Group Of Operators Research Articles

Long-term outcomes and operators' experience in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) is typically performed by experienced operators. Therefore, the safety of pPCI for STEMI performed by less experienced operators with the support of experienced operators remains unknown. We aimed to investigate the long-term outcomes of pPCI for STEMI performed by less experienced operators with the support of experienced operators. In total, 775 STEMI patients were enrolled and divided into groups according to operator experience in PCI: less experienced (n = 384) and experienced (n = 391) operator groups. Experienced operators were defined as those who had performed > 50 elective PCI procedures per year as the first operator or instructional assistant, whereas less experienced operators were defined as others. When less experienced operators performed the pPCI, experienced operators supported them. The primary endpoint was any cardiovascular event, defined as a composite of cardiovascular death, nonfatal myocardial infarction, and unplanned hospitalization for heart failure. In the propensity score-matched analysis, 324 patients were included in each group. The cumulative incidence of the primary endpoint over a median of 5years in the less experienced operator group was similar to that in the experienced operator group (15% vs. 18%, P = 0.209). In the multivariate Cox proportional hazards model, there was no excess risk for patients operated upon by less experienced operators for the primary endpoint (adjusted hazard ratio, 0.85; 95% confidence interval, 0.58-1.25; P = 0.417). pPCI for STEMI by less experienced operators did not increase the risk of in-hospital mortality or 5-year long-term cardiovascular events if supported by experienced operators.

Methodical approach to determining the main parameters of the evacuation system for the wounded with the use of different types of transport

The timeframe for evacuating the wounded is a critical factor that largely determines the fate of a wounded soldier. Even at the initial stage of the war waged by the russian federation against Ukraine, there were almost no frontline ambulances, and there was a critical shortage of ambulances. At present, despite significant efforts to provide the Armed Forces of Ukraine with weapons and military equipment, as well as material and technical means, including medical equipment and property, in particular through international technical assistance, the problem of the lack of the required number of specialised medical evacuation vehicles has not been fully resolved. From this point of view, the issue of correct formulation of requirements for the rational composition and specially equipped various types of vehicles (including sanitary transporters, ambulances), including general use, the system of evacuation of the wounded, and determining the possibility of its further improvement through the methodological apparatus is relevant. The purpose of the article is to present a methodological approach to determining the main parameters of the system of evacuation of the wounded of an operational group of troops with the involvement of various types of transport. The formation of a model of the casualty evacuation system as a mass service network (MSN) will minimise the time spent waiting for medical care by wounded personnel, determine the rational composition of forces and means of the tactical casualty evacuation system. To model the system and processes of evacuation of the wounded from the battlefield during hostilities, including their transportation to medical facilities located in the depths of the third logistics zone, the mathematical apparatus of the theory of mass service was used. In particular, we are talking about the devices of queuing systems (QS) and MSN. The existing system of military evacuation of the wounded and sick is a four-tier system in which all wounded with moderate and severe severity are evacuated. Based on this, the system of evacuation of the wounded can be represented as an MSN, which has a number of features. First of all, this MSN is an open queuing network (OQN), i.e. the flow of requests to enter the network is unlimited, homogeneous and comes from an external independent source. As a result of the calculations, data were obtained on the values of network parameters (average number of applications in queues – 119.47 applications/hour, average number of applications in the network – 158.53 applications/hour, average waiting time for applications in queues for service – 11.95 hours, average time of application stay in the network – 15.85 hours) and the parameters of each QS operating in the MSN – transmission coefficient, incoming flow intensity, load factor, average number of busy channels, average number of applications per QS, average queue length, average waiting time for an application in the service queue, average time for an application to stay in the QS. Analysing the calculated data, from the point of view of creating a rational OQN, the casualty evacuation system achieves maximum efficiency when its productivity in processing the incoming flow of requests is maximised, and the minimum values of such parameters as the number of requests for service in the queue and the number of service channels operating in the network are minimal.

