General Items Research Articles

Enhancing Elderly Nutrition: A Qualitative Evaluation of Menus in a Social Solidarity Institution in the North of Portugal.

This work addresses the importance of food and nutrition in promoting the health of the elderly population, with a specific focus on the qualitative evaluation of menus provided by a social solidarity institution in Portugal. The aim of this study is to conduct a qualitative evaluation of menus furnished by a social solidarity institution situated in the northern region of Portugal in order to prevent and/or treat malnutrition in the elderly. The methodology involves the evaluation of four weekly menus, totaling 28 complete daily menus for the elderly, using the "Avaliação Qualitativa de Ementas Destinadas a Idosos" (AQEDI) tool. This assessment tool comprises six domains: general items, soup, protein suppliers, carbohydrate suppliers, vegetable suppliers, and dessert, each consisting of various parameters. The findings reveal that all menus were classified as "acceptable," with percentages ranging from 60.73% to 68.84%, and suggest that there exists room for improvement. This study emphasizes the necessity for coordinated efforts within the institution to enhance menu planning, taking into account both nutritional guidelines and sensory aspects of food. Effective coordination within the institution is crucial for maintaining positive aspects and rectifying inadequacies in menu planning.

How far can reformulation participate in improving the nutritional quality of diets at population level? A modelling study using real food market data in France

BackgroundFood reformulation is promoted as a tool to improve the nutritional quality of population diets. However, the potential impact of industry-wide reformulation on dietary intake has been investigated minimally.ObjectivesThe aim...

Verification of Dichotomous Scored Junior Secondary Schools Certificate Examination in Mathematics Achievement Test Using Classical Test Theory

In educational assessment there are two major frameworks by which items contained in a test can be examined. These are classical test theory and item response theory. In this study, the author prove the applicability of the classical test theory to the assessment of the quality of multiple- choice junior secondary mathematics test items. Fifty multiple –choice general mathematics test items were administered to four hundred (400) students randomly selected from twenty (20) Junior Secondary schools three (JSS III) students. Ten (10) schools each were purposively selected from private and public schools in Ado local government area of Ekiti state, Nigeria. Three general questions were generated and answered, while two hypotheses were formulated and tested using t-test statistic at 0.05 level significant. Results showed that, out of the 50 items in the test on the basis of difficulty parameter, five (5) items (10%) failed to meet the set criteria for item qualify while on the basis of item discriminating index five items were of poor quality. However, 45 items based on the established standards were considered ‘good’ items. Finally on the basic of performance, there was no significant differences between students in private and public schools, and also between male and female students from the twenty schools considered for this study which led to the upholding of the two hypotheses formulated for the study at p < 0.0.5. It is recommended that, general mathematics papers, that are to be used to examine students’ learning outcomes in Junior School Certificate Examination should be properly validated.

First Phase Development of a Patient-reported Outcome Measure for Midface Oncology

Background: Facial cancer surgery involving the midface (comprising the lower eyelids, nose, cheeks, and upper lip) can have debilitating life-changing functional, social, and psychological impacts on the patient. Midface symptoms are inadequately captured by existing patient-reported outcome measures (PROMs). PROMs are increasingly used for individual patient care, quality improvement, and standardized reporting of treatment outcomes. This study aimed to present our findings from the first phase of the development of a midface, specifically periocular and nasal, PROM. Methods: After international guidance for PROM development, the first phase comprised identification of salient issues and item generation. Fifteen patients who had midface surgery and 10 clinicians from various specialties with more than 5 years’ experience treating these patients were recruited. Semi-structured interviews explored aesthetic, functional, social, and psychological outcomes, with specific attention to deficiencies in current PROMs. Thematic analysis was used to develop an item pool, and group interviews with clinicians were carried out to create and refine PROM scales. Results: Qualitative data from patient interviews were grouped into aesthetic, functional, and psychosocial domains for the eyelids and nose. Ninety-nine draft items were generated across these domains. Following focus group discussions, the final version of the midface-specific PROM contained 31 items (13 eye-specific, 10-nose-specific, eight general midface items). Conclusions: This midface-specific PROM is valuable in assessing and comparing patient-reported outcomes in those who have undergone complex resection and reconstruction of the midface. This PROM is currently undergoing field testing.

