General Capacity Research Articles

Health system strengthening using a Maximizing Engagement for Readiness and Impact (MERI) Approach: A community case study.

Health system strengthening initiatives in low and middle-income countries are commonly hampered by limited implementation readiness. The Maximizing Engagement for Readiness and Impact (MERI) Approach uses a system "readiness" theory of change to address implementation obstacles. MERI is documented based on field experiences, incorporating best practices, and lessons learned from two decades of maternal, newborn, and child health (MNCH) programming in East Africa. The MERI Approach is informed by four sequential and progressively larger MNCH interventions in Uganda and Tanzania. Intervention evaluations incorporating qualitative and quantitative data sources assessed health and process outcomes. Implementer, technical leader, stakeholder, and policymaker reflections on sequential experiences have enabled MERI Approach adaptation and documentation, using an implementation lens and an implementation science readiness theory of change. The MERI Approach comprises three core components. MERI Change Strategies (meetings, equipping, training, mentoring) describe key activity types that build general and intervention-specific capacity to maximize and sustain intervention effectiveness. The SOPETAR Process Model (Scan, Orient, Plan, Equip, Train, Act, Reflect) is a series of purposeful steps that, in sequence, drive each implementation level (district, health facility, community). A MERI Motivational Framework identifies foundational factors (self-reliance, collective-action, embeddedness, comprehensiveness, transparency) that motivate participants and enhance intervention adoption. Components aim to enhance implementer and system readiness while engaging broad stakeholders in capacity building activities toward health outcome goals. Activities align with government policy and programming and are embedded within existing district, health facility, and community structures. This case study demonstrates feasibility of the MERI Approach to support district wide MNCH programming in two low-income countries, supportive of health outcome and health system improvements. The MERI Approach has potential to engage districts, health facilities, and communities toward sustainable health outcomes, addressing intervention implementation gaps for current and emerging health needs within and beyond East Africa.

Association of BMI with general health, working capacity recovered, and post-acute sequelae of COVID-19.

The aim of this study was to determine the risk of post-acute sequelae of COVID-19 associated with the continuous spectrum of BMI. Epidemiology of Long COVID (EPILOC) is a population-based study conducted in Baden-Württemberg (Germany), including subjects aged 18 to 65 years who tested positive for SARS-CoV-2 between October 2020 and April 2021. Eligible subjects answered a standardized questionnaire, including sociodemographic characteristics, lifestyle factors, and the presence of specific symptoms. Participants assessed their current general health recovery and working capacity compared with the pre-infection situation and provided their body height and weight. Generalized additive models were used to assess the association of BMI with general health recovered, working capacity recovered, and prevalence of fatigue, cognitive impairment, and chest symptoms. The analyses included 11,296 individuals (41% male), with a mean age of 44.0 (SD 13.7) years. Best general health recovery was observed at BMI of 22.1 (95% CI: 21.0-27.0) kg/m2 in men and BMI of 21.6 (95% CI: 20.3-23.1) kg/m2 in women. In addition, we found that increasing BMI was consistently associated with post-COVID fatigue, neurocognitive impairment, and chest symptoms. High BMI contributes to impaired recovery after SARS-CoV-2 infection; however, a low BMI is associated with impaired recovery as well.

A Proof-of-Concept Preclinical Study Using a Novel Thermal Insulation Device in a Porcine Kidney Auto-Transplantation Model.