Mapping quantum circuits to shallow-depth measurement patterns based on graph states

Abstract The paradigm of measurement-based quantum computing (MBQC) starts from a highly entangled resource state on which unitary operations are executed through adaptive measurements and corrections ensuring determinism. This is set in contrast to the more common quantum circuit model, in which unitary operations are directly implemented through quantum gates prior to final measurements. In this work, we incorporate concepts from MBQC into the circuit model to create a hybrid simulation technique, permitting us to split any quantum circuit into a classically efficiently simulatable Clifford-part and a second part consisting of a stabilizer state and local (adaptive) measurement instructions—a so-called standard form—which is executed on a quantum computer. We further process the stabilizer state with the graph state formalism, thus, enabling a significant decrease in circuit depth for certain applications. We show that groups of mutually-commuting operators can be implemented using fully-parallel, i.e. non-adaptive, measurements within our protocol. In addition, we discuss how groups of mutually commuting observables can be simulatenously measured by adjusting the resource state, rather than performing a costly basis transformation prior to the measurement as it is done in the circuit model. Finally, we demonstrate the utility of our technique on two examples of high practical relevance—the Quantum Approximate Optimization Algorithm and the Variational Quantum Eigensolver (VQE) for the ground-state energy estimation of the water molecule. For the VQE, we find a reduction of the depth by a factor of 4 to 5 using measurement patterns vs. the standard circuit model. At the same time, since we incorporate the simultaneous measurements, our patterns allow us to save shots by a factor of at least 3.5 compared to measuring Pauli strings individually in the circuit model.

Integrating health and child protection systems: towards collaboratively improving health outcomes for children in kinship care in rural Australia

PurposeThere is a growing recognition that the integration of health systems will benefit children in out-of-home care (OOHC), especially those who have experienced trauma. This paper examines the adaptation of existing health systems and the persistent barriers between rural health and child protection programs. It focuses on health systems integration for children aged 0–6 years in kinship care and their siblings.Design/methodology/approachThe study applied a multi-methods qualitative approach involving individual interviews and focus groups with project members from operational or strategic reference groups, child protection personnel and the kinship carer program. We also reviewed documentary evidence.FindingsWe found evidence that health clinicians and child protection practitioners adapted and adjusted services as they collaboratively worked together to improve care delivery to children in kinship care. Yet, despite successful adaptations to systems and the appointment of a health navigator, systemic barriers remain. These include service and staff shortages in rural Australia, complications around information sharing, authority and power dynamics and siloed operations. Such barriers prevent better-integrated health systems and ultimately impair health outcomes for children in kinship care.Originality/valueThis paper contributes to knowledge and practice to improve the integration of child protection and healthcare services in Australian OOHC. It provides valuable insights into the challenges and successes of health systems integration, highlighting the need for continued collaborative effort to create effective, place-based models of care that benefit these children and their carers.

How do food safety technical working groups within a One Health framework work? Experiences from Vietnam and Ethiopia

BackgroundPersistent challenges of fragmented, food safety management in low- and middle-income countries underscore the need for more robustly coordinated mechanisms. National food safety technical working groups, operating under a One Health framework, offer potential in streamlining coordination efforts to effectively address these challenges. However, more clarity regarding their formation and functioning is important for understanding how to best establish and support such groups. The aim of this study is to systematically document the development process of established groups in Vietnam and Ethiopia.MethodsWe assess the process used to establish and support the technical working groups against six critical success factors for multisectoral collaboration: drive change, define, design, realise, relate, and capture success. To do so, we review meeting minutes, Terms of Reference, and other related publications.ResultsThe analysis underscores the importance of financial and technical support by development partners in initiating working groups while also highlighting the challenge posed by the absence of legal frameworks to secure government commitment. Embedding the technical working groups within existing government structures – such as One Health platforms – from the outset could help to ensure the active participation and sustainability of such groups.ConclusionBoth Vietnam and Ethiopia have established operational and institutionalized technical working groups to bolster national food safety efforts under a One Health framework. The approaches employed in these countries could serve as valuable models for others seeking to establish comparable multisectoral collaborative mechanisms to address emerging health risks.

