Quality Index Research Articles

Hospital-to-Home-Health Transition Quality (H3TQ) Index: Further Evidence on its Validity and Recommendations for Implementation.

We developed the Hospital-to-Home-Health Transition Quality (H3TQ) Index for skilled home healthcare (HH) agencies to identify threats to safe, high-quality care transitions in real time. Assess the validity of H3TQ in a large sample across diverse communities. A survey of recently hospitalized older adults referred for skilled HH services and their HH provider at two large HH agencies in Baltimore, MD, and New York, NY. There were five hundred eighty-seven participants (309 older adults, 141 informal caregivers, and 137 HH providers). Older adults, caregivers, and HH providers rated 747 unique transitions. Of these, 403 were rated by both the older adult/caregiver and their HH provider, whereas the remaining transitions were rated by either party. Construct, concurrent, and predictive validity were assessed via the overall H3TQ rating, correlation with the care transition measure (CTM), and the Medicare Outcome and Assessment Information Set (OASIS). Proportion of transitions with quality issues as identified by HH providers and older adults/caregivers, respectively; Baltimore 55%, 35%; NYC 43%, 32%. Older adults/caregivers across sites rated their transitions as higher quality than did providers (P<0.05). H3TQ summed scores showed construct validity with the CTM-3 and concurrent validity with OASIS measures. Summed H3TQ scores were not significantly correlated with 30-day ED visits or rehospitalization. The H3TQ identifies care transition quality issues in real-time and demonstrated construct and concurrent validity, but not predictive validity. Findings demonstrate value in collecting multiple perspectives to evaluate care transition quality. Implementing the H3TQ could help identify transition-quality intervention opportunities for HH patients.

Medical X-ray images enhancement based on super resolution convolution neural network

&lt;p&gt;Pneumonia is a severe lung infection, chest X-ray (CXR) image preferred to find infection. Real images lost its quality, resolution and other feature due to transmission. So good qualitative datasets are very limited. Quality enhancement in medical images is challenging task for researchers. And quality in clinical diagnosis of any disease in deep learning play a very important role. So, this paper presents an aspect with importance of quality in medical images CXR of a particular dataset and how to enhance and create new images with high quality resolution, that is re-used for classification in deep learning. Super resolution convolutional neural netwok (SRCNN) is deep learning based method, which is used for improving resolution in image. Super resolution means low resolution (LR) images from dataset is to be reconstructed or magnified into high resolution (HR). The objective behind this study is to measure the effect of super resolution with quality index, peak signal-to-noise ratio (PSNR), mean squared error (MSE), and structural similarity index measure (SSIM). This experinment performed on 200 images with 10 batches, each batch has 20 images from Kermany dataset, select LR images and converted into HR with SRCNN. Then we find PSNR value of image is increase upto 2 to 5 DB, and MSE of qood quality images is near to zero and MSE decrease up to 20-25, SSIM value have little variation due to same pattern is found in input and output images. Enhancement means highlight or improve the region of interest of pneumonic images. Main goal of this study is to preapare a modified dataset which is further used for classification.&lt;/p&gt;

Content, educational value and quality analysis of videos about neurorehabilitation in people with multiple sclerosis on YouTube®.

The use of YouTube® has spread among patients with chronic diseases such as multiple sclerosis (MS). These patients consult the available videos to learn more about their disease in terms of diagnosis and making decisions about treatments, including rehabilitation. The aim of this study was to evaluate the content, educational value, and quality analysis of MS videos about neurorehabilitation on YouTube® using quantitative instruments. A search was conducted on YouTube®. The first 30 videos that met the inclusion criteria were reviewed. The videos were classified according to the upload source and the content. All videos included in the review were assessed by the DISCERN questionnaire, the JAMA benchmark, the global quality scale (GQS) and the video information and quality index (VIQI). The mean scores were: 28.3 (±9.33) in DISCERN, 2 (±0.81) in JAMA, 2.57 (±1.22) in GQS, and 11.73 (±4.06) in VIQI. JAMA score statistically significantly differed according to upload source (p = 0.002), video content (p = 0.023) and the speaker (p = 0.002). The DISCERN, JAMA, GQS, and VIQI scores showed significant correlations with each other. The analyzed videos about neurorehabilitation in people with MS on YouTube® were quite old since the upload, with a moderate duration and number of views, but with a poor quality of the content, educational value, and quality analysis of the videos. Our research showed that there were statistically significant differences in terms of quality, transparency, and reliability of the information, depending on the upload source, video content and the speaker.

