Acceptable Quality Level Research Articles

Power Quality Analysis of a Microgrid-Based on Renewable Energy Sources: A Simulation-Based Approach

At present, microgrids (μGs) are a focal point in both academia and industry due to their capability to sustain operations that are stable, resilient, reliable, and of high power quality. Power converters (PCs), a vital component in μGs, enable the decentralization of power generation. However, this decentralization introduces challenges related to power quality. This paper introduces a μG model, based on the IEEE 14-bus distribution system, with the objective of investigating power quality when the μG is operating in conjunction with the conventional power grid. The μG model was developed using MATLAB-Simulink®, a tool specialized for electrical engineering simulations. The results obtained undergo thorough analysis and are compared with the compatibility levels set by the IEEE-519 standard. This method enables a precise evaluation of the μGs’ capacity to maintain acceptable power quality levels while interconnected with the conventional power grid. In conclusion, this study contributes significantly to the field of μGs by providing a detailed and quantitative assessment of power quality. This will assist in the design and optimization of μGs for effective implementation in real-world electric power systems.

Machine Learning-Based Resource Allocation Algorithm to Mitigate Interference in D2D-Enabled Cellular Networks

Mobile communications have experienced exponential growth both in connectivity and multimedia traffic in recent years. To support this tremendous growth, device-to-device (D2D) communications play a significant role in 5G and beyond 5G networks. However, enabling D2D communications in an underlay, heterogeneous cellular network poses two major challenges. First, interference management between D2D and cellular users directly affects a system’s performance. Second, achieving an acceptable level of link quality for both D2D and cellular networks is necessary. An optimum resource allocation is required to mitigate the interference and improve a system’s performance. In this paper, we provide a solution to interference management with an acceptable quality of services (QoS). To this end, we propose a machine learning-based resource allocation method to maximize throughput and achieve minimum QoS requirements for all active D2D pairs and cellular users. We first solve a resource optimization problem by allocating spectrum resources and controlling power transmission on demand. As resource optimization is an integer nonlinear programming problem, we address this problem by proposing a deep Q-network-based reinforcement learning algorithm (DRL) to optimize the resource allocation issue. The proposed DRL algorithm is trained with a decision-making policy to obtain the best solution in terms of spectrum efficiency, computational time, and throughput. The system performance is validated by simulation. The results show that the proposed method outperforms the existing ones.

Factors Influencing the Engagement with Electronic Mental Health Technologies: A Systematic Review of Reviews.

Mental disorders impact approximately one-third of the global population, affecting adults, children, and youth worldwide. Recently, electronic mental health (e-mental health) technologies have been proposed to facilitate the provision of mental health care by professionals and other stakeholders, aiming to address the challenges associated with delivering mental health services. The objective of this study was to investigate the existing factors influencing engagement with e-mental health technologies. This study was a systematic review of existing reviews conducted in 2024. PubMed, Scopus, ProQuest, and Cochrane databases were searched. The authors assessed the quality of the studies using the CASP (Critical Appraisal Skills Programme) Checklist. Subsequently, they extracted and analyzed the data, utilizing the Boyatzis thematic analysis approach. The systematic review resulted in 15 papers, all of which exhibited an acceptable level of quality and risk of bias. The thematic analysis classified the data into five main themes: 'Technical', 'Ethical and Legal', 'Clinical', 'Organizational', and 'Social'. The study underscored the significance of ensuring accessibility, affordability, and reimbursement to effectively engage patients with e-mental health services. Additionally, transparency-facilitated by self-certification and user involvement-alongside critical factors like informed consent and privacy safeguards, was presented as playing a pivotal role in the process. Moreover, facilitators, including tailored interventions that consider the specific needs of particular groups and temporary project teams composed of individuals working together on specific initiatives, were identified as essential contributors. Overall, the factors influencing engagement with e-mental health technologies and potential solutions for enhancing such engagement appear to be interconnected.