Comparative Study of Bacillus-Based Plant Biofertilizers: A Proposed Index.

The market for bacteria as agricultural biofertilizers is growing rapidly, offering plant-growth stimulants; biofungicides; and, more recently, protectors against extreme environmental factors, such as drought. This abundance makes it challenging for the end user to decide on the product to use. In this work, we describe the isolation of a strain of Bacillus velezensis (belonging to the operational group Bacillus amyloliquefaciens) for use as a plant-growth-promoting rhizobacterium, a biofungicide, and a protector against drought. To compare its effectiveness with other commercial strains of the same operational group, Bacillus amyloliquefaciens, we analyzed its ability to promote the growth of pepper plants and protect them against drought, as well as its fungicidal activity through antibiosis and antagonism tests, its ability to solubilize potassium and phosphates, and its ability to produce siderophores. Finally, we used a probit function, a type of regression analysis used to model the outcomes of analyses, to quantify the biostimulatory effectiveness of the different plant-growth-promoting rhizobacteria, developing what we have called the Agricultural Protection Against Stress Index, which allowed us to numerically compare the four commercial strains of the operational group Bacillus amyloliquefaciens, based on a Delphi method-a type of regression analysis that can be used to model a cumulative normal distribution-and integrate the results from our panel of tests into a single value.

Spin Space Groups: Full Classification and Applications

In this work, we exhaust all the spin space symmetries, which fully characterize collinear, noncollinear, and commensurate spiral as well as incommensurate spiral magnetism, etc., and investigate enriched features of electronic bands that respect these symmetries. We achieve this by systematically classifying the so-called spin space groups (SSGs)—joint symmetry groups of spatial and spin operations that leave the magnetic structure unchanged. Generally speaking, they are accurate (approximate) symmetries in systems where spin-orbit coupling (SOC) is negligible (finite but weaker than the energy scale of interest), but we also show that specific SSGs could remain valid even in the presence of strong SOC. In recent years, SSGs have played increasingly pivotal roles in various fields such as altermagnetism, topological electronic states, and topological magnon, etc. However, due to its complexity, a complete SSG classification has not been completed up to now. By representing the SSGs as O(N) representations, we—for the first time—obtain the complete classifications of 1421, 9542, and 56 512 distinct SSGs for collinear (N=1), coplanar (N=2), and noncoplanar (N=3) magnetism, respectively. SSG not only fully characterizes the symmetry of spin degrees of freedom, but also gives rise to exotic electronic states, which, in general, form projective representations of magnetic space groups (MSGs). Surprisingly, electronic bands in SSGs exhibit features never seen in MSGs, such as (i) nonsymmorphic SSG Brillouin zone, where SSG operations behave as a glide or screw when acting on momentum, (ii) effective π flux, where translation operators anticommute with each other and yield duplicate bands, (iii) higher-dimensional representations unexplained by MSGs, and (iv) unconventional spin texture on a Fermi surface, which is completely determined by SSGs, independent of Hamiltonian details. To apply our theory, we identify the SSG for each of the 1595 published magnetic structures in the MAGNDATA database on the Bilbao Crystallographic Server. Material examples exhibiting the novel features (i)–(iv) are discussed with emphasis. We also investigate new types of SSG-protected topological electronic states that are unprecedented in MSGs. In particular, we propose a 3D Z2 topological insulator state with a fourfold degenerate Dirac point on the surface and a new scenario of anomalous Z2 helical states that appear on magnetic domain walls. Published by the American Physical Society 2024

Platelet-rich plasma protects hippocampal neurons and memory functions in a rat model of vascular dementia.