Hospital quality classification based on quality indicator data during the COVID-19 pandemic

This research aim is to propose a machine learning approach to automatically evaluate or categories hospital quality status using quality indicator data. This research was divided into six stages: data collection, pre-processing, feature engineering, data training, data testing, and evaluation. In 2020, we collected 5,542 data values for quality indicators from 658 Indonesian hospitals. However, we analyzed data from only 275 hospitals due to inadequate submission. We employed methods of machine learning such as decision tree (DT), gaussian naïve Bayes (GNB), logistic regression (LR), k-nearest neighbors (KNN), support vector machine (SVM), linear discriminant analysis (LDA) and neural network (NN) for research archive purposes. Logistic regression achieved a 70% accuracy rate, SVM a 68% accuracy rate, and neural network a 59.34% of accuracy. Moreover, K-nearest neighbors achieved a 54% of accuracy and decision tree a 41% accuracy. Gaussian-NB achieved a 32% accuracy rate. The linear discriminant analysis achieved the highest accuracy with 71%. It can be concluded that linear discriminant analysis is the algorithm suitable for hospital quality data in this research.

Patterns of community antibiotic use with reference to the AWaRe classification of the World Health Organization.

Monitoring consumption through quality indicators and providing feedback is an important activity within programmes for improving antibiotic prescription. This study aims to describe the use of antibiotics for systemic use in community setting in Italy and to compare prescription patterns among regions based on quality prescription indicators to identify any inter-regional variability. The 2021 consumption (calculated as DDDs per 1000 inhabitants per day) of antibiotics for systemic use (reimbursed or purchased privately) in community setting were considered. The WHO AWaRe system was used to classify antibiotics into Access, Watch and Reserve groups, using the 60% of prescribed antibiotics belonging to the Access group out of the total DDDs as AWaRe target. The correlation between regional consumption and percentages of DDDs in the Access group was assessed through linear regression. A further indicator 'ratio of broad to narrow-spectrum antibacterials' was also calculated to compare the spectrum of prescribed antibiotics. Overall community antibiotic consumption in Italy in 2021 was 15.6 DDDs per 1000 inhabitants per day, with an increasing trend from north (13.0 DDDs) to south (19.5 DDDs) and the percentages of non-reimbursed consumption decreasing from north (33.1%) to south (21.5%). Only three regions out of 21 reached the AWaRe target (regional range 47.4%-62.9%), with a negative correlation between regional consumption and percentages of antibiotics belonging to the Access group (correlation coefficient -0.8; R 2 = 0.64; P value < 0.001). The 'ratio of broad to narrow-spectrum antibacterials' was 8.5 at national level, with the highest value in the centre (11.0) compared to the south (9.1) and north (7.0). The percentage of consumption of Access group antibiotics correlates very well with regional consumption in Italy, indicating that regions with higher antibiotics consumption also have worse prescribing patterns with a greater impact on bacterial resistance. Additional data are needed to better describe prescription patterns from an antimicrobial stewardship perspective.

Explainable highway performance degradation prediction model based on LSTM

With the dense and huge highway network in China, the highway maintenance management system has become the most concerned issue for Chinese highway managers in recent years. Therefore, based on the highway network in Guizhou Province of China, this paper established the semi-rigid asphalt pavement performance multi-output Long Short-Term Memory (LSTM) prediction model with regional applicability, including Pavement Surface Condition Index (PCI), Pavement Rutting Depth Index (RDI), Pavement Riding Quality Index (RQI) and Pavement Skidding Resistance Index (SRI) and the hyperparameters of the model were optimized by Bayesian optimization algorithm and the casual analysis of the model was conducted based on SHapley Additive exPlanations (SHAP), providing a reference for China's highway network-level preventive maintenance decision-making. The results prove that the established model can effectively predict the performance of the following year through the data of the previous two years. The established model has a better comprehensive prediction effect in comparison to similar multi-output models. The average coefficient of determination (R2) of the four prediction indexes can reach 0.823. Besides, the prediction effect among the indexes is stable and multiple pavement performance indexes can be effectively and reliably predicted at the same time. In addition, the contribution of input feature variables to output is quantified based on SHAP. According to quantified the contribution, the association relationship of the neural network model is set-valued mapped to the causality relationship in the post hoc. The input feature variables with the main contribution are extracted for causal analysis. The causal analysis shows that the degradation of the four pavement performances all have obvious time memory characteristics and have significant differences, but their pavement performance degradation is the result of nonlinear changes caused by the coupling effects of traffic load, road age, climate, and pavement structure.