Development of zeolite 5A-incorporated polyvinyl alcohol membrane for desalination by pervaporation

Abstract With the rapid depletion of potable and useable water resources globally due to population growth and the effects of global warming, the desalination of seawater – the world’s largest source of water – to acceptable quality levels is critical to meeting future water needs. This study investigates the use of zeolite 5A-incorporated polyvinyl alcohol membranes to produce fresh water from seawater for industrial and domestic use and evaluates the application of the pervaporation process on the separation performance. Polyvinyl alcohol and polyvinyl alcohol/zeolite 5A mixed matrix membranes were prepared by solution-casting technique, and their morphological, structural, and mechanical properties were analyzed by field emission scanning electron microscopy, thermogravimetric analysis, Fourier transform infrared spectroscopy, and tensile strength tests. The swelling behavior and pervaporation performance of the membranes were investigated at different temperatures (30, 45, and 60 °C) using synthetic seawater containing 35 g L−1 NaCl, and membrane–solvent interactions were determined using data from sorption experiments. The membrane produced water flux and salt rejection values at 60 °C of 5.82 kg m−2 h−1 and >99.9 %, respectively.

Machine-learning-based sampling inspection under OQC capacity for real-time quality monitoring in the TFT-LCD industry

ABSTRACT In the thin film transistor-liquid crystal display (TFT-LCD) industry, the competition is fierce, and the external failure cost is high. To improve the quality of released products, sampling inspection under outgoing quality control (OQC) is conducted before products are released. Owing to the variety and complexity of inspection items, the task must be carried out manually while realising automation is difficult. Traditional random sampling inspection is limited by sampling quantity, manpower, and material resources. To effectively improve acceptable quality levels, this paper proposes a quality predictive monitoring framework tailored to the production and inspection characteristics of the TFT-LCD industry. This framework includes real-time automatic quality monitoring based on an optimal machine learning prediction model with two-phase feature creation, and it also addresses OQC inspection capacity constraints. Experimental results show the prediction performance based on proposed model is better than the traditional random sampling process. In practice, superior average outgoing quality improves by more than 70% at the same sampling level. In addition, the features of the process can be further controlled and managed based on the prediction model to monitor the key parameters in real time and respond to abnormalities quickly, thereby further improving the quality of released products.

A Bayesian approach with double group sampling plan to estimate quality regions for proportion of nonconforming products in industry based on beta prior

To succeed in the global market, firms must prioritize quality over individual goals and preferences. One of the two primary approaches for ensuring quality is acceptance sampling, which is employed in statistical process control to inspect attributes of the product for acceptance. In acceptance sampling, the lot is either accepted or not-accepted based on predetermined acceptance criteria for inspection. This paper presents a proposed Bayesian double group sampling plan (BDGSP) for estimating quality regions. The binomial distribution is used to construct the likelihood function for both nonconforming and conforming products based on acceptance criteria. To calculate the average probability of acceptance, the beta distribution is used as a suitable prior distribution of the binomial distribution. Four distinct quality regions are predicted for various indicated producer’s and consumer’s risk levels. Based on various combinations of values for design parameters, the suggested plan generates variation point values. Risks for producers and consumers are related to acceptable quality level and limiting quality level. To track the effects of changes in the values of the specified parameters, operating characteristic curves are utilized. The applicability of the proposed plan for current industrial strategies is demonstrated using a real dataset.

Optimizing computed tomography image reconstruction for focal hepatic lesions: Deep learning image reconstruction vs iterative reconstruction

