High Level Of Utilization Research Articles

S-DABT: Schedule and Dependency-aware Bug Triage in open-source bug tracking systems

Fixing bugs in a timely manner lowers various potential costs in software maintenance. However, manual bug fixing scheduling can be time-consuming, cumbersome, and error-prone. In this paper, we propose the Schedule and Dependency-aware Bug Triage (S-DABT), a bug triaging method that utilizes integer programming and machine learning techniques to assign bugs to suitable developers. Unlike prior works that largely focus on a single component of the bug reports, our approach takes into account the textual data, bug fixing costs, and bug dependencies. We further incorporate the schedule of developers in our formulation to have a more comprehensive model for this multifaceted problem. As a result, this complete formulation considers developers' schedules and the blocking effects of the bugs while covering the most significant aspects of the previously proposed methods. Our numerical study on four open-source software systems, namely, EclipseJDT, LibreOffice, GCC, and Mozilla, shows that taking into account the schedules of the developers decreases the average bug fixing times. We find that S-DABT leads to a high level of developer utilization through a fair distribution of the tasks among the developers and efficient use of the free spots in their schedules. Via the simulation of the issue tracking system, we also show how incorporating the schedule in the model formulation reduces the bug fixing time, improves the assignment accuracy, and utilizes the capability of each developer without much comprising in the model run times. We find that S-DABT decreases the complexity of the bug dependency graph by prioritizing blocking bugs and effectively reduces the infeasible assignment ratio due to bug dependencies. Consequently, we recommend considering developers' schedules while automating bug triage.

Vital Signs: Use of Recommended Health Care Measures to Prevent Selected Complications of Sickle Cell Anemia in Children and Adolescents - Selected U.S. States, 2019.

IntroductionSickle cell disease (SCD), a group of inherited blood cell disorders that primarily affects Black or African American persons, is associated with severe complications and a >20-year reduction in life expectancy. In 2014, an expert panel convened by the National Heart, Lung, and Blood Institute issued recommendations to prevent or reduce complications in children and adolescents with the most severe SCD subtypes, known as sickle cell anemia (SCA); recommendations included 1) annual screening of children and adolescents aged 2–16 years with transcranial Doppler (TCD) ultrasound to identify those at risk for stroke and 2) offering hydroxyurea therapy to children and adolescents aged ≥9 months to reduce the risk for several life-threatening complications.MethodsData from the IBM MarketScan Multi-State Medicaid Database were analyzed. TCD screening and hydroxyurea use were examined for 3,352 children and adolescents with SCA aged 2–16 years and continuously enrolled in Medicaid during 2019. Percentage change during 2014–2019 and variation by health subgroups were assessed. Analyses were stratified by age.ResultsDuring 2014–2019, TCD screening increased 27% among children and adolescents aged 10–16 years; hydroxyurea use increased 27% among children aged 2–9 years and 23% among children and adolescents aged 10–16 years. However, in 2019, only 47% and 38% of children and adolescents aged 2–9 and 10–16 years, respectively, had received TCD screening and 38% and 53% of children and adolescents aged 2–9 years and 10–16 years, respectively, used hydroxyurea. For both prevention strategies, usage was highest among children and adolescents with high levels of health care utilization and evidence of previous complications indicative of severe disease.Conclusion and Implications for Public Health PracticeDespite increases since 2014, TCD screening and hydroxyurea use remain low among children and adolescents with SCA. Health care providers should implement quality care strategies within their clinics and partner with patients, families, and community-based organizations to address barriers to delivering and receiving recommended care.

