Lack Of Compliance Research Articles

Gren “fuelled” by fire: lessons for project management

Learning outcomes The learning outcomes of this study are as follows: 1) illustrate the project management failures that contributed to the fire accident at Grenfell using a fishbone diagram; 2) identify and classify the power and influence of various stakeholders involved in a brownfield project using a relevant framework; and 3) elaborate the need for following effective stakeholder management processes and project leadership, especially in the context of a refurbishment/renovation project. Case overview/synopsis On 14th June 2017, the Grenfell Tower in North Kensington, West London, UK, caught fire. The fire raged for 60 h and around 72 people lost their lives. Many criticized the response of the London Fire Brigade (LFB) and their lack of preparedness to respond to such an emergency. There were calls for Dany Cotton, the Chief of LFB, to resign. However, there had been a major cladding-related refurbishment at Grenfell, and subsequent investigations revealed that the use of combustible materials, a lack of compliance with the fire-safety norms and a blatant disregard for resident safety had contributed to the fire. The tragedy was a cumulative outcome of failure on two counts: effective project management and stakeholder management during the process of refurbishment, especially in the context of a low-cost housing project. Given this situation, this case considers whether Dany Cotton should own up to her responsibility and resign from her position. In the process, the case considers Grenfell refurbishment from the theoretical lens of project management in the construction management scenario to understand the factors that could have led to an “avoidable” tragedy. Complexity academic level Postgraduate students of construction management; final year undergraduate engineering students who have a foundational course on project management; and architects. Supplementary materials Teaching notes are available for educators only. Subject code CSS 2: Built environment.

Endoscopic scoring system utilization for inflammatory bowel disease activity assessment: A multicenter real-world study from Argentina

BackgroundThe frequency and patterns of use of scores for the assessment of endoscopic activity in inflammatory bowel disease patients are not known. AimTo describe the prevalence of adequate use of endoscopic scores in IBD patients who underwent colonoscopy in a real-life setting. Materials and methodsA multicenter observational study comprising six community hospitals in Argentina was undertaken. Patients with a diagnosis of Crohn's disease or ulcerative colitis who underwent colonoscopy for endoscopic activity assessment between 2018 and 2022 were included. Colonoscopy reports of included subjects were manually reviewed to determine the proportion of colonoscopies that included an endoscopic score report. We determined the proportion of colonoscopy reports that included all of the IBD colonoscopy report quality elements proposed by BRIDGe group. Endoscopist's specialty, years of experience as well as expertise in IBD were assessed. ResultsA total of 1556 patients were included for analysis (31.94% patients with Crohn's disease). Mean age was 45.94±15.46. Endoscopic score reporting was found in 58.41% of colonoscopies. Most frequently used scores were Mayo endoscopic score (90.56%) and SES-CD (56.03%) for ulcerative colitis and Crohn's disease, respectively. In addition, 79.11% of endoscopic reports failed to comply with all recommendations on endoscopic reporting for inflammatory bowel disease. ConclusionsA significant proportion of endoscopic reports of inflammatory bowel disease patients do not include the description of an endoscopic score to assess mucosal inflammatory activity in a real-world setting. This is also associated with a lack of compliance in recommended criteria for proper endoscopic reporting.

Circular economy initiatives are no guarantee for increased plastic circularity: A framework for the systematic comparison of initiatives

Plastic plays a prominent role within circular economy, with many stakeholders promoting initiatives to increase plastic circularity during the manufacturing, use and end-of-life phases. Despite well-meant intentions, many initiatives are characterized by a lack of compliance with basic circular economy principles, implementation barriers, and limited effects on the intended long-term plastic circularity. This study provides a systematic evaluation framework for comparison of plastic initiatives, based on 17 criteria addressing key aspects of plastic circularity. A three-level likelihood ranking approach is applied to analyse the impact of 54 initiatives targeting plastic circularity in a European context. It was found that relatively few of these initiatives were readily implementable without considerable investments, e.g. in new waste management and recycling technologies, and changes in plastic production and product design. The results clearly suggest that current suggestions for circular economy initiatives targeting plastic may have limited effect and not lead to the intended impacts without the support of new regulations and change in plastic demand and consumption. The study stresses the importance of synergies and cooperation between stakeholders across the value chain to reach plastic circularity. The framework offers a consistent basis for decision-makers to identify critical barriers and enablers in relation to plastic circularity characteristics, but the approach may also be applied to other topic areas.