Perceived effects of key audit matters reporting on audit efforts, audit fees, audit quality, and audit report transparency: stakeholders’ perspectives

PurposeThis paper aims to examine the perspectives of auditors, regulators and financial report preparers on the effects of key audit matters (KAMs) reporting on audit effort, fees, quality and report transparency.Design/methodology/approachThe authors conducted 21 semi-structured interviews with stakeholders (13 Audit Partners, 5 Chief Financial Officers and 3 regulators) and thematically analysed the interviews. They use the frame of “Paradox of Transparency” to explain the findings.FindingsAuditors perceive that the overall quality control of their audits has improved both in the planning and execution stages, and such improvement can mostly be attributed to the coercive pressures from professional bodies and regulators. Nevertheless, audit fee remains unchanged. Auditors disclose industry generic items and descriptions of KAMs, sometimes masking the real problem areas of the clients. Even after improving the performative audit quality, transparency of audit reporting has not improved. Issues that warrant going concern qualifications or audit report modifications are now reported as KAMs. Hence, KAMs reporting might make the audit report less transparent.Practical implicationsLocalised audit environments and institutions affect the transparency of KAMs reporting. Without attention to corporate governance and auditors’ independence issues, paradoxically, performative improvement in audit quality (due to the KAMs reporting requirement) does not enhance the transparency of audit reports.Originality/valueTo the best of the authors’ knowledge, this study is the first to provide field-level evidence in Bangladesh and other developing countries about the perceptions of auditors, financial report preparers and regulators on the effects of KAMs reporting on audit efforts, fees, quality and report transparency.

Aggregating knowledge and collaborative information for sequential recommendation

Sequential recommendation aims to predict users’ future activities based on their historical interaction sequences. Various neural network architectures, such as Recurrent Neural Networks (RNN), Graph Neural Networks (GNN), and self-attention mechanisms, have been employed in the tasks, exploring multiple aspects of user preferences, including general interests, short-term interests, long-term interests, and item co-occurrence patterns. Despite achieving good performance, there are still limitations in capturing complex user preferences. Specifically, the current structures of RNN, GNN, etc., only capture item-level transition relations while neglecting attribute-level transition relations. Additionally, the explicit item relations are studied using item co-occurrence modules, but they cannot capture the implicit item-item relations. To address these issues, we propose a knowledge-augmented Gated Recurrent Unit (GRU) to improve the short-term user interest module and adopt a collaborative item aggregation method to enhance the item co-occurrence module. Additionally, our long-term interest module utilizes a bitwise gating mechanism to select historical item features significant to users’ current preferences. We extensively evaluate our model on three real-world datasets alongside competitive methods, demonstrating its effectiveness in top K sequential recommendation.

Uncovering Hidden Framings in Dark Triad Self-Ratings: What Frames-of-Reference Do People Use When Responding to Generic Dark Triad Items?

In typical Dark Triad (DT) questionnaires, generic items oftentimes refer to "others" or "people" in general. Hence, respondents have to mentally aggregate their behavior across several kinds of "others" (e.g., work colleagues, family members, and friends). It remains unknown if individuals consider different kinds of interaction partners equally or if their self-reports contain "hidden" interaction partner-specific tendencies. To shed light on this issue, we assessed generic and contextualized DT items (referring to family, friends, work, and strangers; N = 814 from the general population). The correlated trait-correlated (method - 1) model was used to investigate preregistered research questions. On average, generic DT items showed the strongest association with work-contextualized DT items and the weakest association with family-contextualized DT items. However, the associations varied considerably across DT items and traits. In sum, our results suggest that hidden framings exist in some DT items, which may impact their ability to predict relevant criteria due to contextual (a)symmetries. The generalizability of the findings to other DT instruments, items, and participant groups should be examined in future research.

Effect of Radioiodine Treatment on Quality of Life in Patients with Subclinical Hyperthyroidism: A Prospective Controlled Study.