Feasibility, acceptability, and utility of a nurse-led survivorship program for people with metastatic melanoma (MELCARE)

PurposeImmune checkpoint inhibitors (ICIs) andtargeted therapy (TT) have improved the survival of people with metastatic melanoma. We assessed the feasibility, acceptability, and utility of a novel model of nurse-led, telehealth-delivered survivorship care (MELCARE) for this survivor group.MethodsPeople ≥ 18 years diagnosed with unresectable stage III or stage IV melanoma who were ≥ 6 months post initiation of ICI/TT with a radiological response suggestive of a long-term response to ICI/TT were recruited from a specialist melanoma centre in Australia. All participants received MELCARE, a nurse-led survivorship program involving two telehealth consultations 3 months apart, needs assessment using the Distress Thermometer (DT) and Problem List, and creation of a survivorship care plan. Feasibility, acceptability, and utility were assessed using rates of consent and study completion, time taken to complete each component of MELCARE, the Acceptability of Intervention Measure (AIM), and a customised utility survey.Results31/54 (57%) people consented. Participants were male (21, 68%), with a median age of 67 (range: 46–82). Eleven (35%) were receiving/had received ipilimumab and nivolumab and 27 (87%) had ceased treatment. Feasibility was demonstrated with 97% completing MELCARE. Utility was demonstrated on a customised survey and supported by a reduction in the mean DT score (initial: 5.6, SD: 2.9; follow-up: 1.5, SD: 1.2). Acceptability was demonstrated on 3/4 AIM items.ConclusionMELCARE was feasible and acceptable with high levels of utility. However, the consent rate was 57% indicating some people do not require support. Future studies should consider MELCARE’s optimal timing, resourcing, and cost-effectiveness.

Awareness and Utilization of Moodle among Students at Nursing Schools in North-Western Nigeria

Background: E-learning has been observed to enhance and support the teaching and learning processes, ranging from the way students use educational materials on the web or server and accessing course work online while following a course on campus to programs offered entirely online. Again e-learning allows for efficient transfer of knowledge anywhere and anytime, regardless of subject matter. It opens up a world of learning unavailable in most corners of the world, while at the same time empowering learners with the information technology awareness and skills crucial to succeed in today's global knowledge economy. Aim: The study aimed at assessing the awareness and utilization of moodle among students at nursing schools in North-Western Nigeria. Methodology: A cross-sectional analytic design was used for this study. Multistage sampling technique was used to select three schools; school of nursing Birnin Kudu, Jigawa state, school of nursing Katsina, Katsina state and school of nursing Gusau, Zamfara state which forms the setting for the study. A total of 307 nursing students were selected and recruited for the study. A structured Self-Administered Questionnaire was used for data collection. Descriptive statistics and the Bonferroni Post Hoc test were used in data analysis which. Results: The findings of the study revealed that most of the students (245 out of 305) have an excellent levels of awareness of e-learning with a percentage of 80.4%. The study also found out that most of the students have a high level of utilization of e-learning with 62%. The study also showed a statistically significant relationship between awareness and utilization of elearning among students at nursing schools in North-Western Nigeria with P-values of 0.001. Conclusion: Based on the findings, it was concluded from the results of the study that the students have an excellent level of awareness of e-learning and have a high level of utilization of e-learning.

The Natural Capital approach: A framework for the successful recovery of nature in estuaries

Abstract Estuaries are unique and complex systems that are important for ecological, cultural and economic reasons. They provide valuable habitat for biodiversity and provide a wide range of regulating, cultural and provisioning ecosystem services. Estuaries have a disproportionate importance to people in comparison to other habitats, which has resulted in high levels of utilization and environmental impact. Poor management, ineffective conservation approaches and global economic changes have resulted in many temperate estuaries becoming both economically and environmentally degraded. We present an argument for the use of the Natural Capital approach as part of the wider green economic agenda in temperate estuaries to support both the environmental and economic recovery of these areas. We make the case that in a habitat always likely to be subject to intense human pressure it provides a holistic decision‐making approach which considers ecological aspects alongside the ecosystem's anthropogenic importance and pressures. This allows for damage to be identified quickly and accelerates the process of designing and implementing solutions. It provides a framework for multiple partners with a material interest in maintaining a healthy estuarine environment providing multiple benefits to drive investment in natural capital and delivery of nature recovery. We highlight some of the obstacles in implementing the Natural Capital approach in estuaries at scale, including collaboration and communication between stakeholders in various sectors, the existence of quality natural capital and environmental baselines and the need for partnership to create investment opportunities. We explore how these are being addressed and identify progress in the Natural Capital approach and how this can inform and advance the widespread implementation of the approach.