BackgroundDeep learning image reconstruction (DLIR) is a novel computed tomography (CT) reconstruction technique that minimizes image noise, enhances image quality, and enables radiation dose reduction. This study aims to compare the diagnostic performance of DLIR and iterative reconstruction (IR) in the evaluation of focal hepatic lesions. MethodsWe conducted a retrospective study of 216 focal hepatic lesions in 109 adult participants who underwent abdominal CT scanning at our institution. We used DLIR (low, medium, and high strength) and IR (0 %, 10 %, 20 %, and 30 %) techniques for image reconstruction. Four experienced abdominal radiologists independently evaluated focal hepatic lesions based on five qualitative aspects (lesion detectability, lesion border, diagnostic confidence level, image artifact, and overall image quality). Quantitatively, we measured and compared the level of image noise for each technique at the liver and aorta. ResultsThere were significant differences (p < 0.001) among the seven reconstruction techniques in terms of lesion borders, image artifacts, and overall image quality. Low-strength DLIR (DLIR-L) exhibited the best overall image quality. Although high-strength DLIR (DLIR-H) had the least image noise and fewest artifacts, it also had the lowest scores for lesion borders and overall image quality. Image noise showed a weak to moderate positive correlation with participants’ body mass index and waist circumference. ConclusionsThe optimal-strength DLIR significantly improved overall image quality for evaluating focal hepatic lesions compared to the IR technique. DLIR-L achieved the best overall image quality while maintaining acceptable levels of image noise and quality of lesion borders.

Good-enough Care? How Patients' Perceptions of Counselors' Professional Skills Relate to Everyday Life in Forensic Long-stay Units.

The overall goal of long-term forensic care is to strive toward acceptable levels of adaptation and quality of life (QoL) of the forensic patient in the institutional context. While the bulk of the literature has focused on the deleterious consequences of personality pathology in this regard, research investigating the contribution of the quality of the therapeutic relationship has remained rather scant. Assuming that the perceived competence of the direct counselor, as perceived by patients, forms an important aspect in this regard, the central aim of this study was to investigate the relationship between patients' perceptions of their therapist's professional skills, their self-reported maladaptive behavior on the ward, and their experienced QoL. To this end, we recruited patients (N = 60) in long-stay forensic units and investigated their perceptions of 10 specific skills displayed by their therapist, along a "too little-too much" rating scale. The results revealed that patients who had the overall impression that their counselor was equipped with an adequate set of professional skills showed less maladaptive behavior and perceived a higher QoL on the ward. Conversely, at a more specific competence level, only a positive relationship between a counselor's predictability and self-reported QoL was found. Taken together, these results highlight that an overall professional skill evaluation matters in the context of forensic patients' adaptation and QoL in their long-stay units, with the counselor's predictability serving as a crucial aspect in obtaining the most favorable outcomes.

Grinding of Thermal Spray Coated Aircraft Engine Parts

Aircraft engines that must be certified separately from the platform should comply airworthiness and remain unchanged for all types of operations and in all environments. Together with this, they might only be preferred by airlines if they are competitive in terms of several aspects such as fuel efficiency, speed, and maintainability. These requirements are met by an interdisciplinary effort including engine design, component materials, manufacturing techniques and electronic control. An illustrative example to this is the critical components designed and manufactured of titanium or superalloys and coated afterwards to resist various wear causes and to facilitate easy, cost-effective maintenance by keeping the component itself only via renewing the coating after certain flight hours. Although this solution sounds reasonable and feasible, it needs a considerable know-how level to apply a proper coating and subsequently to size it to an acceptable level of dimensional quality and surface integrity. In order to meet researchers' and engineers' know-how needs on the subject, this paper presents a systematic review on grinding of thermal spray coated aircraft engine parts. In this paper, spray coatings, which offer the widest substrate material range are explained in detail regarding their materials, application methods and characterizations. Later on, grinding of these is narrated considering tools and process parameters such as cutting speed, feed, and depth of cut. Finally, the influence of grinding conditions on dimensions, surface quality, hardness, residual stresses, and microstructure is discussed. The paper is concluded with a state-of-the-art summary and emphasis on research gaps and future perspectives on the subject.

Recent developments of demand‐side management towards flexible DER‐rich power systems: A systematic review

AbstractRecently, various distributed energy resources are significantly integrated into the modern power systems. This introduction of distributed energy resource‐rich systems can cause various power quality issues, due to their uncertainties and capacity variations. Therefore, it is crucial to establish energy balance between generation and demand to improve power system's reliability and stability and to minimize energy costs without sacrificing customers’ comfort or utility. In this regard, power system flexibility concept is highlighted as a robust and cost‐effective energy management system, especially on the demand side, to provide consumers’ demands with an acceptable level of power quality. Accordingly, here, a comprehensive review of recent developments in the power system flexibility and demand‐side management strategies and demand response programs are provided to include mainly classifications, estimation methods, distributed energy resource modelling approaches, infrastructure requirements, and applications. In addition, current research topics for applying power system flexibility solutions and demand‐side management strategies based on modern power system operation are deliberated. Also, prominent challenges, research trends, and future perspectives are discussed. Finally, this review article aims to be an appropriate reference for comprehensive research trends in the power system flexibility concept in general and in demand‐side management strategies and demand response programs, specifically.