Ischemia-reperfusion injury remains a fundamental problem during organ transplantation logistics. One key technical factor is the rapid allograft rewarming during the time of vascular reconstruction in the recipient. In this pilot study, a new thermal insulation bag (TIB) for organ transplantation was used. Insulation capacity, tissue compatibility, and usability were tested initially ex vivo on porcine kidneys (n = 24) followed by the first in vivo usage. Fourteen female German landrace pigs underwent kidney auto-transplantation after 24 h cold storage (4 °C). During the implantation process the kidney was either insulated with the new TIB, or it was not thermo-protected at all, which represents the clinical standard. In this proof-of-concept study, the usability (knife-to-skin-time) and the general thermal capacity (30 min warm storage at 38 °C ex vivo p < 0.001) was shown. The clinical outcome showed significant differences in the determination of CRP and pi-GST levels. Syndecan-1 Antibody staining showed clear significant higher counts in the control group (p < 0.01) indicating epithelial damage. However, the effect on renal outcomes in not severely pre-damaged kidneys does not appear to be conclusively significant. A close follow-up study is warranted, especially in the context of marginal organs or in cases where anastomosis-times are prolonged due to surgical complexity (e.g., multiple vessels and complex reconstructions).

A new method for wear estimation of TBM disc cutter based on energy analysis

The accurate estimation of disc cutter wear has always been a long-term topic affecting the excavation efficiency and construction cost of tunnel boring machines (TBMs), especially in the project of high-strength and high-abrasiveness stratum. In fact, disc cutter wear is one of the comprehensive results of rock-machine interaction during TBM excavation. Therefore, the change of internal energy of rock-machine system describes the wear information of disc cutter. In this study, a new method for estimation disc cutter wear based on energy conversion mechanism is proposed. Firstly, the basic relationship of energy conversion during TBM excavation is analyzed in detail, and an energy equation considering the influence of geological conditions, TBM technical specifications and rock-machine interactions at three levels is established. Based on this context, according to the working characteristics and abrasion mechanism of disc cutter, the conversion mechanism between the disc cutter wear energy and wear capacity is investigated, and the definite relationship between the energy conversion coefficient and the properties of intact rock is obtained. Furthermore, to illustrate the applicability of this method, a case study of the Shenzhen Metro Project in China is introduced and analyzed in detail. The results show that the proposed method can predict 85 % of the average wear of each disc cutter on the cutterhead. Finally, the prediction method provided in this study is compared with Gehring, NTNU and CSM models to validate the rationality and reliability of this method. Evidently, this method can provide an accurate and reliable estimate of the general wear capacity and life of disc cutters on the cutterhead, and it is also a very practical tool for TBM engineers to make decision and optimize the cutter replacement scheme.

Optimize train capacity allocation for the high-speed railway mixed transportation of passenger and freight

The collaborative transportation strategy of passengers and freights can improve the efficiency and revenue of the high-speed railway (HSR) system. This paper focuses on the train capacity allocation problem for the mixed transportation pattern of passenger and freight in HSR systems, in which rail operators introduce revenue management to determine the optimal train capacity allocation plan for each train service. We first propose a general train capacity allocation model which addresses passenger priority and freight loading/unloading capacity, and then the deterministic and stochastic demand scenarios are considered respectively. With the deterministic demand, the train capacity allocation model is linear programming with the objective of maximizing the revenue of the HSR system. While a non-linear programming model is built for the stochastic demand to maximize the expected revenue. For solving the problem with stochastic demand, the non-linear programming model is transformed into a mixed integer linear programming model, which can be easily solved by the existing solver to obtain the optimal solution. Two different-sized numerical experiments are conducted to demonstrate the efficiency and effectiveness of the proposed methods.

From Evidence-Based Implementation Guides to Meaningful Action: Public Health Practitioners Use Readiness Assessments to Build Bridges to Successful Community Prevention Implementation.

Readiness has been cited as a determining factor in whether a community can effectively implement, support, and sustain an initiative. Through readiness assessments and technical assistance, public health practitioners can be the bridge between the gap of reaching goals outlined in Healthy People 2030, or another funder's guides, and actionable, successful, implementation. Readiness assessments are practical tools for implementing change in public health. Here we discuss three readiness assessment activities that we developed for four Texas counties: a partnership mapping tool, an Ease and Impact score, and a round table discussion. Through the assessments, we ascertained both readiness and the relevance of Policy, Systems and Environment opportunities. We used readiness assessments to translate our funder's implementation guide to meet the needs of four counties. Data allowed us to determine whether communities were ready to move forward with minimal technical assistance, needed further assessment to better understand relevance and feasibility within the community to implement the initiative, or whether this opportunity was not a good fit at the time. We adapted readiness tools based on components of the R = MC2 framework so we could assess the readiness (motivation [M]; general organizational capacity [C]; and innovation-specific capacities [C]) of the participant groups and based on that assessment, we provided appropriate, tailored technical assistance. Public health practitioners and local supporters can use readiness tools and technical assistance to build a bridge from implementation guide(s) to effective community program implementation.