Vitamin D Supplementation in Congenital Ichthyosis: A Case Series.

Ichthyosis is a group of genetic keratinization disorders characterized by excessive scaling that is associated with hyperproliferative epidermis and/or cellular retention. Whereas normal outer epidermis thickness is 25 μm, it can be 10-fold greater in patients with ichthyosis. As a result, photoactivation of 7-dehydrocholesterol is impaired, causing systemic vitamin D deficiency.In this case series, 25 patients with congenital ichthyosis with vitamin D deficiency (<10 ng/mL) were supplemented with 60,000 IU of vitamin D3 for 10 days followed by daily allowance of 400 to 600 IU of vitamin D3 and 40 mg/kg per day of elemental calcium. The authors assessed improvement in cutaneous scaling and body and tested patients' blood and urine samples at day 1, day 10, 1 month, and 3 months. They also documented patients' Dermatology Life Quality Index score before and after treatment.All patients had normal vitamin D levels; supplementation was discontinued for two patients who reached a level of 100 ng/mL within 10 days. Subjective improvement of symptoms (dryness of the skin, allergic rhinitis, tightness of the skin, and scaling) was observed by both the provider and the patients. There was remarkable improvement in symptoms of severe ichthyosis such as lamellar ichthyosis (tightness of the skin and scaling). Marked improvement in Dermatology Life Quality Index score was also noted.This case series demonstrated remarkable symptomatic relief with vitamin D supplementation in patients with congenital ichthyosis; however, additional research should be conducted with larger sample sizes to support these findings.

Isotretinoin-Induced Hypersomnia: A Cross-sectional Study and Literature Review.

Isotretinoin is an oral retinoic drug for severe resistant acne cases that has controversially been associated with multiple psychiatric adverse effects. Research has primarily focused on depression and suicidality; however, a few case studies reported hypersomnia and sleep changes after isotretinoin initiation. To assess sleep quality and measure rates of hypersomnia, depression, and anxiety in patients undergoing isotretinoin therapy. This cross-sectional study was conducted at outpatient clinics of the university hospital. The rate of self-reported oversleeping was measured. In addition, researchers used the Pittsburgh Sleep Quality Index to assess sleep quality and conducted semistructured clinical interviews to detect depression and anxiety. Of 123 patients with acne on isotretinoin, 77 (62.6%) reported oversleeping. Nearly half (60 patients, 48.8%) were categorized as poor sleepers according to the Pittsburgh Sleep Quality Index. The interviews revealed anxiety and depression percentages among 9.8% and 4.9% of participants, respectively. Hypersomnia was noticeably high in this study sample; thus, it may cautiously suggest a possible link between isotretinoin and hypersomnia. However, more research is needed to investigate this potential relationship.

Berberine Contents as a Quality Marker in Medicinal Plants and Amounts of Berberine Passing into Serum

Background: Berberine is an alkaloid found in some medicinal plants. Berberine-containing plants have traditionally been used in the treatment of diseases since ancient times. Berberine is a natural compound that has an important place in traditional Chinese medicine. Currently, berberine is being evaluated extensively in clinical trials and is one of the natural products on which most scientific research studies have been published. Numerous clinical and pharmacological research results have been published on the therapeutic effect of berberine against cancer, diabetes, and heart disease Objective: The first purpose of this review is to display the berberine content of plants found in different regions of the world, and the second purpose is to provide the amount of berberine passing into the serum. Methods: Herbal supplements and extracts prepared from plants containing berberine are commercially marketed. The content of berberine in plants varies widely, and berberine is a quality indicator for many medicinal plants. Results: Different analytical methods have been developed for reliable berberine analysis. Plant and serum berberine levels reported between the years 2013 and 2022 in journals covered by SCI are collected in this review article. Conclusion: We hope that this overview of berberine amounts will be useful in future pharmaceutical and pharmacokinetic studies.

