Correct Execution Research Articles

Experimental Validation of a Test Apparatus for the Evaluation of Hydrogen Permeation in Silane-Modified Sealants on Fuel-Cell-Powered Vehicles

Silane-modified sealants are widely used for the construction of railway vehicles and have several advantages in the production of elastic structural joints and seals featuring high bond thickness. The use of hydrogen fuel cells to power newly developed rolling stock places further safety constraints on the design of the sealing elements of those technical compartments that contain the storage tanks of the propulsion system. Given the lack of solutions based on the use of silane-modified sealants validated for operating environments in which leaks of gaseous hydrogen may occur, an experimental test was carried out to characterize the permeability of some adhesive products according to the requirements of the BS ISO 15105-2:2003 standard, and a specific test bench was developed for this. Two different sealants were subjected to the hydrogen permeability test. The processing of the results provided by the apparatus designed specifically for the execution of the test made it possible to determine a permeability rate dependent on the thickness of the adhesive in the order of ng/(min × cm2). The results of the test were subsequently contextualized within the technical application to rolling stock, with the ultimate aim of verifying that the permeability rate determined experimentally is compatible with the design safety criteria. The developed test bench allowed the correct execution of the permeability test. In general, the two sealants showed hydrogen permeability values compatible with the application. In particular, the hydrogen permeation rate (Rp) was lower than 0.25 ng/min for both sealants.

Hearing tests in practice : Audiometric masking in pure-tone and speech audiometry

Correct execution of hearing tests is essential for audiologic diagnostics and selection of treatment by the ENT physician. Especially in the case of pure-tone and speech audiometry, incorrectly performed audiometric masking can lead to false measurement results. Often, hearing that is too good is feigned by overhearing in the contralateral ear. Herein, amasking strategy is described by which errors in the execution of masking can be recognized and corrected. The aim of this paper is to identify and prevent the most common errors made during the masking process in pure-tone and speech audiometry.

P6.01: Actuarial Perspective on the Immunosuppressive Medication Costs and Coverage for Transplant Recipients in the Argentine´S Public System: 2009-2021

Introduction: In 2007, a National Post-Transplant Follow-up Program (PNSPT) was created, which is managed by the Special Programs Coordination Unit (UCPE). One of the objectives of this Unit is to provide immunosuppressive drugs to patients with exclusive public coverage and some special programs. The PNSPT program includes stages that involve the purchase of medicines requested by the Ministry of Health (according to the history of consumption and the balance between registrations and withdrawals of the beneficiary); and the collection in Logistics Operators (medical prescription, request for medicines from each jurisdiction, distribution logistics, patient care and stock management). The cost of immunosuppressive drugs is high, highly variable, and poorly understood. Therefore, the objective of this study was to analyze the evolution of the PNSPT program in compliance with the coverage of immunosuppressive drugs. Methods: This is a descriptive study. The data was obtained from INCUCAI’s National Purchasing and Transplant Information System (SINTRA). The different program regulations were reviewed and medication shipments to the provinces registered and systematized. Subsequently, the following were evaluated annually: the number of patients in the program and the formulary; the amount of medicines distributed, the investment in US dollars made according to the prices paid for each medicine according to the purchase order of the last tender (to control the inflationary effect that occurred during the period analyzed). Results: PNSPT coverage has steadily increased from 705 patients (2009) to 4,351 (2021). Investments in medicines increased even more, going from US$1.1 million in 2009 to US$13.1 million in 2021. Thus, the direct increase in the average investment per patient doubled between the periods analyzed (2009: u $1,559.9; 2021: $3,010.6). The largest investment was in 2019 and there was a slight decrease in the following 2 years, as a result of changes in the management of the Program, related to the search for efficiency in the use and purchase of medicines. Throughout the analyzed period, the vademecum included drugs such as Everolimus, Azatriopine, Tracolimus XL, Meprednisone, Sirolimus, Thymoglobuline, Valganciclovir, Ganciclovir, Basiliximab and Belatacept; Oral sirolimus and eye drops for pre and post corneal transplant treatment. Conclusions: From the creation of the PNSPT, the INCUCAI increased the coverage and the annual investment for transplant patients with exclusive public coverage and for the beneficiaries belonging to the other coverage under the program. The expansion of the vademecum allowed patients under the program in all regions of the country to have full coverage of induction and immunosuppression drugs. Taking into account that the medication favors the patient´s adherence to the treatment, it is probable that the correct execution of the program benefits the patient, increasing the survival of the graft and the patient.