Study aim was to evaluate thyroid-related QoL in patients with subclinical hyperthyroidism mostly due to toxic nodular goitre undergoing RIT, compared to a control group of euthyroid subjects. Study design was monocentric, prospective, controlled. Fifty control subjects were enrolled and 51 RIT patients. Most subjects were examined at least twice at an interval of 6 months, with visits immediately before and 6 months after treatment in the RIT group. QoL was estimated with the ThyPRO questionnaire, using its composite scale as primary outcome. Treatment effect was the mean adjusted difference (MAD) between groups over time, using repeated? measures mixed? effects models. TSH concentrations were lower in the RIT group prior to treatment and recovered thereafter slightly above the level of the control group. Correspondingly, QoL improved significantly after 6 months from a worse level in the RIT group, compared to controls (MAD -10.3 [95% CI -14.9, -5.7], p<0.001). QoL improvements were strong for general items, but less pronounced for the hyperthyroid domain. Compared to controls, thyroid volume, thyroid functional capacity (SPINA-GT) and deiodinase activity (SPINA-GD) were significantly reduced in the RIT group. Patients with subclinical hyperthyroidism improve both biochemically and in their QoL after RIT, compared to controls. QoL assessment should have a wider role in clinical practice to complement biochemical tests and help with treatment decisions.

Assessing hypo-arousal during reward anticipation with pupillometry in patients with major depressive disorder: replication and correlations with anhedonia

Major depressive disorder (MDD) is a devastating and heterogenous disorder for which there are no approved biomarkers in clinical practice. We recently identified anticipatory hypo-arousal indexed by pupil responses as a candidate mechanism subserving depression symptomatology. Here, we conducted a replication and extension study of these findings. We analyzed a replication sample of 40 unmedicated patients with a diagnosis of depression and 30 healthy control participants, who performed a reward anticipation task while pupil responses were measured. Using a Bayesian modelling approach taking measurement uncertainty into account, we could show that the negative correlation between pupil dilation and symptom load during reward anticipation is replicable within MDD patients, albeit with a lower effect size. Furthermore, with the combined sample of 136 participants (81 unmedicated depressed and 55 healthy control participants), we further showed that reduced pupil dilation in anticipation of reward is inversely associated with anhedonia items of the Beck Depression Inventory in particular. Moreover, using simultaneous fMRI, particularly the right anterior insula as part of the salience network was negatively correlated with depressive symptom load in general and anhedonia items specifically. The present study supports the utility of pupillometry in assessing noradrenergically mediated hypo-arousal during reward anticipation in MDD, a physiological process that appears to subserve anhedonia.

Patient knowledge in anaesthesia: Psychometric development of the RAKQ-The Rotterdam anaesthesia Knowledge questionnaire.

The transition from in-person to digital preoperative patient education requires effective methods for evaluating patients' understanding of the perioperative process, risks, and instructions to ensure informed consent. A knowledge questionnaire covering different anaesthesia techniques and instructions could fulfil this need. We constructed a set of items covering common anaesthesia techniques requiring informed consent and developed the Rotterdam Anaesthesia Knowledge Questionnaire (RAKQ) using a structured approach and Item Response Theory. A team of anaesthetists and educational experts developed the initial set of 60 multiple-choice items, ensuring content and face validity. Next, based on exploratory factor analysis, we identified seven domains: General Anaesthesia-I (regarding what to expect), General Anaesthesia-II (regarding the risks), Spinal Anaesthesia, Epidural Anaesthesia, Regional Anaesthesia, Procedural sedation and analgesia, and Generic Items. This itemset was filled out by 577 patients in the Erasmus MC, Rotterdam, and Albert Schweitzer Hospital, Dordrecht, the Netherlands. Based on factor loadings (≥0.25) and considering clinical relevance this initial item set was reduced to 50 items, distributed over the seven domains. Each domain was processed to produce a separate questionnaire. Through an iterative process of item selection to ensure that the questionnaires met the criteria for Item Response Theory modelling, 40 items remained in the definitive set of seven questionnaires. Finally, we developed an Item Response Theory model for each questionnaire and evaluated its reliability. 1-PL and 2-PL models were chosen based on best model fit. No item misfit (S-χ2, p<0.001 = misfit) was detected in the final models. The newly developed RAKQ allows practitioners to assess their patients' knowledge before consultation to better address knowledge gaps during consultation. Moreover, they can decide whether the level of knowledge is sufficient to obtain digital informed consent without face-to-face education. Researchers can use the RAKQ to compare new methods of patient education with traditional methods.