Availability and utilization of digital marketing tools among fresh African catfish marketers in Omambala Region of Anambra State, Nigeria

This study examined the availability and utilization of digital marketing tools among fresh African catfish marketers in Omambala region of Anambra State, Nigeria. Frequency count, percentage, mean score and multiple regression analysis were used to analyze the data collected from 120 respondents. Social media marketing (84.2%), video/YouTube marketing (79.2%), websites (71.7%) and mobile applications (55.0%) were the digital marketing tools available to them in the study area. Perceived benefits of digital marketing included easy access to unlimited geographical location and information, its less expensive nature, convenient store hours, and increased customer base, sales, and profit. Level of utilization of digital marketing tools amongst the fresh African catfish marketers showed that there were high levels of utilization of social media marketing, video/YouTube marketing, Mobile applications, and websites, with social media marketing being the most utilized. High cost of mobile phones and laptops, inadequate operating capital, poor power supply, computer literacy, huge advertisement and internet subscription cost, limited access to internet, and lack of awareness were the identified constraints to the marketers’ utilization of digital marketing strategies. Age of the marketers had negative effect on their level of utilization of digital marketing tools, while educational qualification, marketing experience and availability of fund had positive effect on the marketer’s level of utilization of digital marketing tools. Fresh African catfish marketing is a source of livelihood in the study area and the marketers utilize some digital marketing tools. Fresh African catfish marketers be given financial support, and more awareness created on other digital marketing tools for increased income and livelihood.

Feasibility of establishing a multi-center research database using the electronic health record: The PURSUIT network

Although multi-center research is needed in pediatric urology, collaboration is impeded by differences in physician documentation and research resources. Electronic health record (EHR) tools offer a promising avenue to overcome these barriers. To assess the accuracy, completeness, and utilization of structured data elements across multiple practices. A standardized template was developed and implemented at five academic pediatric urology practices to document clinic visits for patients with congenital hydronephrosis and/or vesicoureteral reflux. Data from standardized elements in the template and from pre-existing EHR fields were extracted into a secure database. A 20% random sample of infants with data from structured elements from 1/1/2020 and 4/30/2021 were identified and compared to manual chart review at sites with >100 charts; all other sites reviewed at least 20 charts. Manual chart review was standardized across sites and included: clinic and operative notes, orders linked to the clinic encounter, radiology results, and active medications. Accuracy of data extraction was evaluated by computing the kappa statistic and percentage agreement. For sites that had adopted the templates prior to 6/1/2019 (early adopters), a list of eligible patients with an initial clinic visit from 1/1/2020-7/27/2020 was generated using standardized reporting techniques and confirmed by manual chart review. Physician utilization of the template was then calculated by comparing patients with data obtained from the note template to the generated list of eligible patients. 230 patient records met study criteria. Agreement between manual chart review and data extracted from the EHR was high (>85%). Race, ethnicity and insurance data were misclassified in about 10-15% of cases; this was due to site-specific differences in how these fields were coded. Renal ultrasound was misclassified 12% of the time; this was primarily due to outside images documented in radiology results but not included in the clinical note. All other data elements had >90% agreement (Figure). Template utilization for early adopters was >75% (75.5-87.5%). This is the first study in urology to demonstrate that use of structured data elements can support multi-center research. Limitations include: inclusion of only academic sites with the Epic EHR and lack of data on utilization and sustainability at sites without a prior history of structured template use. Multi-center research collaboration using EHR-based data collection tools is feasible with generally high accuracy compared to manual chart review. Additionally, sites with a long history of template adoption have high levels of provider utilization.

Abstract 77: Pilot Outcomes Of A Multi-component Support Intervention For Caregivers Of Persons With Heart Failure