Constructing Optimal Quick Switching System with Hurdle Poisson Distribution

Objectives: Optimizing the sum of risks involved in the selection of acceptance sampling plans playing a vital role. This paper uses the Hurdle Poisson distribution to design an optimal quick switching system attribute plan for a given acceptable quality level (AQL) and limiting quality level (LQL) involving a minimum sum of risks. Methods: The sum of producer's and consumer's risks has been met for the specified AQL and LQL. The sum of these risks, as well as the acceptance and rejection numbers have been calculated using the Hurdle Poisson distribution. The operating characteristic function for the quick switching system attribute plan has also been derived using the Hurdle Poisson distribution. Findings: The producer and the consumer both represent the same party in the final inspection. As a result, the sum of these two risks should be minimized. In this paper, the sum of risks for various operating ratios are tabulated using the Hurdle Poisson distribution. These tabulated values are less than the sum of risks calculated using the Weighted Poisson distribution. Novelty: Reducing the sum of risks is the ultimate aim of the work. In this proposed paper, to attain the minimum sum of risks, the authors make an attempt to approach the Quick Switching System Sampling Plan, when the number of defectives in the submitted lots are very less. In other words, the probability of getting defective is very less. This indicates the quality of the lot selected for the inspection to ensure the protection for the consumer. And the plan is also designed in the way that the producer is also not get affected by rejecting a good lot by the consumer. This is the requirement of minimizing the risks. Keywords: Acceptable Quality Level (AQL), Limiting Quality Level (LQL), Minimum Risk Plan, Quick Switching System Sampling Attribute Plan, Operating Characteristic (OC) Function, Hurdle Poisson Distribution

Qualimetric assessment of the quality of cold-formed pipes.

To quantify product quality, complex indicators using the principles of qualimetry are increasingly used. The use of complex indicators makes it possible to evaluate and compare product quality for various technological process options, but a unified methodological approach to quality assessment and management has not been formulated. The article lists examples of complex indicator definition in various works and presents an approach to assessing the quality of cold-deformed stainless pipes according to GOST 9941. The results of the analysis of GOST requirements for these products are presented, 15 individual indicators are identified. The values of eight individual quality indicators are defined as the probability of falling into a given interval; for seven individual indicators, the probability calculation was carried out for a quantitative characteristic. The calculated complex indicator is assessed according to the Harrington desirability scale: the range of values 0.37–0.63 is a satisfactory level of quality. To improve the complex criterion to values within the range of “acceptable and good quality level”, recommendations have been formulated in the direction of improving technology

Organoleptic quality and formaldehyde content of mackerel marketed in Dar es Salaam, Tanzania