Prevalence and predictors of depression and anxiety among workers at two points of entry in Botswana during the COVID-19 pandemic.

points of entry (POE) staff are particularly prone to depression and anxiety during outbreaks. The study aimed to determine the prevalence and predictors of depression and anxiety among POE staff in Botswana. this was a cross sectional study at Sir Seretse Khama International Airport (SSKIA) and Tlokweng border from 02/12/2021 to 24/02/2022 during the COVID-19 outbreak. The Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 item scale (GAD-7) were used to screen for depression and anxiety respectively. Logistic regression was used to determine predictors of depression (PHQ-9≥10) and anxiety (GAD-7 ≥10). a total of 276 POE workers participated in the study of which 60 (21.7%) had an abnormal PHQ-9 score (had depression). Anxiety levels were abnormal in 31 (11.2%) participants. The predictors of depression were working at SSKIA (Adjusted odds ratio (AOR) 0.22, 95% Confidence interval (CI) 0.08-0.65), age >39 years (AOR 0.15, 95% CI 0.03-0.68), having a diploma (AOR 0.27, 95% CI 0.008-0.89), having a degree or higher (AOR 0.23, 95% CI 0.07-0.80), history of asthma (AOR 4.43, 95% CI 1.17-16.72), experience of stigma and discrimination (AOR 2.93, 95% CI 1.01-8.55) and having older people (>65 years) in the household (AOR 4.61, 95% CI 1.64-12.99). The predictors of anxiety were having chronic medical conditions (AOR 5.76, 95% CI 1.34-24.78) and experience of stigma and discrimination (AOR 6.82, 95% CI 1.42-32.46). depression and anxiety were detected in a significant number of participants. Multiple risk factors were identified. Public health interventions should target these risk factors.

Validação de cartilha de orientações fonoaudiológicas para pacientes oncológicos disfágicos

ABSTRACT Purpose: to validate the content and appearance of a booklet of speech therapy guidelines on dysphagia for adult oncology patients presented with dysphagia. Methods: a methodological study with a mixed approach, developed for the validation of a guidebook. The validation of the guidebook was made by five expert judges and eleven non-specialist ones. For validation, the Content Validity Index was used: CVI for each item, as well as for the general items. Results: the expert judges assigned the Content Validity Index value above 80% and of 92.20%, and the non-specialist judges attributed values above 90.9% and of 98.0%, which were considered excellent. Conclusion: the proposed guidebook was validated according to content and appearance. It is believed that this material can contribute to the understanding of the health-disease process, promote self-care and arouse the interest of other health professionals in the development of educational technologies in search of better health conditions for the target population.

The organization of care in pediatric radiotherapy across SIOP Europe affiliated centers: A multicenter survey in the framework of the ‘Joint Action on Rare Cancers’ project

Background/purposeTo reduce inequalities among SIOPE-affiliated countries, standard and optional levels to deliver ‘Good Clinical Practice’ compliant treatment in pediatric radiation oncology have been published. The aim of this project was to map the availability of pediatric radiotherapy resources across SIOPE-affiliated radiotherapy departments. Materials/methodsAn online survey with 34 questions was distributed to 246 radiotherapy departments across 35 SIOPE-affiliated countries. In addition to demographic data, 15 general items related to the organization of the radiotherapy process, and 10 radiotherapy-specific items were defined. For each of the 25 items, sum scores were calculated per center and country. Mann-Whitney U tests were used to analyze associations. ResultsBetween March-June 2019, 121 departments (49 %) out of 31 countries (89 %) completed the survey. At center level, involvement of core disciplines in tumor boards (28 %), and integration of dedicated pediatric radiation therapy technologists (24 %) are limited, while rare & complex brachytherapy procedures are performed in many centers (23 %). For general and radiotherapy-specific items respectively, a relevant variation of sum scores was observed across countries (Δgeneral: ≤10 points; ΔRT_specific: ≤5 points) and among centers within a country (Δgeneral: ≤9 points; ΔRT_specific: ≤6 points). Sum scores for general and radiotherapy-specific items were higher in countries with a high-income (p < 0.01) and higher health development index (p < 0.01). A larger annual number of irradiated pediatric patients was associated with higher sum scores for general items (p < 0.01). ConclusionThis survey demonstrates the disparities in organization of pediatric radiotherapy departments between SIOPE-affiliated countries and centers within the same country. Investment is needed to reduce inequalities in pediatric radiotherapy care.