Background: Caregivers of persons with heart failure must manage high levels of patient health care utilization, treatment complexity and often unpredictable stressors associated with intermittent symptom exacerbations and mortality. Interventions have often focused on the needs of the person with HF, not the caregiver. Therefore, we developed an intervention using human-centered design to provide caregiver-targeted support for this population. Objective: Pilot test the feasibility and gauge initial effect size of the Caregiver Support intervention to improve quality of life (mental and physical), caregiver burden, and self-efficacy among family caregivers from baseline to 16 weeks. Methods: The intervention includes five individualized, nurse-led sessions over 10 weeks conducted remotely (due to COVID-19). Intervention components focus on 1) nature of caregiving, 2) life purpose, 3) co-development of an action plan to address caregiver goals to reduce caregiver burden and improve caregiver well-being, 4) exploration of social and community resources to support unmet needs, and 5) building a sustainability plan for addressing future caregiver needs. We tested our approach in a randomized waitlist control pilot trial (N=35) from August 2020 through March 2022. We calculated enrollment and retention rates, described acceptability, and computed intervention effect sizes from baseline to 16 weeks. Results: 35 out of 101 (35%) eligible caregivers enrolled and were majority female (93.3%), White (60%) and spousal caregivers (63.3%). Average age was 59.4 ± 16.6 years. Overall retention was 69%. All intervention participants completed the five core components, reporting high levels of satisfaction and acceptability of activities. Between-group effect sizes (n=21) at 16 weeks suggest improvement in the mental health component of quality of life, caregiver burden, and self-efficacy (effect sizes 0.88, 0.31, and 0.63, respectively). Conclusion: Caregivers found Caregiver Support acceptable and study methods were feasible, despite challenges to engaging during the COVID-19 pandemic. Findings provide foundational evidence that this person-centered behavioral intervention can contribute to enhanced caregiver outcomes.

Provider perspectives on emergency department initiation of medication assisted treatment for alcohol use disorder

BackgroundAlcohol use disorder (AUD) is ubiquitous and its sequelae contribute to high levels of healthcare utilization, yet AUD remains undertreated. The ED encounter represents a missed opportunity to initiate medication assisted treatment (MAT) for patients with AUD. The aims of this study are to identify barriers and facilitators to the treatment of AUD in the ED, and to design interventions to address identified barriers.MethodsUsing an implementation science approach based on the Behavior Change Wheel framework, we conducted qualitative interviews with staff to interrogate their perspectives on ED initiation of AUD treatment. Subjects included physicians, nurses, nurse practitioners, clinical social workers, and pharmacists. Interviews were thematically coded using both inductive and deductive approaches and constant comparative analysis. Themes were further categorized as relating to providers’ capabilities, opportunities, or motivations. Barriers were then mapped to corresponding intervention functions.ResultsFacilitators at our institution included time allotted for continuing education, the availability of clinical social workers, and favorable opinions of MAT based on previous experiences implementing buprenorphine for opioid use disorder. Capability barriers included limited familiarity with naltrexone and difficulty determining which patients are candidates for therapy. Opportunity barriers included the limited supply of naltrexone and a lack of clarity as to who should introduce naltrexone and assess readiness for change. Motivation barriers included a sense of futility in treating patients with AUD and stigmas associated with alcohol use. Evidence-based interventions included multi-modal provider education, a standardized treatment algorithm and order set, selection of clinical champions, and clarification of roles among providers on the team.ConclusionsA large evidence-practice gap exists for the treatment of AUD with Naltrexone, and the ED visit is a missed opportunity for intervention. ED providers are optimistic about implementing AUD treatment in the ED but described many barriers, especially related to knowledge, clarification of roles, and stigma associated with AUD. Applying a formal implementation science approach guided by the Behavior Change Wheel allowed us to transform qualitative interview data into evidence-based interventions for the implementation of an ED-based program for the treatment of AUD.

Exergy analysis and optimisation of an industrial-scale circulation counter-flow paddy drying process

Drying is a process of removing water from products down to a specific moisture content. It is an energy-intensive process widely-used for grain and biomass processing. Because of the complicated thermodynamics and transport phenomena involved in drying, it is challenging to analyse and optimise drying operations. In this study, computer simulations using a transient model are performed to simulate the real-time paddy drying, and analyse the exergy components, exergy efficiency, exergy loss and destruction of industrial-scale drying process under changing drying air temperature (60–80 °C) and flow velocity (0.56–0.83 m/s) and initial moisture content (0.22–0.3 g water/g wet matter) on a circulation counter-flow paddy dryer. Results show our model can predict paddy moisture content and temperature with mean relative deviations of 5.5% and 1.42%, respectively. Exergy efficiency of drying process is specified to be in the range of 28.75–35.68%. Main factor affecting drying rate and energy consumption in high moisture content regions of drying process is drying air flow velocity while that in low moisture content regions is drying air temperature. We also propose control strategy based on two-stage variable ventilation parameters that achieves high exergy utilization level, high drying rate, and high product quality for grain drying.