FEATURES AND PLACE OF BUSINESS PARTNERSHIPS IN THE SYSTEM OF COMMERCIAL CORPORATE LEGAL ENTITIES

Business partnership, as an organizational and legal form of legal entities, appeared in connection with an attempt to develop in Russia innovative venture activities similar to western organizations. However, due to the fact that this activity in Russia is not fully regulated and is risky, this form is unpopular, given that economic partnerships have general legal capacity and their legal status is not fully regulated. Having significant differences in the legal status of participants and the institution, organization and management, business partnerships are most similar to limited liability companies and economic fellowships. The similarity of business partnerships with limited liability companies is manifested in the same limit of the number of participants and the consequences of exceeding it, in the presence of a pre-emptive right to purchase the share of the participant in case of his exit. Business partnerships are similar to economic fellowships in the contractual model of functioning and in the fact that these organizations tend to «unite persons», where personal participation comes to the fore. They are also connected with each other by a legislative ban on the creation of organizations by one person. Purpose: to analyze the legal regulation of business partnerships and identify their distinctive features as a separate type of corporations, to compare them with other organizational and legal forms of legal entities. Methods: the method of interpretation and comparison, the system-structural method allows us to consider the object of the research in relation to other phenomena, as well as the method of system analysis. Results: in the system of corporate commercial organizations, a business partnership has a number of features of the composition of its participants and the order of establishment, organization and management of activities. The specifics of the legal status of participants in business partnerships are related to the requirement for them: the presence of other persons, the prohibition to be a participant or founder of a number of other legal entities, the procedure for the formation of the pooled capital.

Large-scale multimodal transportation network models and algorithms-Part II: Network capacity and network design problem

Transportation network capacity enhancement is essential in urban transportation planning. In this paper, a general multimodal network capacity problem (MNCP) is proposed, which can depict the transfers, mode overlap, and common line problem and congestion effect of transit. The problem is established as a bi-level model with combined mode choice and traffic assignment as the lower-level programming. Based on the MNCP, a tri-level multimodal network design problem (MNDP-MNCP) is developed to maximize the network capacity. The models are solved with an efficient Kriging-surrogate-based optimization algorithm in real-scale urban networks. Numerical results demonstrate the performances of the proposed framework.

Post-acute sequelae of covid-19 six to 12 months after infection: population based study

ObjectivesTo describe symptoms and symptom clusters of post-covid syndrome six to 12 months after acute infection, describe risk factors, and examine the association of symptom clusters with general health and...

Adaptive responding to prolonged stress exposure: A binational study on the impact of flexibility on latent profiles of cognitive, emotional and behavioural responses to the COVID-19 pandemic.

The high level of uncertainty brought about by the COVID-19 pandemic has affected the general population's well-being and capacity for adaptive responding. Studies indicate that flexibility, defined as the ability to choose and employ a variety of emotional, cognitive and behavioural strategies in accordance with changing contextual demands, may significantly contribute to adaptive responding to long-term stressors such as COVID-19. In the current study, we aimed to investigate which facets of flexibility predict different latent profiles of adaptive responding to the COVID-19 pandemic in Israel and Germany. A total of 2330 Israelis and 743 Germans completed online questionnaires measuring cognitive and coping regulatory flexibility and cognitive, emotional and behavioural responding to the COVID-19 pandemic. Analyses revealed three distinct response profiles in each country (high, medium and low). These profiles differed in both anxiety and depression symptoms with the non-adaptive response group experiencing clinically relevant symptoms both in Israel and Germany. Additionally, cognitive flexibility and coping flexibility emerged as significant predictors of response profiles in both countries. Training cognitive and coping flexibility may thus help individuals respond more adaptively to psychosocial stressors such as COVID-19. Such training could be selectively administered to less flexible subpopulations as well as adapted to the specific population characteristics.