Trust as a metric for auction-based task assignment in a cooperative team of robots with heterogeneous capabilities

As robots become part of our everyday lives, they may be required to cooperate without being aware of each other’s capabilities (e.g., because different teams have developed them), and therefore will have to trust each other to work together safely and efficiently. Starting from this premise, this work identifies trust as an essential metric to assign tasks to robots using auction-based mechanisms. We model trust by taking inspiration from popular models in the literature and adapting them to an open environment in which heterogeneous robots may dynamically enter or exit, execute assigned tasks, or verify the correct execution of tasks by other robots. Robots are considered to be heterogeneous in the sense that they may have different capabilities in executing and verifying the execution of actions. In the proposed model, “doing an action” and “verifying the execution of an action” are distinct, not necessarily overlapping, capabilities. Some robots may be able to do an action, whereas some robots may not be able to do it but only to observe and judge the ability of other robots to do it. After introducing the relevant formalism, the article describes the system’s architecture implemented in ROS and multiple experiments performed in simulation and with real robots (one NAO and two Pepper robots by SoftBank Robotics), providing a proof-of-concept for broader utilization of the system in cooperative robotic scenarios.

Динаміка рівнів біомаркерів ендотеліальної функції у хворих на резистентну артеріальну гіпертензію під впливом лікування

The purpose of the study was to determine the biomarker levels dynamics of endothelial function in patients with treatment resistant hypertension under the influence of treatment. Materials and methods. A comprehensive outpatient examination was conducted in 117 patients with a preliminary diagnosis of treatment resistant hypertension. 71 patients with hypertension of the stage II and 35 practically healthy individuals were examined. The quantitative content of endothelin-1 was determined by enzyme immunoassay using a set of reagents Endothelin-1 ELISA kit (Biomedica, Austria). The method for determining stable final metabolites of nitric oxide in the blood is based on the reduction of nitrates to nitrites with the determination of the latter by reaction with the Gris reagent. Results and discussion. The level of endothelin-1 between the groups of patients was significantly higher among patients with treatment resistant hypertension than among patients with hypertension of the stage II – 1.64 [1.16; 2.18] fmol/l versus 0.98 [0.73; 1.02] fmol/l, respectively, (p<0.05). The NO2 index had the lowest value in the group of patients with treatment resistant hypertension 6.00 [5.10; 7.30] mmol/l and was significantly lower by 20.0% compared to the group of patients with hypertension of the stage II – 7.50 [6.80; 9.40] mmol/L. The NO3 level among patients with treatment resistant hypertension was 13.50 [11.20; 14.80] mmol/l, which was significantly lower by 11.8% and 18.2% compared to the group of patients with hypertension of the stage II and the group of practically healthy individuals, respectively (p<0.05). In the first group, blood pressure levels <140/90 mmHg were reached by 29 (56.9%) people, which significantly exceeded the percentage in the second group – 15 (30.6%) patients (p<0.05). Treatment of patients with treatment resistant hypertension should include optimizing dosages and prescribing rational combinations of antihypertensive drugs in order to enhance synergistic effects. Among the measures to overcome low adherence to treatment of hypertension, the following should be recommended: assessment and selection of patients with low compliance (according to the Morisky-Green scale); optimization of pharmacotherapy by prescribing drugs with fixed combinations; control of drug intake. The Morisky-Green scale test should be applied at the beginning of treatment of patients with hypertension, since it allows the doctor to understand how supportive the patient is to treatment and will correctly perform the appointment. After all, only accurate and correct execution of prescriptions can bring the maximum positive effect of therapy and prevent the development of complications. The fixed combination of amlodipine-indapamide-perindopril has one important advantage, which is to increase adherence to treatment due to the principle of "one day – one pill". Conclusion. Among patients with hypertension, the development of endothelial dysfunction is noted, which increases with treatment resistant hypertension. The combination of amlodipine-indapamide-perindopril is effective in reducing blood pressure and correcting endothelial dysfunction. The use of a fixed combination of amlodipine-indapamide-perindopril in the form of a single pill by patients is accompanied by a large percentage of those who have reached blood pressure levels <140/90 mmHg