38 Utilizing an Implementation Science Framework to Design a Burn Resuscitation Bundle in a Resource-limited Setting

IntroductionProtocolized burn resuscitation algorithms with hourly, closed loop feedback, have reduced instances of over- and under-resuscitation and improved outcomes in high income countries. However, a “know-do” gap exists as this practice has yet to be adopted in many low- and middle-income countries (LMIC). We aimed to describe the change management process of the development and implementation of a contextually driven protocolized burn resuscitation bundle at a tertiary burn center in an LMIC using an implementation science framework.MethodsWe applied strategies from the Expert Recommendations for Implementing Change (ERIC) for the design and implementation of a burn resuscitation bundle at a major burn center in an LMIC, over a 9-month period. Semi-structured focus group discussions (FGD) were conducted with stakeholders to understand facilitators and barriers to developing and using the protocol, with iterative feedback used to inform and adjust the protocol and documentation tools. Responses were analyzed using content analysis and particularly unique and useful responses were highlighted.ResultsStakeholders identified resource constraint-related concerns about the feasibility of an hourly IV resuscitation protocol and reached consensus on performing 2-hourly assessments and fluid adjustments. Corresponding documentation tools were developed and iteratively adjusted. Several initial barriers to adoption and institutionalization were encountered. ERIC strategies used to promote intervention uptake included simplification and visualization of the protocol, identification of a project champion, development of educational materials for multiple cadres (e.g., nurses, physicians, health assistants), use of chain of command to enable change and accountability, utilizing institutional branding and ultimately obtaining endorsement by the center’s leadership (Table 1). Post-implementation FGD with stakeholders revealed high levels of acceptance, utilization and adherence of the protocol bundle, with occasional opportunities for improvement identified in protocol completeness and accuracy.ConclusionsAdoption of change in clinical resuscitation practice in a resource-constrained setting required a contextually driven, multi-faceted approach led by a team of change champions and leaders. The ERIC framework allowed for an iterative approach to prioritize stakeholder engagement and feedback, in order to implement a protocolized IV resuscitation bundle in a LMIC.

Severe asthma in children: Description of a large multidisciplinary clinical cohort.

Children with severe asthma have substantial morbidity and healthcare utilization. Pediatric severe asthma is a heterogeneous disease, and a multidisciplinary approach can improve the diagnosis and management of these children. We reviewed the electronic health records for patients seen in the Severe Asthma Clinic (SAC) at UPMC Children's Hospital of Pittsburgh between August 2012 and October 2019. Of the 110 patients in whom we extracted data, 46% were female, 48% were Black/African American, and 41% had ≥1 admission to the pediatric intensive care unit (PICU) for asthma. Compared to patients without a PICU admission, those with ≥1 PICU admission were more likely to be non-White (64.4% vs. 41.5%, p = 0.031) and more atopic (eosinophil count geometric mean = 673 vs. 319 cells/mm3 , p = 0.002; total IgE geometric mean = 754 vs. 303 KU/L, p = 0.003), and to have lower pre-bronchodilator FEV1 (58.6% [±18.1%] vs. 69.9% [±18.7%], p = 0.002) and elevated FeNO (60% vs. 22%, p = 0.02). In this cohort, 84% of patients were prescribed high-dose ICS/LABA and 36% were on biologics. Following enrollment in the SAC, severe exacerbations decreased from 3.2/year to 2.2/year (p < 0.0001); compared to the year before joining the SAC, in the following year the group had 106 fewer severe exacerbations. This large cohort of children with severe asthma had a high level of morbidity and healthcare utilization. Patients with a history of PICU admissions for asthma were more likely to be nonwhite and highly atopic, and to have lower lung function. Our data support a positive impact of a multidisciplinary clinic on patients with severe childhood asthma.