PO242 / #615 ULTRASOUND-GUIDED PERCUTANEOUS PERIPHERAL NERVE STIMULATION FOR POST-OPERATIVE PERONEAL AND TIBIAL NEUROPATHY FOLLOWING A BILATERAL LUNG TRANSPLANT: E-POSTER VIEWING

The rehabilitation goals in the early phase post- lung transplant are to increase general mobility, functional capacity, muscle strength and endurance, and facilitate discharge from hospital. We present a case of a patient 6-week postoperative bilateral lung transplant complicated with ECMO cannulation of the right groin now with severe hyperalgesia of the right lower leg with peroneal nerve injury and foot drop. Electromyography demonstrated active denervation of the lower leg muscles. The ECMO was discontinued with cardiopulmonary stabilization with need for physical therapy and ambulation.

Charismatic Children: Heredity, Environment and ICTs

The aim of this article is to investigate whether or not charisma in children is considered inherited or not. There is no generally accepted definition of the gifted-charismatic child. However, various definitions of intellectual superiority include either general high capacity or high special capacity. The charisma of a child becomes apparent early in life. It can be considered as a biologically rooted label for a high level of intelligence, which shows an advanced and accelerating development of functions within the brain that allow its more efficient use. However, an interaction between the environment and the genetic framework creates intelligence, even the perception of reality. It is often difficult to separate the influences of genetics and the environment on human traits. Genetic traits do not appear instantly at the time of birth; instead, they tend to follow inherent epigenetic development pathways. Charismatic children develop asynchronously: their minds are often more ahead of their natural development and specific cognitive and emotional functions often develop differently at different stages of development. Finally, both the genetic material of the child, the environment within which the child grows and the ICTs usage and training, contribute to the development of charisma.

Readiness to implement screening, brief intervention, and referral to treatment in school-based health centers.

The purpose of this study was to evaluate the readiness of a university-based school-based health center (SBHC) program to implement the screening, brief intervention, and referral to treatment (SBIRT) model.We completed preimplementation surveys and interviews with providers, staff, and administrators at participating SBHCs (N = 19) to measure current protocols for and barriers to addressing adolescent substance use and barriers and facilitators to implementing SBIRT. We used the R = MC2 heuristic (readiness equals motivation, general organizational capacity, and innovation-specific capacity) to interpret findings from the data.Using the R = MC2 heuristic, we identified factors that may aid implementation, including the prioritization of substance use and a supportive organizational culture, as well as potential barriers, including competing high-priority health issues and a lack of resources for innovation.This study contributes to the emerging literature on the implementation of the SBIRT model with adolescents and in SBHCs and demonstrates the practical applicability of the R = MC2 heuristic for assessing implementation readiness. SBHCs are ideal locations for addressing substance use but SBHC providers also face unique challenges when implementing the SBIRT model.

Improving single-track railway line capacity using extended station switch point area

The paper focuses on the possible capacity improvement of a segment between two stations of a single-track railway line by using of extended station switch point area and on methods assessing the capacity of such railway infrastructure, where a part of a single-track line segment being not equipped itself with e.g. line blocks becomes partially double-tracked. These methods can extend state-or-art general capacity assessment methods and allow more detailed assessment in this specific case. The research was conducted on three levels. The first is only analytic, the second is based on the developed own mesoscopic stochastic simulation model and the third is based on a stochastic microsimulation model elaborated by using the OpenTrack software. Divided solutions on each level can provide assessments with different demands on computation and model development. Stepwise solutions at the individual level may rationalize capacity assessment.