Diagnostic and Surgical Treatment of Multi-Valve Heart Disease with Infective Endocarditis

" Diagnostic and surgical treatment of multi-valve heart disease with infective endocarditis" Objective: The aim of the study was to analyze our own experience of diagnosis, choice of tactics and execution of multi-valve surgical correction of heart defects in infective endocarditis (IE). Methods: We retrospectively analyzed data and clinical results of 156 patients with infective endocarditis who underwent the cardiac surgery in our clinic. Among them, 85 were men (56.5%), and women - 71 (45.5%). Age of our patients ranged from 12 to 68 (mean 32.76 (1.6)) years. The patients were divided into 2 groups: group 1, 89 (57.4%) patients who underwent a complex of developed by the author’s antibiotic therapy, surgical treatment and preventive measures and 2-group 67 (42.6%) patients who underwent the traditional surgical treatment scheme. We analyzed electrocardiography, chest X-Ray, transthoracic echocardiography, transesophageal echocardiography, cardiac catheterization and coronary angiography and blood culture analysis. Results: Intraoperative treatment - preventive measures (TPM) were as follows; mechanical and chemical sanitation of the infected area of the heart; implantation of valves with antibacterial properties; hyperthermic perfusion; antimicrobial therapy, including anti-fungal agents. Application of the above measures reduced mortality in the study group to 5.1%, in the control group - 9.3%. In dynamics, mortality declined to 3.9% in the study group. Conclusion: Our results of surgical treatment of multi-valve heart defects with infective endocarditis showed the efficacy of developed complex preoperative and intraoperative measures in surgical treatment of IE. This new treatment approach is associated with significant improvement of left ventricular function and low mortality rate.

Criteria for determining the market value of real estate for adjustments to their cadastral value

The analysis of the formed market system is given, in which the procedure for determining the ca-dastral value seems to be the most problematic. It is the cadastral value that is the basis for calculat-ing the main indicators of the payment of non-property objects and determines the subject of dis-putes between the state, citizens and entrepreneurs in terms of the amount of such payments.
 According to the current legislation, namely Federal Law No. 135-FZ of 29.07.1998 "On Valuation activities in the Russian Federation", the results of cadastral valuation can be challenged by individ-uals and legal entities in court or in a commission established under the Federal Register.
 Since the cadastral value was determined by mass valuation methods, the final value may incorrectly reflect market reality. However, all the current regulatory legal acts, methodological guidelines for evaluation are aimed at more correct execution of appraisal activities and, accordingly, at displaying adequate results of real estate valuation.

Letter on the results of the BASiNET method in the paper 'A systematic evaluation of computational tools for lncRNA identification'.

This letter points out a conceptual error made by the authors of a published paper, which presents a review and evaluation of computational methods in lncRNA identification. The error was made in the execution of the BASiNET method when considering an example file (toy model) made available by the authors with the aim of showing how a classification model could be stored in a file for later use. In this letter, this error is contextualized, the correct use of the BASiNET method is pointed out and the results of its correct execution to one of the datasets used in the review article are presented. The results clearly show the misuse of the method and present its correct use so that it can be fairly compared with other methods in the literature and prevent its misuse from being replicated by new studies.

Should the Heels Touch the Floor During the Plié in Classical Ballet Jumps

This paper aimed to review the literature concerning the correct execution of the plié movement in the performance of different classical dance jumps. Studies about jumping techniques (such as countermovement jump, squat jump, and drop jump), the stretch-shortening cycle of short and long duration, classical dance jump and ballet mechanical action description by Agrippina Vaganova and Balanchine raised questions concerning different forms of plié execution preceding small and big jumps. Depending on the circumstance, they were especially concerning the heels contact on the floor during the plié execution before each jump. Understanding when the contact should happen or not is crucial for the prescription of adequate and specific training.