An e-learning pediatric cardiology curriculum for Pediatric Postgraduate trainees in Rwanda: implementation and evaluation

BackgroundAccess to pediatric sub-specialty training is a critical unmet need in many resource-limited settings. In Rwanda, only two pediatric cardiologists are responsible for the country’s clinical care of a population of 12 million, along with the medical education of all pediatric trainees. To strengthen physician training opportunities, we developed an e-learning curriculum in pediatric cardiology. This curriculum aimed to “flip the classroom”, allowing residents to learn key pediatric cardiology concepts digitally before an in-person session with the specialist, thus efficiently utilizing the specialist for additional case based and bedside teaching.MethodsWe surveyed Rwandan and US faculty and residents using a modified Delphi approach to identify key topics in pediatric cardiology. Lead authors from Rwanda and the USA collaborated with OPENPediatrics™, a free digital knowledge-sharing platform, to produce ten core topics presented in structured videos spanning 4.5 h. A mixed methods evaluation was completed with Rwandan pediatric residents, including surveys assessing knowledge, utilization, and satisfaction. Qualitative analysis of structured interviews was conducted using NVivo.ResultsAmong the 43 residents who participated in the OPENPediatrics™ cardiology curriculum, 33 (77%) completed the curriculum assessment. Residents reported using the curriculum for a median of 8 h. Thirty-eight (88%) reported viewing the curriculum on their personal or hospital computer via pre-downloaded materials on a USB flash drive, with another seven (16%) reporting viewing it online. Twenty-seven residents viewed the course during core lecture time (63%). Commonly reported barriers to utilization included lack of time (70%), access to internet (40%) and language (24%). Scores on knowledge assessment improved from 66.2% to 76.7% upon completion of the curriculum (p < 0.001) across all levels of training, with most significant improvement in scores for PGY-1 and PGY-2 residents. Residents reported high satisfaction with the visuals, engaging presentation, and organization of the curriculum. Residents opined the need for expanded training material in cardiac electrocardiogram and echocardiogram and requested for slower narration by foreign presenters.ConclusionVideo-based e-learning via OPENPediatrics™ in a resource-limited setting was effective in improving resident’s knowledge in pediatric cardiology with high levels of utilization and satisfaction. Expanding access to digital curriculums for other pediatric sub-specialties may be both an effective and efficient strategy for improving training in settings with limited access to subspecialist faculty.

Utilization of Cognitive Diagnostic Assessment (CDA) As A Feedback Tool by Secondary School Teachers in Maiduguri Metropolis, Borno State

The study determined the utilization of cognitive diagnostic assessment (CDA) as a tool for feedback among secondary school teachers in Maiduguri Metropolis, Borno State. The objectives of the study were to determine level of utilization of cognitive diagnostic assessment as a tool for feedback among secondary school teachers and if there are statistically significant differences in the level of utilization among teachers of secondary schools due to the variables of academic qualification, years of experience and gender. The study used exploratory survey research design to obtain data for the study. The target population for this study was all secondary school teachers in Maiduguri metropolis, Borno state. There were 3,170 secondary school teachers within the metropolis as at May, 2021. The sample for the study was one hundred and eighty-five teachers randomly sampled. The instrument for data collection was a researcher designed questionnaire consisting of 19 items. The Cronbach’s Alpha reliability of the instrument was .75. The instrument was administered to the teachers in their offices and was collected on the same day. Percentage and frequency count were used to analyze data on the level of utilization of cognitive diagnostic assessment as a feedback tool by teachers while Krustal-Wallis Test Chi-Square was used to analyze data on differences in utilization of cognitive diagnostic assessment among teachers by academic qualification and years of experience. Data on gender difference in utilization of cognitive diagnostic assessment as among teachers was analysed by means of t-test of independent samples. Results on level of utilization of cognitive diagnostic assessment indicate a high level of utilization among teachers. On difference in utilization of cognitive diagnostic assessment the study found no significant differences among teachers by academic qualifications and years of experience. The result however indicates a significant gender difference in utilization of cognitive diagnostic assessment among teachers in favour of females.