Platelet-rich plasma (PRP) is a promising biomaterial rich in bioactive growth factors, offering potential as a therapeutic agent for various diseases. However, its effectiveness in central nervous system disorders like vascular dementia (VaD) remains underexplored. This study investigated the potential of PRP to mitigate VaD progression in vivo. A rat model of VaD was established via bilateral common carotid artery occlusion and hypovolemia operation. Rats were randomly assigned to receive either PRP or platelet-poor plasma (PPP)-the latter being a byproduct of PRP preparation and used as a reference standard-resulting in the groups designated as 'operated group (OP)+PRP' and 'OP+PPP', respectively. PRP or PPP (500 μl) was administered intraperitoneally on the day of the operation and postoperative days 2, 4, 6, and 8. Cognitive function was assessed using the Y-maze, Barnes maze, and passive avoidance tests. On postoperative day 8, hippocampal samples were subjected to histological and semi-quantitative analyses. OP exhibited significant memory decline compared to controls, while the 'OP+PRP' group showed notable improvement. Histological analysis revealed increased neuronal loss and neuroinflammation in OP hippocampi, mitigated in 'OP+PRP'. Semi-quantitative analysis showed decreased expression of brain-derived neurotrophic factor (BDNF) and its receptor tropomyosin receptor kinase B (TrkB) in OP, restored in 'OP+PPP' and further in 'OP+PRP'. These results highlight PRP's protective effects against VaD-induced hippocampal damage and cognitive impairment, partially attributed to BDNF/TrkB pathway upregulation.

Quantum annealer accelerates the variational quantum eigensolver in a triple-hybrid algorithm

Hybrid algorithms that combine quantum and classical resources have become commonplace in quantum computing. The variational quantum eigensolver (VQE) is routinely used to solve prototype problems. Currently, hybrid algorithms use no more than one kind of quantum computer connected to a classical computer. In this work, a novel triple-hybrid algorithm combines the effective use of a classical computer, a gate-based quantum computer, and a quantum annealer. The solution of a graph coloring problem found using a quantum annealer reduces the resources needed from a gate-based quantum computer to accelerate VQE by allowing simultaneous measurements within commuting groups of Pauli operators. We experimentally validate our algorithm by evaluating the ground state energy of H2 using different IBM Q devices and the DWave Advantage system requiring only half the resources of standard VQE. Other larger problems we consider exhibit even more significant VQE acceleration. Several examples of algorithms are provided to further motivate a new field of multi-hybrid algorithms that leverage different kinds of quantum computers to gain performance improvements.

Comparing qSMI and qCEUS for assessing vascularization in uterine cervical cancer: operable versus non-operable group.

The present study aimed to compare the effectiveness and reliability of quantified superb microvascular imaging (qSMI) and quantified contrast-enhanced ultrasonography (qCEUS) in assessing vascularization in both operable and non-operable uterine cervical cancer. A case-control study included 64 patients with pathology-proven and untreated cervical cancer, who underwent transvaginal ultrasonography combined with qSMI and qCEUS between January 2022 and June 2023. SMI results were quantified as the vascular index (VI), which were compared to 12 quantitative parameters of CEUS calculated with time-intensity curves (TIC). According to FIGO staging and different treatment regimens, 64 patients with cervical cancer were divided into operable group (IA ~ IIA, n = 19) and non-operable group (IIB ~ IV, n = 45). In comparison to the operable group, the non-operable group showed significantly higher values in VI, peak intensity (PI), area under the curve (AUC), wash-in area (iAUC), wash-out area (oAUC), wash-in rate (WiR), mean intensity (Mean Int), and standard deviation (STD) (all P < 0.05). VI demonstrated strong correlations with CEUS parameters, notably PI (r = 0.854, P < 0.001) and AUC (r = 0.635, P < 0.001). Furthermore, VI showed a better predictive performance for treatment-group assignment than qCEUS parameters, with an 80.7% accuracy, 64.4% sensitivity and 89.5% specificity. Both qSMI and qCEUS exhibit significant and comparable utility in detecting microvascular hyperplasia and predicting treatment-group assignments in cervical cancer. Furthermore, qSMI may offer added convenience in implementation.