Assessment of Water Quality Index Study of River Chambal at Gandhisagar, Mandshour Madhya Pradesh, India

Abstract: Water is one of the earth most important resources that use for Human life and it, s quality is totally depend on geological environment. Chambal is an important river in Mandshour M.P. Hence made to WQI and Pollution or change in the quality of water. The Quality Index (WQI) Is an important tool to determine the drinking water quality in rural, urban, agriculture and industrial area. WQI follows four step parameter selection, sub-indices, establishing weight, and final index aggregation. Assessment of WQI of River Chambal includes physic-chemical parameter viz. Biological Oxygen Demand, Dissolved Oxygen, PH , Total Hardness, Total alkaline ions and solids thate indicate the extent of pollution.

Examining the knowledge level of nurses regarding aseptic non touch technique in nurses: a cross-sectional study

BackgroundHealthcare-associated infections (HAIs) are important indicators of healthcare quality. The aseptic non touch technique (ANTT), a standardised aseptic technique, is a crucial preventative measure against HAIs. However, there is insufficient evidence currently available regarding ANTT awareness and proficiency among nurses. This study aimed to investigate the status of ANTT proficiency in a cohort of nurses and analyse the associated risk factors, with the ultimate goal of providing a reference for promoting the application of ANTT in clinical practice.MethodsThe study population was sampled from nurses working in a tertiary hospital in Zhejiang Province, China, in January 2024. A cross-sectional survey was conducted using a self-designed questionnaire to assess ANTT knowledge. Multivariate linear regression analysis was used to analyse the risk factors influencing ANTT knowledge in nurses.ResultsA total of 458 nurses were included in this study. The cohort had an overall score of 49.7% correct responses on the ANTT knowledge questionnaire, with a mean score of 12.4 ± 2.4 out of 25, and 30.1% of the nurses felt that they did not need training related to ANTT. Multivariate linear regression analysis indicated that professional title, educational level, and the need for ANTT training were independently associated with ANTT knowledge in nurses. Nurses with Master’s degrees and associated chief nurses were observed to have higher levels of ANTT knowledge compared to the rest.ConclusionsANTT knowledge is insufficient among nurses in China, and its importance is not widely recognised. Continuous efforts are required to strengthen this knowledge. Constructing sustained, multiform, and stratified training programmes may represent an effective method to strengthen ANTT knowledge among nurses and promote its clinical use.

Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis.

Despite the historical neurological use of Withania somnifera, limited evidence supports its efficacy for conditions like anxiety and insomnia. Given its known anti-stress properties, this review evaluated its safety and efficacy for anxiety and insomnia. We searched Medline, Cochrane Library, and Google Scholar until August 2023 for randomized controlled trials (RCTs) comparing W. somnifera to placebo in patients with anxiety and/or insomnia. Outcome measures included changes in anxiety levels via the Hamilton Anxiety Scale (HAM-A), Sleep Onset Latency (SOL), Total Sleep Time (TST), Wake After Sleep Onset (WASO), Total Time in Bed (TIB), Sleep Efficiency (SE), and Pittsburgh Sleep Quality Index (PSQI) score. We utilized a random-effect model for pooling Mean Differences (MD) with a 95% Confidence Interval (CI). Heterogeneity was assessed through sensitivity and subgroup analysis, and the quality of RCTs was evaluated using the Cochrane revised risk of bias tool. Pooled results from five RCTs (n=254) demonstrated that W. somnifera significantly reduced HAM-A scores (MD=-5.96; [95% CI -10.34, -1.59]; P=0.008; I2=98%), as well as sleep parameters such as SOL, TST, PSQI, and SE, but not WASO and TIB. While W. somnifera extracts yielded promising results, further research with larger sample sizes is needed to confirm its effects on anxiety and insomnia.