BackgroundFish constitutes a nutritious food that deteriorates quickly when poorly preserved. Several biochemicals, including formaldehyde, accumulate naturally in the fish post-mortem. Apart from this natural formaldehyde, reports reveal the deliberate addition of formalin (37% formaldehyde solution) to the stored fish as a preservative. This is risky to consumers since formaldehyde is carcinogenic, genotoxic, and a potentiator of other carcinogens.AimThis study aimed to assess both the organoleptic quality and formaldehyde content of mackerels, the most consumed fish in Dar es Salaam, Tanzania.MethodsA total of 60 mackerel samples were conveniently and equally obtained from the local markets, street vendors, and supermarkets in five districts of the Dar es Salaam region. Organoleptic quality was evaluated based on organoleptic characteristics. Formaldehyde analysis was done by High-Performance Liquid Chromatography (HPLC). Analysis of variance was subsequently run to test the variation of formaldehyde content in mackerel by outlet type and district.ResultsAll analyzed mackerel samples had acceptable levels of organoleptic quality (2.46 ± 0.50) and a mean formaldehyde concentration of 10.89 ± 2.44 mg/kg. On average, the samples from supermarkets had the highest level of organoleptic quality (2.20 ± 0.21) but were also the most contaminated with formaldehyde (16.07 ± 4.68 mg/kg), while those from local markets were the least contaminated (3.91 ± 1.86 mg/kg) (p = 0.000). Moreover, 0% (n = 0), 20% (n = 4), and 35% (n = 7) of samples from local markets, street vendors, and supermarkets, respectively, had formaldehyde concentrations above 20 mg/kg, the previously estimated highest concentration for naturally formed formaldehyde in fish.ConclusionMackerels marketed in Dar es Salaam have acceptable organoleptic quality but are substantially contaminated with formaldehyde. Whether this is natural or artificial formaldehyde, our findings are inconclusive given the conflicting global standards. Nonetheless, the findings reveal the potential exposure of fish consumers to formaldehyde. Future research should explore the dynamics of the accumulation of natural formaldehyde in marketed fish and accurately assess the risk associated with the exposure of consumers to the formaldehyde in fish. The emanating findings will ultimately guide the development of local guidelines for natural and permissible formaldehyde concentrations in fish and fish products in Tanzania.

Wastewater irrigation beneath the water table: analytical model of crop contamination risks

Wastewater irrigation alleviates freshwater scarcity. However, conventional (near)surface irrigation techniques directly expose crops to contaminants. Irrigating wastewater into shallow phreatic zones to raise the water table enhances groundwater evapotranspiration, while using the vadose zone as a bioreactor that attenuates contaminants through dilution, adsorption, and biodegradation. Nevertheless, contaminants may spread across the groundwater, soil, and vegetation. In this study, we focus on the crop contamination risks, and derive a simple analytical model to estimate crop solute uptake. Although crops are not directly exposed to the irrigated wastewater, contaminants (and nutrients) may spread to the root zone. Results show that crop contamination is primarily determined by the root zone water balance, and by solute dispersion and biogeochemical reaction parameters. The model contributes towards identifying hydrogeologically and climatically suitable locations for phreatic zone wastewater irrigation, determining acceptable levels of irrigation water quality, and evaluating crop contamination hazards against the fertigative value of wastewater.

The influence of early diet quality on the mental health of college students: the mediation effects of height and qi-deficiency.

In China, the prevalence of mental health issues among college students is a significant concern in society. This study aims to investigate the impact of early dietary quality on the psychological well-being of college students and elucidate the underlying mechanisms through which these effects occur, specifically focusing on height and qi-deficiency as mediators according to Chinese traditional medicine (CTM). A total of 655 college students were surveyed in October 2023 using paper-pencil-based questionnaires at four second-tier universities in Sichuan Province. The assessment included mental health, height, and qi-deficiency. Pearson's correlation and linear regression analyses were employed to examine the mediation model and test the hypotheses. The college students exhibited acceptable levels of early diet quality (M = 3.72) and mental health (M = 3.63), while also presenting mild qi-deficiency symptoms (M = 2.25). Their average height was measured at 164.61 cm. Early diet quality demonstrated significant associations with mental health (r = 0.38, p < 0.01), height (r = 0.32, p < 0.01), and qi-deficiency (r = -0.32, p < 0.01). Mental health displayed correlations with height (r = 0.32, p < 0.01) and qi-deficiency (r = -0.49, p < 0.01). The results of linear regression analyses revealed significant associations between early diet quality and mental health (β = 0.31, p < 0.01), height (β = 0.21, p < 0.01), as well as qi-deficiency (β = -0.26, p < 0.01). Furthermore, when early diet quality was included in the regression model, both height (β = 0.21, p < 0.01) and qi-deficiency (β = -0.35, p < 0.01) emerged as significant mediators in the relationship with mental health. The mediation model and hypotheses were strongly supported, demonstrating that early diet quality exerted an influence on the mental health of college students through two distinct pathways: height and qi-deficiency. Moreover, the mediating effect of qi-deficiency was found to be more pronounced than that of height in the relationship between early diet quality and mental health among college students.