An Entropy-View Secure Multiparty Computation Protocol Based on Semi-Honest Model

Data interaction scenarios involving multiple parties in network communities have problems of trust, data security, and reliability of the parties, and secure multiparty computation(SMPC) can effectively solve these problems. To address the security and fairness issues of SMPC, this study considers that semi-honest participants can lead to deviations in the security and fairness of the protocol, and combines information entropy and mutual information to present an n-round information exchange protocol in which each participant broadcasts a relevant information value in each round without revealing other information. The uncertainty of the correct outcome value is blurred by the interaction information in each round, and each participant is not sure of the correct outcome value until the end of the protocol, which effectively prevents malicious behavior and ensures the correct execution of the protocol. Security and fairness analysis shows that our protocol guarantees the security and relative fairness of the output obtained by the participants after completing the protocol.

ADAPTIVE IMAGE SUPER-RESOLUTION ALGORITHM BASED ON FRACTIONAL FOURIER TRANSFORM

Super-resolution imaging is a critical image processing stage that improves visual image quality. Super-resolution imaging has a wide array of use in different fields, such as medical, satellite, and astronomical images. The correct execution of this stage could increase the accuracy and quality of any available processes in different executive fields. Learning methods, especially deep learning, have become much more popular in recent years for performing the super-resolution imaging process. Methods with this approach have high-quality levels but lack appropriate performance times. This study intends to perform super-resolution imaging using an algorithmic approach based on the particle swarm optimization algorithm and the fractional Fourier transform. The test results on a dataset show the 92.16% accuracy of this proposed method.

A Fault-Tolerant Workflow Composition and Deployment Automation IoT Framework in a Multicloud Edge Environment

With the increasing popularity of IoT application, e.g., smart home, smart manufacturing, the importance of underlying system availability, safety, reliability, and maintainability become crucial in the development processes. IoT applications are expected to continuously provide reliable services and features, which put the fault-tolerance mechanism as a priority. Current IoT fault-tolerant systems are designed to overcome any faults caused by human activities and physical errors to preserve the correct IoT workflow execution. However, addressing fault-tolerant interaction in multicloud edge environment and failed service deployment automation remains challenging. This article proposes a novel fault-tolerant model that offers the self-detection and automatic recovery of faults to increase IoT applications’ reliability and to address the infrastructure level failure in the heterogeneous IoT environments. Based on the proposed model, we implement a fault-tolerant workflow composition and deployment automation system, which is empowered by a layered architecture and a time-dependent failure model. The efficiency and effectiveness of the proposed system are validated and evaluated with a real-world IoT application.

Clinical pathway on pediatric cardiomyopathies: a genetic testing strategy proposed by the Italian Society of Pediatric Cardiology

Pediatric cardiomyopathies are rare diseases, heterogeneous in clinical presentation, etiology and prognosis. Etiological diagnosis, where genetic analysis plays a key role, is of fundamental importance for defining diagnostic and therapeutic pathways. Furthermore, the identification of the genetic substrate represents a prerequisite for cascade screening in the proband's family members and to allow conscious reproductive choices. To date, genetic testing is performed with the analysis of gene panels (targeted panels) or with the study of the entire exome (whole exome sequencing) using next generation sequencing (NGS) technology. The great genetic heterogeneity and the temporal variability of the clinical manifestations lead to unique problems for pediatric cardiomyopathies, distinct from those of the adult, such as the possible indications for access to the test, the type of test to be used (exome or panel of genes), the importance of analyzing parents, especially in cases with neonatal onset; moreover, the correct execution of bioinformatics analysis and the interpretation of NGS data play a crucial role in the impact of the results on clinical management.