A general tail item representation enhancement framework for sequential recommendation

A general tail item representation enhancement framework for sequential recommendation

Use of the National Cancer Institute Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events to assess treatment tolerability in pulmonary arterial hypertension: qualitative patient research findings in current and former users of oral selexipag

BackgroundUnderstanding patients’ perspectives regarding drug tolerability, in addition to effectiveness, provides a complete picture of the patient experience and supports more informed therapeutic decision-making. The item library of the National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) was developed to measure patient-reported frequency, severity, and interference of adverse events (AEs) associated with cancer therapies. This qualitative interview study assessed the suitability of items selected from the PRO-CTCAE library for assessing tolerability of selexipag, a medication targeting the prostacyclin pathway for patients with pulmonary arterial hypertension (PAH).MethodsTwo rounds of 10 qualitative, web-assisted telephone interviews following a semi-structured guide were conducted in individuals with recent experience taking oral selexipag for PAH. Each interview included concept elicitation to gather participants’ perspectives on symptomatic AEs (type, frequency, severity, and interference) and cognitive debriefing of PRO-CTCAE items addressing the most frequently reported AEs of oral selexipag.ResultsInterviews were conducted with 20 participants with PAH (mean [range] age 50 [24–68] years; 75% female; 85% in World Health Organization Functional Class II–III), comprising different races/ethnicities, levels of education, and employment status. Fifteen participants were currently treated with selexipag; five had taken selexipag for ≥ 6 months before discontinuing. The most frequently reported AEs included headache, jaw pain, and nausea (n = 15, 12, and 10 participants, respectively). Diarrhea and headache were identified as the most bothersome AEs by 5 and 4 participants, respectively. Some AEs were transitory (e.g., jaw pain); others were long-lasting (e.g., muscle pain). Based on findings from Round 1 interviews, a flushing item was added and the PRO-CTCAE general pain item was modified to be specific to jaw pain for testing in Round 2. Interview findings identified the following AEs as relevant to assess in a PAH clinical trial: nausea, vomiting, diarrhea, flushing, jaw pain, headache, aching muscles, and aching joints.ConclusionsThe PRO-CTCAE items selected in this study and the additional symptomatic AEs identified as patient-relevant have the potential to be included in assessments capturing the patient perspective on tolerability in future studies of selexipag and possibly other PAH therapies.

Measuring in-hospital quality multidimensionally by integrating patients’, kin’s and healthcare professionals’ perspectives: development and validation of the FlaQuM-Quickscan

BackgroundMeasuring quality is essential to drive improvement initiatives in hospitals. An instrument that measures healthcare quality multidimensionally and integrates patients’, kin’s and professionals’ perspectives is lacking. We aimed to develop and validate an instrument to measure healthcare quality multidimensionally from a multistakeholder perspective.MethodsA multi-method approach started by establishing content and face validity, followed by a multi-centre study in 17 Flemish (Belgian) hospitals to assess construct validity through confirmatory factor analysis, criterion validity through determining Pearson’s correlations and reliability through Cronbach’s alpha measurement. The instrument FlaQuM-Quickscan measures ‘Healthcare quality for patients and kin’ (part 1) and ‘Healthcare quality for professionals’ (part 2). This bipartite instrument mirrors 15 quality items and 3 general items (the overall quality score, recommendation score and intention-to-stay score). A process evaluation was organised to identify effective strategies in instrument distribution by conducting semi-structured interviews with quality managers.ResultsBy involving experts in the development of quality items and through pilot testing by a multi-stakeholder group, the content and face validity of instrument items was ensured. In total, 13,615 respondents (5,891 Patients/kin and 7,724 Professionals) completed the FlaQuM-Quickscan. Confirmatory factor analyses showed good to very good fit and correlations supported the associations between the quality items and general items for both instrument parts. Cronbach’s alphas supported the internal consistency. The process evaluation revealed that supportive technical structures and approaching respondents individually were effective strategies to distribute the instrument.ConclusionsThe FlaQuM-Quickscan is a valid instrument to measure healthcare quality experiences multidimensionally from an integrated multistakeholder perspective. This new instrument offers unique and detailed data to design sustainable quality management systems in hospitals. Based on these data, hospital management and policymakers can set quality priorities for patients’, kin’s and professionals’ care. Future research should investigate the transferability to other healthcare systems and examine between-stakeholders and between-hospitals variation.