Indoor Air Quality and Ventilation Energy in University Classrooms: Simplified Model to Predict Trade-Offs and Synergies

Students and educators spend significant time in learning spaces on university campuses. Energy efficiency has become a concern among facility managers, given the need to maintain acceptable indoor air quality (IAQ) levels during and after the COVID-19 pandemic. This paper investigates the relationship between control and extraneous variables in a university classroom’s total mechanical ventilation (kWh). The model is built using Grasshopper software on Rhino Version 7. Our methodology encompasses (1) an extensive review of recent trends for studying IAQ and energy, (2) selecting parameters for simulation, (3) model configuration on Grasshopper, and finally, (4) a formulation of a pertinent equation to consolidate the relationship between the studied factors and the total mechanical ventilation energy (kWh). Central to this study are two key research questions: (1) What correlations exist between various parameters related to occupancy and IAQ in educational spaces? And (2) how can we optimize energy efficiency in university classrooms? The main contribution of this research is a generated equation representing the annual mechanical ventilation energy consumption based on selected parameters of classroom height, area, occupancy, window location, and ventilation rate of HVAC systems. We find that occupancy and class volume are the two most influential factors directly affecting mechanical ventilation energy consumption. The equation serves as a valuable estimation tool for facility managers, designers, and campus operations to investigate how fluctuations in occupancy can influence ventilation energy consumption in the physical attributes of a university classroom. This enables proactive decision-making, optimizing energy efficiency and resource allocation in real-time to promote sustainable and cost-effective campus operations.

Quality of examination gloves in health facilities in Addis Ababa, Ethiopia

Background: Examination gloves are used in health facilities to protect health professionals and patients from the risk of infection and reduce opportunities for cross-transmission of infectious microorganisms. Poor-quality examination gloves can expose health professionals to infectious diseases such as Covid-19, Hepatitis, HIV/AIDS, and other contagious diseases. Hence, this study aimed to assess the quality of examination gloves in health facilities in Addis Ababa.&#x0D; Methods: A cross-sectional study design was employed. The examination gloves were collected from randomly selected health facilities in Addis Ababa. The gloves were examined following standard procedure in the Ethiopian Food and Drug Authority. Holes in the examination gloves were detected using the watertight (leakage test) and geometrical dimensions such as thickness, width, and length were measured.&#x0D; Results: A total of 2500 selected examination gloves were collected between Feb 10 and Feb 20, 2021. The gloves were sampled from health facilities in Addis Ababa. From the total samples collected, only 2280 examination gloves of five different brands were tested, which makes the response rate 91.2%. The proportion of gloves with holes detected ranged from 5.7% to 21.9%. Overall, only 0.17% and 3.2% of the gloves had width and length below standard, respectively. None of the gloves tested in this study had a thickness below the standard.&#x0D; Conclusions: All brands of examination gloves tested had a higher hole (leakage) rate than the acceptable quality limit. This implies there is a substantial risk of infectious disease transmission to health professionals and patients in healthcare settings. Hence, regulatory enforcements need to be strengthened across the life cycle of the product.

Reliability-based conformity control method for chloride diffusivity of coastal reinforced concrete buildings

Chloride diffusivity significantly affects the durability of coastal reinforced concrete (RC) buildings, and is one of the major concerns in practice. However, its design and conformity control are commonly based on “deem-to-satisfy” methodology, and consequently it's difficult to evaluate the building's durability performance. In this paper, a reliability-based conformity control method for diffusivity is proposed to eliminate the gap. First, the existing empirical method and semi-empirical method are reviewed, and their drawbacks are addressed according to the reliability assessment. Then, based on the statistical acceptance sampling theory and the engineering practice of Hong Kong-Zhuhai-Macau sea-link project, the reliability-based method for diffusivity is proposed, which can be applied in the construction of coastal RC buildings. In this method, effects of local environmental conditions (e.g., temperature and humidity) on chloride diffusivity are considered, and the relation between diffusion coefficient for design (Da0) and for conformity control (Dnssm) is suggested accordingly. Finally, the conformity control for the concrete's chloride diffusivity of an accessory RC building in the Shantou Harbor is taken as the example, and the schemes by empirical method, semi-empirical method and reliability-based method respectively are established. Their acceptable quality level (AQL) and limiting quality level (LQL), probabilities of acceptance and outcomes in terms of durability reliability are evaluated and compared. It is found that the reliability-based method can offer the schemes that is consistent with the design target, and reject most of the nonconforming lots without harming the producers' benefits.