Aklın Kemâl Yolculuğu: Hâris el-Muhâsibî’de (öl. 243/857) Akıl Terbiyesi

İnsanı insan kılan temel unsur akıldır. Akıl ayrıca insanın inanç, ibâdet ve ahlâkî sorumluluklarının temelidir. Aklın işlevlerini doğru bir şekilde icra etmesi, zikredilen alanlardaki sorumluluklarını yerine getirmesiyle doğrudan ilişkilidir. Bu yönüyle akıl, başta felsefe olmak üzere kelâm, fıkıh ve tasavvuf gibi ilmî disiplinlerin ortak konusunu teşkil etmiştir. Akıl-irâde, akıl-îmân, akıl-nefis, bilgi ve duyu ilişkisi, akıl türleri, aklın neyi bilip bilmeyeceği, sahîh akıl, doğru düşünmenin neliği ve imkânı üzerinde durulan bazı konulardır. Ancak mezkûr ilimlerin bu konularla ilgili akla yaklaşımları birbirinden farklıdır. Söz gelimi sahîh düşünmeyi/akletmeyi engelleyen reziletlerin nefyedilip faziletlerle donanmayı görüş ve yöntemlerin ortaya konması tasavvufu diğerlerinden ayırmaktadır. Bu bağlamda Hâris el-Muhâsibî (öl. 243/857) de öncelikle huy ve eylemlerin kaynağı konumundaki kalbin ve aklın eğitilerek doğru düşünmenin sağlanmasıyla ilgilenmiştir. Doğru/sağlıklı düşünmenin konusu Allah ve kişinin Allah’la her türlü ilişkisi iken yöntemi, sorumlu tutulduğu hususları yerine getirerek Allah’ın ahlâkıyla ahlâklanmak ve hukukuna riayet etmektir (er-ri‘âye li-hukûkillâh/takvâ). Akıl Muhâsibî’de basîret ve ma‘rifet yönünde eğitilip i‘tibar, tefekkür, tezekkür ve tedebbür yönünden işlevsel kılınarak geliştirilmesi gereken bir melekedir. Nitekim doğru/sahîh düşünme/akletme ve aklî kemâle bu süreç sonucunda erişilebilmektedir. Bu yönüyle eğitim de aklı doğru ve yerinde kullanma çabası olarak kabul edilebilir. Ayrıca aklın terbiye edilmek suretiyle kemâl bulması; îmân, ibâdet ve ahlâk alanlarının birlikteliğini gerektirdiğinden konu din eğitimi açısından da önem arz etmektedir. Bu çalışma, Muhâsibî’nin akıl anlayışını kendisine konu edinmektedir. Amacı, Muhâsibî özelinde aklın tanımı, kapsamı ve kemâl sürecini (terbiyesini) ele almaktır. Araştırma yazılı dokümanların incelenmesi yöntemiyle ele alınmıştır. Buna göre veriler Muhâsibî’nin başta Mâ(h)iyetü’l-‘akl olmak üzere farklı eserlerinden hareketle ortaya konmuş ve bunların çözümlenmesinde betimsel analiz ve içerik analizi tekniklerinden faydalanılmıştır. Muhâsibî, aklın kimi tanımlarına yer verip bunlarla ilgili değerlendirmelerde bulunsa da akla dair ayrıntılı teorik tartışmalara girmemektedir. Aklı temelde doğuştan sahip olunan (ğarîzî) ve sonradan kazanılan (mükteseb) olmak üzere ikiye ayırmaktadır. Muhâsibî, îmân ve ahlâkla ilişkisine odaklanarak aklın kemâl yönündeki gelişimine odaklanmıştır. Bu nedenle onun düşüncesinde îmân, ahlâk ve akıl/akletme birbirinde ayrılmayan alanlardır. Aklın kemâli bağlamında Allah korkusu (havf), yakîn kuvveti ve dinde basîret ve tefakkuhun birlikteliğini özellikle vurgulamıştır. Akıl-ahlâk ilişkisinde ise ahlâkı akla öncelemiş, aklın terbiye edilmek suretiyle olgunlaşmasını reziletlerden arınıp dinî/ahlâkî faziletlerle donanmaya bağlamıştır.

KAP1 is a new non-genetic vulnerability of malignant pleural mesothelioma (MPM).