In-Depth Steel Crack Analysis Using Photoacoustic Imaging (PAI) with Machine Learning-Based Image Processing Techniques and Evaluating PAI-Based Internal Steel Crack Feasibility

Steel plays an indispensable role in our daily lives, permeating various products ranging from essential commodities and recreational gears to information technology devices and general household items. The meticulous evaluation of steel defects holds paramount importance to ensure the secure and dependable operation of the end products. Photoacoustic imaging (PAI) emerges as a promising modality for structural inspection in the realm of health monitoring applications. This study incorporates PAI experimentation to generate an image dataset and employs machine learning techniques to estimate the length and width of surface cracks. Furthermore, the research delves into the feasibility assessment of employing PAI to investigate internal cracks within a steel sample through a numerical simulation-based study. The study’s findings underscore the efficacy of the PAI in achieving precise surface crack detection, with an acceptable root mean square error (RMSE) of 0.63 ± 0.03. The simulation results undergo statistical analysis techniques, including the analysis of variance (ANOVA) test, to discern disparities between pristine samples and those featuring internal cracks at different locations. The results discern statistically significant distinctions in the simulated acoustic responses for samples with internal cracks of varying sizes at identical/different locations (p &lt; 0.001). These results validate the capability of the proposed technique to differentiate between internal crack sizes and positions, establishing it as a viable method for internal crack detection in steel.

VIDEO STREAMING PLATFORMS FOR LEARNING ENGLISH – CASE STUDY: NETFLIX

We live in an age of technology when people increasingly give up on television and turn to online streaming sources to entertain. These services provide an alternative to cable and satellite on-demand service, sometimes at a lower cost. Due to its intense development over the last few years, video streaming technology has attracted academic attention as a valuable tool for learning or improving English. Thus, this study discusses the practicality of video streaming use in foreign language higher education. It starts with a brief review of the literature on the use of video for language learning, focusing on the main benefits for learners. Then, the study presents the video as a learning tool underlying its advantages over the other previous physical technologies. To highlight the value of video streaming to language education, benefits and problems are explained, and Netflix is outlined as an example of a streaming video platform that may be used within English language teaching. General vocabulary items will be acquired, and listening skills will be improved. However, the interest in studying and approaching new topics focusing on specialized vocabulary will be recognized as an advantage when utilizing video streaming platforms. Next, specific strategies for using video streaming platforms will be outlined. The first was that short documentaries could be watched along with multiple-choice questions to promote general vocabulary building. The second is that Netflix’s series or movies can be utilized to find specific themes to help explain particular grammar or vocabulary points while improving the specialized business vocabulary.

건설업 안전관리자 인식도 조사를 통한 스마트안전기술 활성화 방안

To prevent accidents in the construction industry, the government is using smart safety technologies such as ICT and IoT to increase efficiency by digitization and automating existing safety management methods. However, at the present time, where quantitative effectiveness has not been shown, such as overlapping policies divided between the Ministry of Land, Infrastructure and Transport and the Ministry of Employment and Labor, and the reduction of accident rates due to the introduction of smart safety technology, a revitalization plan is needed through a survey of awareness of smart safety technology. In order to derive measures to revitalize smart safety technology in the construction industry from the government, developer, and construction company perspectives, survey items were determined through visits and brief interview targeting smart safety experts, construction company headquarters, and field workers. The general survey items and smart safety technology introduction and application groups were classified into groups, and a population was selected targeting safety managers at construction sites across the country, and a survey was conducted using a self-administered survey method. Research results: First, as a result of the survey on awareness, introduction status, and effectiveness of smart safety technology, the effectiveness of smart safety technology introduction and application was found to be high. Second, “Construction machinery and equipment access warning system” was the highest among the smart safety technologies currently operating and scheduled to be introduced in the future by groups that are currently introducing and operating smart safety technologies. Third, in terms of excellence in smart safety technology, “Easy to monitor work situation” was the highest, and excellent results were also found in groups that have not currently introduced smart safety technology at construction sites but are planning to introduce it in the future. Fourth, in terms of lack of effectiveness and ways to improve the effectiveness of smart safety technology, “introduction of technology that does not suit the construction site situation” was analyzed the most highly, and the same result was analyzed for groups that are currently not introducing smart safety technology to construction sites but are planning to introduce it in the future. It has been done. As a way to address the problems of introducing and applying smart safety technology and to prevent disasters, the government provides active education and promotion, produces and distributes smart safety technology guidelines that can be applied to each construction type, and provides clear guidelines so that owners and constructors can clearly understand them.&#x0D; Specific settlement method for the use of smart safety technology, development of customized smart safety technology for practical introduction by type of work, preemptive and quick solution of after-sales service problems for developers, management of smart safety technology at the construction company headquarters level and clarification of work scope for each person in charge and labor cost support, continuous It was concluded that measures such as improving managers' awareness through education are necessary.