Формирование свойств биодеградируемых пленок на основе рыбного желатина

Nowadays in the food and nutrition industry special attention is paid to the creation of non-toxic, easily recy-clable packaging materials of a new assortment, capable of providing reliable protection of products from harmful factors. The object of the study was biodegradable film compositions based on fish gelatin and agar, with the addition of plasticizing agent - glycerol. Experimental and analytical studies were carried out using standard and original methods. Modeling of the process of thermal treatment of film compositions was carried out, the experimental dependence of moisture absorption of films on temperature (range 120-160 °C) and duration of the thermal modification process (10-30 minutes) was established. The possibility of thermal modification of biodegradable film compositions was determined. The rational mode of thermal treatment of films is the temperature interval of 140 °C for 20 minutes, which allows to keep the moisture absorption index at the maximum level (842%), exceeding the initial index by 8.4 times, during 120 hours. The established parameters of thermal structuring allow to keep organoleptic quality indicators of films at a high level and to obtain a homogeneous, porous and elastic film. Thermally modified films at temperatures of 140 and 160 °C are characterized by increased dissolution time up to 40 and 70 minutes respectively at dissolution temperature of 60 °C and up to 15 and 30 minutes respectively at dissolution temperature of 75 °C. It is shown that thermal modification of biodegradable films will contribute to compliance with safety requirements, environmental friendliness, absence of toxicity. Thermal modification allows to increase functional and technological properties of composite biodegradable films, which can be used to create a wide range of modern packaging barrier materials.

A new approach for discriminating spatially acquired SERS spectra using antiretroviral drug emtricitabine as a test sample

AbstractIn this study, an antiretroviral drug emtricitabine (also known as FTC or Emtriva) was detected and quantified down to 40 ng/ml by using surface‐enhanced Raman spectroscopy (SERS). Its aqueous standards were tested with two types of silver nanoparticles (colloidal and dendritic) using a specially developed aluminum well plate. The SERS spectra were acquired using a Raman scanning device with 30‐μm spatial resolution. The spectral data were analyzed using a new approach for the discrimination of the spatially acquired spectra based on the Quality index (Qi). After the Qi is calculated, the spectral data are sorted based on the Qi. This is followed by selecting only the spectra with a high Qi index and comparing the average of all the spatially acquired spectra. This results in an improvement in the spectral signal‐to‐noise and higher analytical sensitivity of the built calibration curves.

Resilience of socio-ecological and energy systems: Intelligent information technologies for risk assessment of natural and technogenic threats

A method for studying the resilience of energy and socio-ecological systems is considered; it integrates approaches developed at the International Institute of Applied Systems Analysis and the Melentyev Institute of Energy Systems (MESI) of the Siberian Branch of the Russian Academy of Sciences. The article discusses in detail the methods of using intelligent information technologies, in particular semantic technologies and knowledge engineering (cognitive probabilistic modeling), which the authors propose to use in assessing the risks of natural and man-made threats to the resilience of the energy sector and social and ecological systems. More attention is paid to the study and adaptation of the integral indicator of quality of life, which makes it possible to combine these interdisciplinary studies.

Efficacy of Omega-3 in Improving Sleep Quality of Healthcare Workers with Shiftwork Sleep Disorder: Phase III, Double-blind, Placebo-controlled Trial Study Protocol (SLEEP-O3 Trial)

Introduction: Healthcare workers are especially vulnerable to sleep disturbances, including shift work sleep disorder (SWSD). Even though omega-3 supplementation has been studied to enhance sleep quality in different populations, there is lack of evidence to support its effectiveness in SWSD. This trial aims to evaluate this compound potential benefits towards health care personnel suffering from SWSD. Methods: This study protocol consists of a phase III, single-center, double-blind, placebo-controlled randomized clinical trial. Participants will receive sleep hygiene orientation in addition to either omega-3 dietary supplementation or placebo for 8 weeks. The primary outcome will be sleep quality as measured by the Pittsburgh Sleep Quality Index and one of the secondary outcomes would be actigraphy as a reliable sleep assessment. The sample size will be 136 subjects. Discussion: The importance of improving sleep quality of health care workers relies on its impact on their wellness, and on patient safety. Sleep deprivation and disorders are responsible for multiple workplace errors and worse health outcomes alike. This trial can help determine if omega-3 supplementation can contribute to ameliorate sleep disturbances in health care professionals.