Effects of intensive care unit quality assessment on changes in medical staff in medical institutions and in-hospital mortality

BackgroundQuality assessments are being introduced in many countries to improve the quality of care and maintain acceptable quality levels. In South Korea, various quality assessments are being conducted to improve the quality of care, but there is insufficient evidence on intensive care units (ICUs). This study aims to evaluate the impact of ICU quality assessments on the structural indicators in medical institutions and the resulting in-hospital mortality of patients.MethodsThis study used data collected in the 2nd and 3rd ICU quality assessments in 2017 and 2019. A total of 72,879 patients admitted to ICUs were included during this period, with 265 institutions that received both assessments. As for structural indicators, changes in medical personnel and equipment were assessed, and in-hospital deaths were evaluated as patient outcomes. To evaluate the association between medical staff and in-hospital mortality, a generalized estimating equation model was performed considering both hospital and patient variables.ResultsCompared to the second quality evaluation, the number of intensivist physicians and experienced nurses increased in the third quality evaluation; however, there was still a gap in the workforce depending on the type of medical institution. Among all ICU patients admitted during the evaluation period, 12.0% of patients died in the hospital. In-hospital mortality decreased at the 3rd assessment, and hospitals employing intensivist physicians were associated with reduced in-hospital deaths. In addition, an increase in the number of experienced nurses was associated with a decrease in in-hospital mortality, while an increase in the nurse-to-bed ratio increased mortality.ConclusionsICU quality assessments improved overall structural indicators, but the gap between medical institutions has not improved and interventions are required to bridge this gap. In addition, it is important to maintain skilled medical personnel to bring about better results for patients, and various efforts should be considered. This requires continuous monitoring and further research on long-term effects.

Efficacy of quadratus lumborum block in the treatment of acute and chronic pain after cesarean section: A systematic review and meta-analysis based on randomized controlled trials.

This analysis aimed to explore the analgesic effects of quadratus lumborum block on acute and chronic postoperative pain among patients undergoing cesarean section. PubMed, Cochrane, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases for Randomized Controlled Trials (RCTs) that focused on the use of quadratus lumborum block in cesarean section procedures were searched from the inception of the databases until December 2022. Studies were screened based on inclusion and exclusion criteria, and were then conducted for quality assessment and data extraction. Meta-analysis was performed using Stata 15.0 software. Two researchers independently screened the studies, extracted data, and evaluated the risk of bias for the included studies. In case of any disagreements, it was resolved by consultation with a third party opinion. A total of 21 studies involving 1976 patients were finally included, with an overall acceptable study quality level. Compared to the control group, the administration of Quadratus Lumborum Block (QLB) resulted in significant reduction in the postoperative 24-hour visual analog scale (VAS) score (WMD = -0.69, 95% CI: -1.03 ~ -0.35, P < .001) and the consumption of opioid analgesics within 24 hours after surgery (WMD = -2.04, 95% CI: -2.15 ~ -1.92, P = .002). The incidence of chronic pain 3 months QLB (OR = 0.41, 95% CI: 0.09 ~ 1.88, P = .253) and 6 months (OR = 0.83, 95% CI: 0.33 ~ 2.07, P = .686) after surgery were observed to increase as compared with the control group. The use of QLB for postoperative analgesia after cesarean section, particularly in the relief of acute postoperative pain, had been proven to significantly decrease the VAS score and morphine consumption within the first 24 hours after surgery. However, further studies are needed to determine its impact on managing chronic postoperative pain.