Malignant pleural mesothelioma (MPM) is a rare and incurable cancer, which incidence is increasing in many countries. MPM escapes the classical genetic model of cancer evolution, lacking a distinctive genetic fingerprint. Omics profiling revealed extensive heterogeneity failing to identify major vulnerabilities and restraining development of MPM-oriented therapies. Here, we performed a multilayered analysis based on a functional genome-wide CRISPR/Cas9 screening integrated with patients molecular and clinical data, to identify new non-genetic vulnerabilities of MPM. We identified a core of 18 functionally-related genes as essential for MPM cells. The chromatin reader KAP1 emerged as a dependency of MPM. We showed that KAP1 supports cell growth by orchestrating the expression of a G2/M-specific program, ensuring mitosis correct execution. Targeting KAP1 transcriptional function, by using CDK9 inhibitors resulted in a dramatic loss of MPM cells viability and shutdown of the KAP1-mediated program. Validation analysis on two independent MPM-patients sets, including a consecutive, retrospective cohort of 97 MPM, confirmed KAP1 as new non-genetic dependency of MPM and proved the association of its dependent gene program with reduced patients’ survival probability. Overall these data: provided new insights into the biology of MPM delineating KAP1 and its target genes as building blocks of its clinical aggressiveness.

Study on Measuring and Evaluating Shoulder Joint Flexibility in Karate Practitioners using Emerging Technologies

The research aims to highlight new methods of measuring and assessing flexibility using emerging technologies. Using Mobee Med equipment as an emerging technology, we can quickly and accurately measure flexibility of the humeral-scapulo joint. The analysis is performed using a compact, sensor-based device, which is also used to conveniently control the software. We can follow the execution of the movement in real time, and we can enter additional relevant information, such as pain data whether or not it exists. A good flexibility at the level of the humeral-scapulo joint leads to a correct execution of the arm techniques, to a better use of strength and speed.

An Effective Method to Identify Microarchitectural Vulnerabilities in GPUs

Graphics Processing Units (GPUs) are increasingly adopted in several domains where reliability is fundamental, such as self-driving cars and autonomous systems. Unfortunately, GPU devices have been shown to have a high error rate, while the constraints imposed by real-time safety-critical applications make traditional (and costly) replication-based hardening solutions inadequate. This work proposes an effective methodology to identify the architectural vulnerable sites in GPUs modules, i.e., the locations that, if corrupted, most affect the correct instructions execution. We first identify, through an innovative method based on Register-Transfer Level (RTL) fault injection experiments, the architectural vulnerabilities of a GPU model. Then, we mitigate the fault impact via selective hardening applied to the flip-flops that have been identified as critical. We evaluate three hardening strategies: Triple Modular Redundancy (TMR), Triple Modular Redundancy against SETs ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\Delta $ </tex-math></inline-formula> TMR), and Dual Interlocked Storage Cells (Dice flip-flops). The results gathered on a publicly available GPU Model (FlexGripPlus) considering functional units, pipeline registers, and warp scheduler controller show that our method can tolerate from 85% to 99% of faults in the pipeline registers, from 50% to 100% of faults in the functional units and up to 10% of faults in the warp scheduler, with a reduced hardware overhead (in the range of 58% to 94% when compared with traditional TMR). Finally, we adapt the methodology to perform a complementary evaluation targeting permanent faults and identify critical sites prone to propagate fault effects across the GPU. We found that a considerable percentage (65% to 98%) of flip-flops that are critical for transient faults are also critical for permanent faults.