PENERAPAN CRITICAL PATH METHOD (CPM) DALAM MENGANALISIS MANAJEMEN WAKTU PADA PERENCANAAN IKLAN GMS DIGITAL MARKETING

Planning helps monitor activities. to achieve the expected efficiency and effectiveness. In advertising planning at GMS Digital Marketing, there are often losses. The purpose of this study is to find out how to manage good time in advertising planning in GMS Digital Marketing and find out what efforts can be made so that advertising planning has efficient time. A mathematical approach called Critical Path Analysis (CPM) is used to organize the grouping of project operations. The project activities described using the CPM Method are a two-round procedure consisting of a forward and backward approach to setting a schedule when conducting a critical path analysis. ES and EF are set up during the forwarding process. During the transfer, LS and LF are determined. Early Start (ES) is the fastest way to start an activity. CPM is a cost-cutting approach for projects. We can know when costs and schedules need to be negotiated to meet project deadlines while keeping costs as low as possible. When a dimension is used, then CPM is used. (More accurate time estimates). Therefore, from the results of this study, a critical path is obtained that requires additional labor and time in completing the work

О реализации территориальными органами полиции на районном уровне правоохранительной функции (на примере сферы миграции)

The author has developed and presented the concept of a law enforcement function implemented by the state, and the implementation of this function is considered on the example of the migration sphere. The author declares the need to revise the norm enshrined in part 7 of Article 32.10 of the Administrative Code of the Russian Federation. As organizational measures aimed at identifying and suppressing administrative offenses committed in the field of migration, it is proposed to create operational groups in the territorial bodies of the Ministry of Internal Affairs of Russia at the district level, whose activities should be aimed at the daily implementation of measures aimed at identifying, suppressing, fixing (documenting) administrative offenses, as well as crimes related to migrants.

Features of the dental status of specialists-operators of underwater technical means of marine equipment

BACKGROUND: Conduct a comparative analysis of the dental status of specialists-operators of underwater technical equipment and military personnel of the St. Petersburg garrison. MATERIALS AND METHODS: A retrospective study of the dental formula of 66 contract servicemen was conducted. The main group consisted of 37 operators of underwater technical equipment aged 32 to 56 years, with average age of 44,7 ± 5,7 years. The comparison group included 29 officers of the St. Petersburg garrison aged 39 to 52 years, with average age of 46,3 ± 3,2 years. Dental status was assessed by the value of the intensity coefficient of carious process, and the level of dental care according to the generally accepted formula of P.A. Leus. RESULTS OF THE STUDY: It was found that the dental status of underwater equipment operators differs significantly in the number of decayed and extracted teeth, and although their coefficient of intensity of the carious process did not have statistical differences, it was significantly less (10 units) than in the comparison group (11 units). These features were naturally reflected in the reliable differences in the indicator of the level of dental care. In the group of operators of underwater technical means, it amounted to 92,4 ± 14,1%, and in the group of officers of the St. Petersburg garrison — 57,1 ± 18,4%. There were no significant differences in the study parameters when patients were divided into subgroups by age (young, medium). CONCLUSION: Despite the peculiarities of professional activity, the dental status and the level of dental care for underwater equipment operators are better than for officers of the St. Petersburg garrison. This can be explained not only by the higher level of medical and preventive dental care for these servicemen, but also by the better motivation to maintain dental health in connection with long autonomous trips.

