Development Of Management Algorithms Research Articles

FOREIGN EXPERIENCE IN IMPROVING THE EFFICIENCY OF THE SYSTEM OF STATE REGULATION OF INNOVATION ACTIVITIES

Therefore, the transition to an innovative economy requires the development of a network of regional innovation systems. At the same time, the regional innovation policy should be aimed at the formation of regional innovation clusters as the basis of the innovation system of the region, where the best conditions for the innovation process are located. Of particular interest are regions with high scientific potential (as a rule, they include scientific fences and a number of academic towns and other territories with high scientific potential), as they have a significant stock of developments ready for commercialization. It is on the basis of such territories that it is necessary to develop regional innovation clusters. Despite the fact that the problem has been studied and the high level of attention, many of its aspects remain unresolved. Many authors have pointed out the limited possibilities of using classical methods of evaluating investment projects for innovation, and thus the proposed alternatives have not been widely used. The practical and actual significance of the problems of management and evaluation of innovative projects and the use of the most effective methods for this purpose, determined the choice of the dissertation topic, its content, goals and problems. The practical significance of Makala is in the development of management algorithms and evaluation methods for innovative projects. The algorithm includes intra-stage project evaluation and methodological justification of the manager's decision-making in the implementation of the project at each stage and ensuring the need to adjust the strategy. In addition, the analysis of the main barriers to practical implementation was carried out and recommenda-tions were developed to eliminate them. The developed method includes all the prerequisites for successful application in the specific activity of the region.

The OxyTain Algorithm: An Approach to Airway Management in the Cannot Intubate and Cannot Oxygenate Scenario.

Although rare, cannot intubate and cannot oxygenate situations are challenging acute events. The development of management algorithms, standardized equipment provisions, and appropriate clinical training in the application of front-of-neck access techniques are necessary to optimize procedural success to ensure adequate oxygenation. The OxyTain algorithm is an institutionally developed protocol to manage cannot intubate and cannot oxygenate events. With proper implementation, this unique process aligning the cannula cricothyroidotomy and scalpel bougie as primary and secondary techniques, respectively, can potentially optimize procedural success. This algorithmic approach is trained routinely among our anesthesia providers, while the equipment is standardized throughout our anesthetizing locations.

A Concept Map of Neonatal Hypoglycemia

Objectives: To analyze current management of neonatal hypoglycemia and establish a concept map based on testimonials from physicians who use capillary blood glucose tests to guide management. Methods: This was an observational, descriptive, mixed qualitative and quantitative study. A questionnaire was administered to physicians, seeking to characterize their responses to neonatal hypoglycemia in pregnancy, labor and delivery, and the immediate neonatal period. Data collection was performed with two groups of Brazilian physicians: neonatologists (group GN) and pediatricians (group GP). A Likert-type scale was used to collect responses. The Mann-Whitney test and Fisher’s exact test were used for statistical analysis of continuous and categorical variables respectively. Statistical significance was accepted at 5%. Principal components analysis with varimax rotation and Kaiser normalization was used to verify the structure of question/answer factors in the two groups of professionals. A concept map was constructed using the Cmap Tools Knowledge Kit, version 5.05.01. Results: Of the 98 questionnaires analyzed, 34.7% were completed by neonatologists (n=34/98) and 65.3% by pediatricians (n=64/98). Mean age in the two groups (GN and GP) was 42.4 years (SD: 11.78; 95% CI: 40.10, 44.88; p=0.597), with a significant difference in age in men (mean=50 years; SD: 10.35; 95% CI: 45.20, 54.90; p<0.001); 79.2% of respondents (n=78/98) were women. Overall, 32.7% of respondents (n=32/98) claimed they did not currently work with neonates. Respondents in GN had completed more postgraduate courses (p=0.38). The two groups responded similarly to all questions. The responses highlighted the importance of values lower than 40 mg/dL in the diagnosis of neonatal hypoglycemia, as well as the indication of intravenous infusion when glucose was below 40 mg/dL in symptomatic neonates. Immediate institution of periodic capillary blood glucose measurement was recommended for the following groups of neonates: those born to diabetic mothers, those with intrauterine growth restriction, small for gestational age, large for gestational age, preterm neonates, septic neonates, and those with birth asphyxia. Conclusions: Capillary blood glucose is part of routine neonatal management, especially preventive, in light of the possibility of neonatal hypoglycemia. Our findings highlight that, in high-risk gestational groups, the entire neonatal team should be focused on the risk of hypoglycemia. The development of management algorithms based on the use of peripheral blood glucose test strips has contributed to streamlining the management of neonatal hypoglycemia.

Liver fibrosis in HIV: which role does HIV itself, long-term drug toxicities and metabolic changes play?

Liver disease is one of the main causes of non-AIDS death in HIV-infected individuals from Europe and North America and has been attributed mainly to coinfection with hepatotropic viruses. However, HIV-induced inflammation as well as long-term antiretroviral drug toxicity may also contribute to clinical relevant liver disease. Therefore, a better understanding of liver disease beyond viral hepatitis coinfection is urgently needed in HIV-infected individuals. Cross-sectional fibroscan studies in HIV-infected patient populations have reported unexpectedly high rates of advance fibrosis in HIV-infected patients even without underlying viral hepatitis or alcohol abuse suggesting that HIV itself may contribute independently to liver disease. Finally, HIV therapy itself either through direct hepatotoxicity or long-term metabolic changes, such as dyslipidemia and/or insulin resistance, may additionally cause liver damage in life long treatment. Therefore, aging of the liver in HIV may play a much more pivotal role in the future considering age-related effects, coinfection with hepatotropic viruses and the toxicity of long-term antiviral treatment. Thus, adequate monitoring of liver disease and development of management algorithms are clearly needed to optimize outcome and care of the aging liver in an HIV-infected individual.