Psychometric properties of performance-based measures of physical function administered via telehealth among people with chronic conditions: A systematic review.

Telehealth could enhance rehabilitation for people with chronic health conditions. This review examined the psychometric properties of performance-based measures of physical function administered via telehealth among people with chronic health conditions using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) approach. This systematic review was registered with Prospero (Registration number: CRD42021262547). Four electronic databases were searched up to June 2022. Study quality was evaluated by two independent reviewers using the COSMIN risk of bias checklist. Measurement properties were rated by two independent reviewers in accordance with COSMIN guidance. Results were summarised according to the COSMIN approach and the modified GRADE approach was used to grade quality of the summarised evidence. Five articles met the eligibility criteria. These included patients with Parkinson's Disease (n = 2), stroke (n = 1), cystic fibrosis (n = 1) and chronic heart failure (n = 1). Fifteen performance-based measures of physical function administered via videoconferencing were investigated, spanning measures of functional balance (n = 7), other measures of general functional capacity (n = 4), exercise capacity (n = 2), and functional strength (n = 2). Studies were conducted in Australia (n = 4) and the United States (n = 1). Reliability was reported for twelve measures, with all twelve demonstrating sufficient inter-rater and intra-rater reliability. Criterion validity for all fifteen measures was reported, with eight demonstrating sufficient validity and the remaining seven demonstrating indeterminate validity. No studies reported data on measurement error or responsiveness. Several performance-based measures of physical function across the domains of exercise capacity, strength, balance and general functional capacity may have sufficient reliability and criterion validity when administered via telehealth. However, the evidence is of low-very low quality, reflecting the small number of studies conducted and the small sample sizes included in the studies. Future research is needed to explore the measurement error, responsiveness, interpretability and feasibility of these measures administered via telehealth.

Speciation, leachability and bioaccessibility of tungsten in tungsten ore processing residue.

Tungsten ore processing residue (TOPR) poses a potential risk due to tungsten (W) leaching. However, the leachability of W in TOPR is not well understood. Herein, the mechanism of W leachability from TOPR was investigated using complementary characterization techniques and leaching experiments. Our X-ray absorption near edge structure (XANES) analysis resolved wolframite in TOPR with a distorted octahedral coordination. The sequential extraction procedure showed that 78% of mobile fraction W in TOPR were bound to Fe oxides, and consequently W leachability was positively correlated with dissolved Fe concentration as evidenced by the general acid neutralizing capacity (GANC) test. The GANC results showed that the W release was negatively correlated with Ca concentration due to CaWO4 precipitation. The in vitro gastrointestinal procedure (IVG) results indicated that organic acids, abundant in fruits and vegetables, significantly improved the bioaccessibility of W from 10% to 20% of total W in TOPR. As a consequence, accidental ingestion of TOPR with a chemical daily intake at 0.8mgkg-1 day-1 evidenced its emerging concern in the environment and human health.

Assessing readiness factors for implementation of LGBTQ+ affirmative primary care initiatives: Practice implications from a mixed-method study.

Access and utilization barriers in primary care clinics contribute to health disparities that disproportionately affect lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people. Implementing inclusive practice guidelines in these settings may decrease disparities. The purpose of this exploratory/developmental study is to identify key issues affecting the readiness of primary care clinics to implement such guidelines. Using a concurrent mixed-method research design, we conducted surveys, interviews, and focus groups with 36 primary care personnel in clinics in New Mexico, USA, to examine readiness to implement LGBTQ+ inclusive guidelines, analyzing factors affecting motivation, general organizational capacity, and innovation-specific capacity. We supplemented these data by documenting LGBTQ+ inclusive policies and practices at each clinic. We undertook descriptive analyses and between-subscale comparisons controlling for within-rater agreement of the survey data and iterative coding and thematic analysis of the qualitative data. Quantitatively, participants reported significantly more openness toward adopting guidelines and attitudinal awareness for developing LGBTQ+ clinical skills than clinical preparedness, basic knowledge, and resources to facilitate implementation. Six themes derived from the qualitative findings corroborate and expand on these results: (1) treating all patients the same; (2) addressing diversity in and across LGBTQ+ populations; (3) clinic climates; (4) patient access concerns; (5) insufficient implementation support; and (6) leadership considerations. This study demonstrates that personnel in primary care clinics support initiatives to enhance service environments, policies, and practices for LGBTQ+ patients. However, drawing on Iris Young's theory of structural injustice, we found that neutralizing discourses that construct all patients as the same and time/resource constraints may diminish motivation and capacity in busy, understaffed clinics serving a diverse clientele and reinforce inequities in primary care for LGBTQ+ people. Efforts are needed to build general and innovation-specific capacities for LGBTQ+ initiatives. Such efforts should leverage implementation teams, organizational assessments, education, leadership support, community engagement, and top-down incentives.