Impact of the pre-slaughter period on the contamination of bovine leather and the operational sanitary procedure for skinning on the quality and microbiological safety of the carcass

Sanitary procedures are essential in cattle slaughter processes to minimize microbiological hazards from meat consumption. This study aimed to verify the influence of the pre-slaughter period and the correct execution of the operational sanitary procedure (OSP) for skinning in the breast region on the counts of indicator microorganisms and the occurrence of enteropathogens in the hides and carcasses of cattle. Forty-eight animals were evaluated and divided into 12 clusters, half of which were allowed 13 h of preslaughter rest, while the other half were allowed 23 h of pre-slaughter rest. The presence of microbiological indicators, including Salmonella spp., Listeria spp., and Shiga toxin-producing (STEC), enteropathogenic (EPEC), and enterohemorrhagic (EHEC) Escherichia coli, were evaluated in superficial samples of leather and carcass in which the OSP for skinning of the chest was performed either correctly or incorrectly. There was no significant effect (p &gt; 0.05) of the pre-slaughter period on the counts of total coliforms, E. coli, enterobacteria, and mesophilic aerobics in the hide or carcass, although, in the carcasses, this difference was 93.4% for mesophilic aerobics and enterobacteria in the group of animals subjected to 23 h of rest compared to those subjected to 13 h of rest. Regarding the correct execution of the skinning OSP, there was also no significant effect (p &gt; 0.05) on the indicator quantifications, but in relation to the presence of enteropathogens, it was possible to proportionally identify more EPEC and STEC in carcasses subjected to the wrong OSP, as it was only possible to identify Salmonella spp. and EHEC in carcasses subjected to the wrong OSP. The correct execution of the OSP for skinning incision in the chest region of the animal reduced the microbiological risk of the carcasses for the presence of enteropathogens and facilitated compliance with the microbiological standards for the carcass.

Standard operating procedure for the management of hypertensive urgencies in a community health centre in rural Tamil Nadu: a quality improvement project

Background: Hypertension is one of the heaviest health care burdens in rural India where less than 1/10th of patients has blood pressures under control. This sheds limelight on community healthcare centers to proactively prevent, manage and treat hypertension and its complications. St. Ann’s Hospital is one such CHC located in the Elathigiri subdisrtict of Tamil Nadu. We formulated a standard operating procedure at the CHC for the effective prevention and treatment of hypertensive urgency- one of the easily treatable but highly impactful complications of hypertension. We then strengthened its usage using plan-do-study-act cyclesMethods: An SOP was formulated using international and national guidelines, contoured to the low resources present at the center. Healthcare workers were trained to follow the SOP. Sequential PDSA cycles were then used to evaluate and control the step-ladder of barriers in effective management. The results were analyzed using indicators and compared to baseline values established at the start of the study.Results: A rise of 41.4% was seen in correct SOP execution at the end of PDSA-2. At the end of the study, there was a 22% increase in the percent of patients correctly diagnosed, 19% increase in patients stabilized in the first hour and 14% increase in patients returning for follow up visits (p&lt;0.05).Conclusions: Our SOP could significantly reduce the burden of HU at the CHC. We encourage its usage in similar low resource centers and promote PDSA cycles as a method to ensure its efficient utilization.

Recommendations for cardiovascular magnetic resonance and computed tomography in congenital heart disease: a consensus paper from the CMR/CCT working group of the Italian Society of Pediatric Cardiology (SICP) and the Italian College of Cardiac Radiology endorsed by the Italian Society of Medical and Interventional Radiology (SIRM) Part I

Cardiovascular magnetic resonance (CMR) and computed tomography (CCT) are advanced imaging modalities that recently revolutionized the conventional diagnostic approach to congenital heart diseases (CHD), supporting echocardiography and often replacing cardiac catheterization. Nevertheless, correct execution and interpretation require in-depth knowledge of all technical and clinical aspects of CHD, a careful assessment of risks and benefits before each exam, proper imaging protocols to maximize diagnostic information, minimizing harm. This position paper, written by experts from the Working Group of the Italian Society of Pediatric Cardiology and from the Italian College of Cardiac Radiology of the Italian Society of Medical and Interventional Radiology, is intended as a practical guide for applying CCT and CMR in children and adults with CHD, wishing to support Radiologists, Pediatricians, Cardiologists and Cardiac Surgeons in the multimodality diagnostic approach to these patients. The first part provides a review of the most relevant literature in the field, describes each modality's advantage and drawback, making considerations on the main applications, image quality, and safety issues. The second part focuses on clinical indications and appropriateness criteria for CMR and CCT, considering the level of CHD complexity, the clinical and logistic setting and the operator expertise.