Improvement of Air Quality During Lockdown Period of COVID-19 Pandemic in Kathmandu Valley, Nepal

The Kathmandu Valley is currently Nepal's most hazardous region for human health and environmental sustainability because of increased air pollution and high particulate matter levels. According to multiple studies and observations, Nepal's urban districts saw an improvement in air quality during the COVID-19 lockdown. The Air Quality Index (AQI) is a standard method of informing the public about air pollution levels. The AQI is based on the quantitative value of pollutants' constituent parts, such as particulate matter (PM). Thus, the focus of this study was on how the AQI values change in the Ratna Park suburb of the Kathmandu district in the Kathmandu Valley and how those fluctuations are related to lockdown and non-lockdown times during the COVID-19 pandemic and comparing them to identify crucial information’s. This study shows that during the lockdown, the air quality in the Kathmandu Valley dramatically improved, with average AQI values for PM2.5 and PM10 rising to 21.34 and 64.42 from 50.74 and 106.51, respectively. Furthermore, we investigate the positive correlation between relative humidity, a meteorological component, and air quality.

Does sunlight exposure predict next-night sleep? A daily diary study among U.S. adults.

Poor sleep is becoming increasingly prevalent and is associated with adverse health outcomes. Sunlight exposure may improve sleep by regulating circadian rhythms, increasing vitamin D, and influencing melatonin production. However, research on the sunlight-sleep association is limited, especially outside of cross-sectional designs. This study examined associations between daily self-reported sunlight exposure and next-night sleep quality in 103 adults for up to 70 days. The timing of sunlight exposure predicted next-night sleep quality. Specifically, morning sunlight exposure, relative to no sunlight, predicted better sleep quality based on responses to the brief Pittsburg Sleep Quality Index. Duration of sunlight exposure was generally not associated with sleep quality. Morning sunlight may regulate circadian rhythms, subsequently improving sleep. Findings have potential implications for sleep interventions and daylight savings time policies. Future research should test whether morning sunlight exposure can enhance the effectiveness of sleep interventions.

Deucravacitinib Improves Patient-Reported Outcomes in Patients with Moderate to Severe Psoriasis: Results from the Phase 3 Randomized POETYK PSO-1 and PSO-2 Trials.

Deucravacitinib, a novel, oral, selective allosteric tyrosine kinase 2 inhibitor, demonstrated superiority versus placebo and apremilast in the POETYK PSO-1 and PSO-2 studies. We describe patient-reported outcomes with deucravacitinib treatment versus placebo and apremilast in these studies. Two multicenter, global, double-blind, placebo- and active comparator-controlled studies randomized patients with moderate-to-severe plaque psoriasis 1:2:1 to placebo, deucravacitinib 6mg once daily, or apremilast 30mg twice daily. Score changes from baseline and meaningful within-patient change responses for Psoriasis Symptoms and Signs Diary (PSSD) and Dermatology Life Quality Index (DLQI) were assessed. In POETYK PSO-1 (n = 666) and PSO-2 (n = 1020), respectively, improvement from baseline in PSSD total score was greater with deucravacitinib (- 27.8 and - 30.1) versus placebo (- 4.4 and - 5.9) and apremilast (- 18.9 and - 22.5) at Week 16 and versus apremilast at Week 24 (deucravacitinib: - 32.8 and - 30.7; apremilast: - 21.6 and - 22.8) (nominal p < 0.0001). Improvement from baseline in DLQI score was also greater with deucravacitinib (- 8.5 and - 7.6) versus placebo (- 3.3 and - 3.0) and apremilast (- 5.9 and - 5.8) at Week 16 and versus apremilast at Week 24 (deucravacitinib: - 8.6 and - 7.5; apremilast: - 5.6 and - 5.5) (nominal p < 0.0001). Achievement of meaningful within-patient change in PSSD total score and in DLQI score occurred more frequently with deucravacitinib than placebo and apremilast at Week 16 and versus apremilast at Week 24. Deucravacitinib demonstrated meaningful improvements in patient-reported outcomes in patients with moderate-to-severe plaque psoriasis compared with apremilast and placebo. NCT03624127, NCT03611751.

Optimization of Product Quality Indicators in the “Producer–Consumer” System Based on Fuzzy Cognitive Maps and Genetic Algorithm

Optimization of Product Quality Indicators in the “Producer–Consumer” System Based on Fuzzy Cognitive Maps and Genetic Algorithm