A nonasymptotic analysis for re‐solving heuristic in online matching

We investigate an online edge‐weighted bipartite matching problem with general capacity constraints. In this problem, the resources are offline and nonreplenishable with different capacities. Demands arrive online and each requests a certain amount of resources. The goal is to maximize the reward generated by successful matches. We model the offline optimization problem as a deterministic linear program (LP) and present multiple randomized online algorithms based on the solution to the offline LP. We analyze the performance guarantee of each algorithm in terms of its competitive ratio (CR). Importantly, we introduce a re‐solving heuristic that periodically recomputes the offline LP and uses the updated offline solution to guide the online algorithm decisions. We find that the algorithm's CR can be significantly improved when re‐solving at carefully selected time steps. Finally, we investigate the value of the demand distribution in further improving the algorithm efficiency. We conduct extensive numerical studies to demonstrate the efficiency of the proposed algorithms. The effect of market conditions on the algorithm performance is also investigated.

Comparative Study on Field Tests of Two Kinds of Shallow Treatment of Soft Soil Foundation

Through the vacuum preloading test with three different arrangements and the in-situ curing treatment at different depths, the treatment effect reached the expectation, indicating that both the vacuum preloading method and the in-situ curing method can achieve good reinforcement effect. Among them, the local curing method has remarkable effect on treating waste engineering mud, and its bearing capacity is far beyond expectation, which can be used as the foundation of high-grade highway. After the test, it is found that the real air filtration test area can also improve the treatment effect by reducing the distance between drainage plates, and the local curing treatment can further optimize the admixture content to achieve better reinforcement effect and further reduce the project cost. For the construction site with general bearing capacity requirements, vacuum filter tube or air pipe can be used to meet the requirements. For sites requiring higher bearing capacity, true air filter tube treatment can be used, and higher grade roadbed can be used in situ curing treatment.

The heart to make the right choice: Vagal (re)activity and recovery predict advantageous decision-making

From simple everyday choices to life-altering decisions, decision-making is a crucial cognitive process in our daily life. Psychophysiological theories of heart-brain interactions involvement in cognition predict that general self-regulation capacities underlie cognitive processes including decision-making. Yet, in the context of decision-making, the somatic maker hypothesis postulates that the adaptability of the current physiological state should be the best predictor of advantageous decision-making. The present study tests compare self-regulation in general (indexed by resting vagal activity) and in a specific decisional context (vagal reactivity and recovery) to explain advantageous decision-making. Young adults (n = 54) completed a decision-making task while wearing a heart rate monitor. Bayesian regressions show that vagal reactivity and recovery combined is the preferred statistical model to explain advantageous decision-making (BF10 = 163.85). Those findings 1) support the somatic marker hypothesis highlighting the key role of in situ self-regulation in decision-making processes and 2) show that the popular and often used index of general self-regulation, resting vagal activity, is not the best predictor of decision-making performance, and perhaps even for other cognitive functions. A next step could be interventional studies to test whether vagal modulation of heart rate underlies decision-making through interventions that influence vagal activity, which could provide relevant clinical leads.