Women’s perception of quality and utilization of antenatal care and delivery services in Oshimili South Local Government Area of Delta State, Nigeria

Background: The perception of quality of antenatal care and delivery services is one of the several factors that influence utilization of these services. This study assessed the perception of quality and utilization of antenatal care (ANC) and delivery services among women of childbearing age in Oshimili South Local Government Area (LGA) of Delta State, Nigeria.Methods: A cross-sectional study among 301 women aged 15-49 years selected by multistage random sampling technique using mixed methods of data collection. Quantitative data were analyzed using SPSS version 21 while thematic analysis was done for the qualitative data.Results: The mean age of the women was 32.0 ± 2.5 years. Most were married 287 (95.3%), had secondary education 211 (70.1%)) and self-employed 227 (75.4%). One hundred and forty-eight (49.2%) had good perception of technical competence of staff, 132 (43.9%) their safety consciousness and 134 (44.5%) effectiveness/efficiency of drugs. However, 136 (43.5%) had poor perception of waiting time, 118 (39.2%) health workers respectfulness and 116 (38.5%) compassion for patients. Two hundred and seventy-three (90.7%) and 251(83.4%) utilized ANC and delivery services, respectively, while 22 (7.3%) delivered at home.Conclusion: The women’s perception of quality of ANC and delivery services varied across domains. There was a high level of utilization of antenatal care and delivery services. However, there were few traditional birth attendant (TBA) and home deliveries. Addressing the issues of long waiting time and attitude of health workers will encourage full scale utilization of health facilities and discourage TBA and home deliveries&#x0D; Keywords: Antenatal care; Delivery services; Perception; Quality of care; Utilization; Nigeria

Bot-Based Emergency Software Applications for Natural Disaster Situations

Upon a serious emergency situation such as a natural disaster, people quickly try to call their friends and family with the software they use every day. On the other hand, people also tend to participate as a volunteer for rescue purposes. It is unlikely and impractical for these people to download and learn to use an application specially designed for aid processes. In this work, we investigate the feasibility of including bots, which provide a mechanism to get inside the software that people use daily, to develop emergency software applications designed to be used by victims and volunteers during stressful situations. In such situations, it is necessary to achieve efficiency, scalability, fault tolerance, elasticity, and mobility between data centers. We evaluate three bot-based applications. The first one, named Jayma, sends information about affected people during the natural disaster to a network of contacts. The second bot-based application, Ayni, manages and assigns tasks to volunteers. The third bot-based application named Rimay registers volunteers and manages campaigns and emergency tasks. The applications are built using common practice for distributed software architecture design. Most of the components forming the architecture are from existing public domain software, and some components are even consumed as an external service as in the case of Telegram. Moreover, the applications are executed on commodity hardware usually available from universities. We evaluate the applications to detect critical tasks, bottlenecks, and the most critical resource. Results show that Ayni and Rimay tend to saturate the CPU faster than other resources. Meanwhile, the RAM memory tends to reach the highest utilization level in the Jayma application.

Intelligent Gate Drivers for Future Power Converters

This article gives insights into recent developments in the field of power semiconductor gate drivers that exhibit intelligent features. Such features are active switching transient control and optimization of overshoots, electromagnetic interference, and switching losses. Additionally, these aspects are providing safe operation at fast and extreme switching instances and short-circuit events. Furthermore, integrated sensing capabilities that extract thermal response as well as state-of-health data constitute an intelligent gate driver. During the last decade, researchers transformed gate drivers from simple amplifiers to intelligent control units. Intelligent implies in this context that the driver can gather information and adapt its operation behavior to changing conditions. This includes detecting and clearing fault states, electrical and thermal management, and additionally <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">in situ</i> detection of aging effects. Furthermore, this article identifies challenges and opportunities that arise with intelligent operation of wide-bandgap semiconductors. Future applications of semiconductor devices demand a high level of integration and utilization that can only be achieved by safe operation within but close to their electrical and thermal limits. Intelligent gate drivers provide a unique manipulability that enables high-performance and secure operation through extracting and using information about the switching process and the power module.

Utilization of a Smart Sock for the Remote Monitoring of Patients With Peripheral Neuropathy: Cross-sectional Study of a Real-world Registry.