Differential Evolution Algorithm with Three Mutation Operators for Global Optimization

Differential evolution algorithm is a very powerful and recently proposed evolutionary algorithm. Generally, only a mutation operator and predefined parameter values of differential evolution algorithm are utilized to solve various optimization problems, which limits the performance of the algorithm. In this paper, six commonly used mutation operators are divided into three categories according to their own features. A mutation pool is established based on the three categories. A parameter pool with three predefined values is designed. During evolution, three mutation operators are randomly chosen from the three categories, and three parameter values are also randomly selected from the parameter pool. The three groups of mutation operators and parameter values are employed to produce trial vectors. The proposed algorithm makes good use of different mutation operators. Three recently proposed differential evolution variants and three non-differential evolution algorithms are used to make comparisons on the 29 testing functions from CEC. The experimental results have demonstrated that the proposed algorithm is very competitive. The proposed algorithm is utilized to solve three real applications, and the results are superior.

Cohomologies and deformations of relative Rota-Baxter operators on n-Lie superalgebras

In this paper, we characterize a relative Rota-Baxter operator on an n-Lie superalgebra with a representation (called an n-LSRep pair) as a Maurer-Cartan element of a certain Lie n-algebra. Then, we introduce the notions of n-pre-Lie superalgebras and symplectic n-Lie superalgebras and give some related results based on relative Rota-Baxter operators. In the next part, we give the cohomologies of relative Rota-Baxter operators on n-LSRep pairs and study infinitesimal deformations and extensions of finite order deformations of relative Rota-Baxter operators through the cohomology groups of relative Rota-Baxter operators. Finally, we build the relationship between the cohomology groups of relative Rota-Baxter operators on n-LSRep pairs and those on ( n + 1 ) -LSRep pairs by certain linear functions.

Development of an evaluation method using a combined cat swarm optimization algorithm

The object of the study is complex dynamic objects with a hierarchical structure. The problem solved in the study is to increase the efficiency of decision-making while ensuring the given reliability. The subject of the study is the process of decision-making in management problems using an improved cat swarm optimization algorithm (CSO), an improved genetic algorithm and evolving artificial neural networks. The proposed method, due to additional and improved procedures, allows you: – to take into account the type of uncertainty of the initial data for setting CA for the local search procedure; – to implement adaptive strategies for finding food sources by CA; – to take into account the experience of the most authoritative CA while conducting local and global search; – to take into account the available computing resources of the state analysis system of complex dynamic objects and determine their required amount for involvement; – to take into account the CA search priority; – to determine the best CA using an improved genetic algorithm; – to conduct training of knowledge bases, which is carried out by training the synaptic weights of the artificial neural network, the type and parameters of the membership function, and architecture of individual elements and the architecture of the artificial neural network as a whole; – to avoid the local extremum problem by using the jump procedure. The proposed method was tested on the example of solving the problem of determining the composition of an operational group of troops (forces) and elements of its operational structure. An example of using the method showed an increase in the efficiency of data processing at the level of 14–19 % by using additional improved procedures. The proposed approach should be used to solve the problems of evaluating complex and dynamic processes characterized by a high degree of complexity

Pricing and revenue allocation mechanisms for regional logistics networks in Cyber-Physical Internet

Cyber-Physical Internet technology links physical and virtual networks, facilitating communication and coordination for logistics stakeholders regarding their operational decisions. However, the optimal pricing within a regional logistics network incorporating Cyber-Physical Internet remains unexplored. To address this issue, this paper develops a Stackelberg game model between a carrier and a group of road operators. We derive and analyze the equilibrium decisions of the carrier’s logistics service fee and road operators’ tolls under distributed and horizontal partnership pricing strategies. Furthermore, we compare these two strategies and design a revenue allocation mechanism for road operators. Our theoretical and numerical analyses yield the following key findings. First, our results debunk the prevailing belief about toll pricing, demonstrating that road operators reduce their toll charges in response to a peer’s toll increase driven by rising unit variable road costs. Second, a collaborative pricing strategy among road operators consistently enhances market demand and profits by minimizing toll charges to the carrier. Third, revenue allocation among road operators is primarily based on unit variable road costs, ensuring fair distribution and encouraging cooperation for long-term benefits. This study enhances our understanding of both theoretical and practical aspects of pricing strategies for carriers and road operators within Cyber-Physical Internet.