Paradoxical Findings in Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with C5 Inhibitors: Suboptimal Disease Control Perceived As Satisfactory

Introduction: The introduction of C5 inhibitors (C5i) for the treatment of patients with paroxysmal nocturnal hemoglobinuria (PNH) has resulted in lower morbidity and mortality rates. However up to 86% of patients still experience anemia and fatigue in 63% of them which may impact their quality of life (QoL). The SATURNO study aimed to assess PNH patient and physician satisfaction with C5i treatment, along with the impact of the disease and clinical outcomes. Methods: A multicenter, observational, cross-sectional study conducted in PNH patients receiving C5i treatment for at least 3 months in Spain. Key clinical and laboratory data were collected, including red blood cells (RBC) transfusions, hemolytic crisis, hemoglobin (Hb), haptoglobin (Hp), lactate dehydrogenase (LDH), absolute reticulocyte count (ARC) and bilirubin. Patient satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM) and Visual Analog Scale (VAS). Physician satisfaction was measured using the TSQM general item and VAS. Fatigue and QoL were evaluated using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), respectively. The Work Productivity and Activity Impairment questionnaire (WPAI) was also used. Results: A total of 56 patients and 13 physicians participated in the study. Median (IQR) age of patients was 54.0 (44.5; 63.5) years, 35.7% were female and median (IQR) duration of treatment with C5i was 6.6 (3.3; 11.6) years. Overall, 94.6% of patients and 90.6% of physicians reported to be satisfied, very satisfied, or extremely satisfied with the treatment. Mean (SD) VAS score for patient satisfaction was 9.0 (1.2) and for physicians 7.9 (1.7) out of 10. Mean (SD) EORTC QLQ-C30 score was 71.7 (21.7) out of 100. Mean (SD) FACIT-F score was 39.7 (10.6) out of 52 and fatigue was reported by 55.2% of patients. Clinical and laboratory parameters showed a significant proportion of patients exhibiting abnormal values. Hb and Hp were below the normal ranges in 67.9% and 65.1% of patients, respectively, whereas elevated LDH, ARC and indirect bilirubin were observed in 50.0%, 83.0% and 75.9% of them, respectively. In the last 12 months, 30.9% of patients had received at least one RBC transfusion, with a mean (SD) number of 8.6 (8.4) RBC transfusions, and 33.9% experienced at least one hemolytic crisis with a mean (SD) of 4.9 (9.4). Work productivity assessment revealed that 60.7% of patients were currently unemployed, a mean (SD) percentage of absenteeism of 5.7% (12.4) and presenteeism of 23.8% (26.0). Overall mean (SD) percentage of work productivity impairment was 25.6% (27.3). Activity impairment was reported by 36.4% (28.3) of patients. Conclusions: The SATURNO study showed that although patients and physicians reported satisfaction with C5i treatment, this might be challenged. A substantial number of PNH patients treated with C5i still experience anemia, fatigue and abnormal laboratory values, indicative of ongoing hemolysis and suboptimal control. Moreover, patients with PNH had affected work productivity and a proportion of them were experiencing activity impairment. These findings highlight the need for comprehensive management strategies to address the impact of the disease on patients with PNH receiving C5i treatment.