BackgroundRemote patient monitoring (RPM) devices are increasingly being used in caring for patients to reduce risks of complications. Temperature monitoring specifically has been shown in previous studies to provide a useful signal of inflammation that may help prevent foot ulcers.ObjectiveIn this cross-sectional study, we evaluated utilization data for patients who were prescribed smart socks as remote temperature monitoring devices.MethodsThis study evaluated data from a patient registry from January to July 2021. The utilization data, which were collected starting from the first full month since patients were prescribed the smart socks, were evaluated along with retention over time, the average time that the socks were worn, and the number of days that the socks were worn per month and per week.ResultsA total of 160 patients wore the smart sock RPM device for 22 to 25 days per month on average. The retention rate was 91.9% (147/160) at the end of the 7-month period; a total of 13 patients were lost to follow-up during this period. The average number of days that the socks were worn per week was 5.8. The percentage of patients with a utilization rate of >15 days ranged from 79.7% (106/133) to 91.9% (125/136) each month.ConclusionsThis study shows a high level of utilization for a smart sock RPM device and a high compliance rate. A future prospective study on the clinical outcomes after the use of the smart socks may further solidify the idea of conducting temperature monitoring for foot ulcer prevention.

Factors influencing the utilization of antenatal and postnatal care services by women of reproductive age group: a cross-sectional study in rural community of Maharashtra

Background: Antenatal care (ANC) and postnatal care (PNC) care services intended to secure and improve maternal health are utilized only to a limited extent. Therefore, this study was conducted to assess various barriers and association of various sociodemographic factors like age, education, economic status and religion with the utilization of services. This revealed the reasons which avert the ladies from utilising the services adequately.Methods: 150 women residents of Uruli Kanchan, a village in Pune district of Maharashtra, having at least 1 child below the age of five years were selected by simple random sampling technique. The data was collected by house-to-house survey and interview technique.Results: In the present study, better utilization of ANC services was observed (99.234%) as compared to PNC services (65.33%). Education, good socioeconomic conditions and religion were the factors which greatly influenced the utilization of PNC services. Lack of desire and awareness of PNC visits (in 55% women) was an important factor for underutilization of PNC services. Lack of trust towards government services (by 34.02%) women was observed.70% of women showed satisfaction towards the maternal and child health care (MCH) services provided by the government.Conclusions: Women showed high level of utilization of ANC services as compared to PNC services which still need a lot of attention and awareness. Women show lack of trust in the government facility.

Healthcare Resource Utilization of Patients With COVID-19 Visiting US Hospitals

ObjectivesSevere cases of COVID-19 have overwhelmed hospital systems across the nation. This study aimed to describe the healthcare resource utilization of patients with COVID-19 from hospital visit to 30 days after discharge for inpatients and hospital-based outpatients in the United States. MethodsA retrospective cohort study was conducted using Premier Healthcare Database COVID-19 Special Release, a large geographically diverse all-payer hospital administrative database. Adult patients (age ≥ 18 years) were identified by their first, or “index,” visit between April 1, 2020, and February 28, 2021, with a principal or secondary discharge diagnosis of COVID-19. ResultsOf 1 454 780 adult patients with COVID-19, 33% (n = 481 216) were inpatients and 67% (n = 973 564) were outpatients. Among inpatients, mean age was 64.4 years and comorbidities were common. Most patients (80%) originated from home, 10% from another acute care facility, and 95% were admitted through the emergency department. Of these patients, 23% (n = 108 120) were admitted to intensive care unit and 14% (n = 66 706) died during index hospitalization; 44% were discharged home, 15% to nursing or rehabilitation facility, and 12% to home health. Among outpatients, mean age was 48.8 years, 44% were male, and 60% were emergency department outpatients (n = 586 537). During index outpatient visit, 79% were sent home but 10% had another outpatient visit and 4% were hospitalized within 30 days. ConclusionsCOVID-19 is associated with high level of healthcare resource utilization and in-hospital mortality. More than one-third of inpatients required post hospital healthcare services. Such information may help healthcare providers better allocate resources for patients with COVID-19 during the pandemic.