Geometry of spectral bounds of curves of unitary operators

This article presents a new proof of a theorem concerning bounds of the spectrum of the product of unitary operators and a generalization for differentiable curves of this theorem. The proofs involve metric geometric arguments in the group of unitary operators and the sphere where these operators act.

Impact of preoperative respiratory distress on outcomes of slide tracheoplasty.

Children with congenital tracheal stenosis born in the developing world face a high risk of mortality due to limited access to proper treatment. Patients who required preoperative respiratory support were suspected to have poor survival after slide tracheoplasty; however, this was not clearly demonstrated in the previous studies. This study aims to investigate the impact of preoperative respiratory conditions on outcomes of slide tracheoplasty. From 2016 to 2022, children who underwent slide tracheoplasty were retrospectively reviewed. Patients with respiratory distress requiring emergency operations (group A) were compared with patients in stable condition who were scheduled for surgery (group B). Perioperative results revealed that group A (n = 43) had a longer bypass time (P < 0.001), operation time (P = 0.01), postoperative ventilation time (P < 0.001) and length of intensive care unit stay (P = 0.00125) than group B (n = 60). The early mortality rate was 7.8%, and the actuarial 5-year survival rate was 85.3%. The cumulative incidence test revealed that group A was highly significant for overall mortality [sudistribution (SHR) 4.5; 95% confidence interval (CI) 1.23-16.4; P = 0.023]. Risk factors for overall mortality were prolonged postoperative ventilation time (hazard ratio 3.86; 95% CI 1.20-12.48; P = 0.024), bronchial stenosis (hazard ratio 5.77; 95% CI 1.72-19.31; P = 0.004), and preoperative tracheal mucositis (hazard ratio 5.67; 95% CI 1.51-21.31; P = 0.01). Four patients needed reintervention during a follow-up of 28.4 months (interquartile range 15.3-47.3). Preoperative respiratory distress negatively affected the outcomes of patients who required slide tracheoplasty. Therefore, early detection of congenital tracheal stenosis and aggressive slide tracheoplasty are crucial and obligatory to enhance long-term survival in this lethal congenital airway disease.

Selection Criteria in the Era of Perfect Competition for Drug-Eluting Stents in Association With Operator Volumes: An Operator-Volume Analysis of the Selection DES Study.

This study aimed to explore the factors influencing the drug-eluting stent (DES) selection criteria of cardiologists in association with percutaneous coronary intervention (PCI) volumes and to determine whether they value further DES improvements and modifications. The survey was conducted on a group of cardiologist operators from April 10 to 30, 2023. The analysis included 126 operators who answered the questions. Of these, low-, intermediate-, and high-volume operators accounted for 49 (38.9%), 47 (37.3%), and 30 (23.8%), respectively. Overall, Xience™ everolimus-eluting stent (CoCr-EES) was most frequently used, with > 70% of cardiologists using it in > 20% of their PCI practice. The percentage of selection by low-, intermediate-, and high-volume operators among the DESs used demonstrated no difference, except for dual-therapy sirolimus-eluting and CD34+ antibody-coated Combo® stent (DTS). Logistic regression analysis revealed that low-volume operators are less likely to be affected in terms of company/sales representative (odds ratio (OR): 0.402, P = 0.031) and bending lesions (OR: 0.339, P = 0.037) for selecting DES. Low-volume operators less frequently selected Resolute Onyx™ zotarolimus-eluting stents (OR: 0.689, P = 0.043) and DTS (Drug-Eluting Stents) (OR: 0.361, P = 0.006) for PCI. The current study results indicate that patient background, DES performance, and product specifications were not criteria for DES selection in cardiologists with different PCI volumes in routine PCI.