of doping nickel with cerium and lanthanum. During this study, the catalytic activity was compared at atmospheric pressure at 750 °C during 4h than 650 °C during 4h toward methane dry reforming (DRM) reaction with a molar ratio CH4/CO2 =1/1 and a Weight Hourly Space Velocity (WHSV) of 60.000 mL.g-1.h-1. The results showed that among the different catalysts 1.5Ce-Ni5/MgAl2O4, synthesized with alumina from Alfa Aesar, exhibited the best catalytic activity for DRM. Furthermore, this catalyst showed the best performance during a stability tes at 600 °C for 24 h under reacting mixture with a low carbon formation rate (2.71 mgC/gcat/h). Such superior activity is consistent with characterization results from BET, XRD, SEM, TPR and TPO analysis. Furthermore, it seems that the addition of Cerium on Ni/MgAl2O4 leads to an increase in catalyst efficiency. It can be due to an effective active oxygen transfer due to the redox properties of CeO2, leading to the formation of oxygen vacancies offering a benefit for DRM reaction

Axial Ferrite-Magnet-Assisted Synchronous Reluctance Motor

International audienceThis paper presents a noval 18 poles /16 slots Axial Flux Permanent Magnet-Assisted Synchronous Reluctance Motor (AF-PMASynRM) with non-overlapping concentrated winding. At first, the torque ripple and iron losses are analyzed using 3D Finite Element Analysis (3D-FEA). Then, a comparison between 3D-FEA and 2D-FEA based on flux and iron losses is established. In this paper, we propose to design the motor for high torque low speed application using a multiobjective optimization. In this kind of iterative procedure, the use of Finite Element is generally time consuming. Thus, we propose a 2D analytical saturated model that considers the local saturation near the iron bridges and the slot tangential leakage flux. The magnetic model is coupled with an electrical model that computes the power factor and the voltage at the motor terminals. A loss model is also developed to calculate the copper and the iron losses. The proposed analytical model is 5 times faster than the 2D- FEA. The optimal axial structure is compared to a previously optimized radial motor in order to evaluate the design benefits of axial flux machines

Modelling of Polymorphic User Interfaces at the Appropriate Level of Abstraction

Polymorphic user interfaces (UIs) can offer different modes of display and interaction for different devices, situations and user needs. This increased variety adds complexity to UI development, which is often addressed by model-based UI development approaches. However, existing approaches do not offer an attractive balance of required abstraction and a graphical and vivid representation for developers. In this paper, we present the Model-with-Example approach that combines abstract interaction modelling with a wireflow-like concrete visualization. The results of a user study with industrial front-end developers show that this concrete visualization can improve development efficiency

Significant Reduction of Radiation Exposure Using Specific Settings of the O-Arm for Percutaneous Cementoplasty in Accordance With the ALARA Principle.

Three-dimensional (3D) navigation has become routinely used in spine surgery, allowing more accurate and safe procedures. However, radiation exposure related to the use of imaging is an unresolved issue, and information about it is relatively scarce. The "as low as reasonably achievable" (ALARA) principle aims to reduce the radiation exposure for the patients as low as possible. The objective of this study was to compare the effective dose related to the use of the O-arm in standard settings with adapted features for dose reduction during percutaneous cementoplasty. From March 2021 to October 2022, all consecutive patients who underwent navigated percutaneous cementoplasty with the use of the O-arm were prospectively included. Demographic, operative, irradiation, and radiological data were collected. The main outcome was the effective dose (E) in millisievert (mSv). Secondary outcomes were the absolute risk of cancer (AR) in percent equivalent to a whole-body exposition, operative time, and radiological results according to Garnier. In group A, patients were operated on with standard settings of the O-arm, whereas in group B, navigation on the field of view, collimation, and low-dose settings were used. A total of 70 patients were included in the study: 43 in group A and 27 in group B. Also, 109 vertebrae were operated: 59 in group A and 50 in group B. Mean E was significantly higher in group A than in group B (9.94 and 4.34 mSv, respectively; P &lt; 0.01). The 3D-related E followed the same trend (7.82 and 3.97 mSv, respectively), as did 2-dimensional-related E (2.12 and 0.37 mSv, respectively; P &lt; 0.01). Average AR was also significantly higher in group A than in group B (5.10 &lt;sup&gt;-4&lt;/sup&gt; % and 2.10 &lt;sup&gt;-4&lt;/sup&gt; % respectively; P &lt; 0.01). Operative time was similar in both groups, but the rate of satisfactory radiological results was higher in group A than in group B (95% and 84%, respectively; P = 0.11), and we found similar rates of cement leakage (22% and 24%, respectively; P = 0.71). The application of settings of the O-arm in accordance with the ALARA principle helped to significantly reduce the radiation exposure and should be routinely used for O-arm-assisted cementoplasty procedures. This study details technical aspects and settings that may help users of the O-arm to decrease radiation exposure to patients and surgeons alike, especially in cementoplasty procedures, as well as in other procedures performed under O-arm guidance