Conspiracy beliefs, COVID-19 vaccine uptake and adherence to public health interventions during the pandemic in Europe.

Conspiracy beliefs can be a major hindrance causing a lack of compliance with public health measures, including vaccination. We examined the relationship between individual attitudes, socio-demographic factors, conspiracy beliefs, COVID-19 vaccine hesitancy and preferences about pandemic policies in Europe. We used data from the 10th round of the European Social Survey, conducted in 2021-22 in 17 European countries. Both a conspiracy index and a personal attitude index for each participant were built by using a Latent Class Analysis model. Then, we used a multilevel regression model to investigate the relationship between a personal attitudes index, socio-demographic factors and country of residence, and a conspiracy index. We descriptively analyse the relationship between the conspiracy index and four main items related to COVID-19. We found that a higher probability of believing in conspiracy theories was associated with male gender, middle age, lower levels of education, unemployment, lower levels of trust and satisfaction and right-wing political orientation. The country of residence was a contextual factor, with eastern European countries having higher levels of conspiracy beliefs. Individuals who expressed conspiracy beliefs had lower COVID-19 vaccine uptake, were less satisfied with the way health services coped with the pandemic and less supportive of governmental restrictions. This study provides valuable insights into the factors associated with conspiracy beliefs and their potential impact on public health. The findings highlight the need for effective strategies to address the underlying factors driving conspiracy beliefs, reduce vaccine hesitancy and promote acceptance of public health interventions.

Slope and frontal axis: three-dimensional analysis and correction with patient-specific cutting guides for the proximal tibia

Three-dimensional correction of the bony alignment in the frontal and sagittal plane of the proximal tibia; surgery is performed via an open- or closing-wedge osteotomy to improve ligament stability and reduce joint degeneration. Chronic anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) instability and ligament revision surgeries; subjective knee instability in patients who are ambitious athletes and people who do physical labor; moderate joint degeneration with meniscus and cartilage damage, post-traumatic deformities. Time pressure (immediate meniscus surgery, since planning and production of patient-specific tools is time-consuming), lack of compliance (need for partial weight bearing, crutches), excessive smoking, vascular pathologies. Planning based on computed tomography (CT) data, determination of the axis of rotation with open or closing wedge, or dome osteotomy; production of corresponding patient-specific cutting blocks. Surgery is performed using the known standard approaches for a high tibial osteotomy (HTO). Exact positioning of cutting guides on the exposed bone. Sawing and adjusting the correction using an osteotomy chisel so that the reduction guide can be attached. Fixation of the achieved correction with angle-stable plate fixator. Partial weight bearing based on the extent of the correction for 6weeks, free range of motion if no additional ligamentous reconstruction was performed. Subsequent full weight bearing after X‑ray and, if necessary, CT control. No general results can be presented, since the surgical procedure, the indication, and the patient group are extremely heterogeneous. Accuracy of the cutting blocks used has been presented in other studies and is given as 0.8° ± 1.5° in relation to the frontal axis. However, the intraoperative change in the correction and adaptation to the surgical site that is presented depends on the surgeon and can greatly influence the extent of correction in terms of accuracy in complex corrections.

Patterns of ovarian cancer care in an elderly population in Australia: A prospective cohort study from the National Gynaecology Oncology Registry (NGOR).

5572 Background: Elderly women with ovarian cancer are often undertreated in comparison to best practice. The National Gynae-Oncology Registry (NGOR) is Australia’s first country-wide clinical quality registry (CQR) measuring compliance with optimal care defined by a set of clinical quality indicators (CQIs). Objectives: To assess compliance with a predefined set of CQIs for elderly women with newly diagnosed ovarian cancer aged > 75 compared to non-elderly women aged <75 years of age from the NGOR sites. Methods: All women with newly diagnosed ovarian cancer from May 2017 – July 2022 were eligible for inclusion. Data were collected from medical records and relevant hospital linked databases by expert data managers. Results: A total of 1590 women were eligible for inclusion from 21 hospitals across 5 Australian states. The CQI data were subsequently aggregated and are summarised in the table. The proportion of elderly women receiving first-line chemotherapy with a platinum and taxane doublet was significantly lower compared to non-elderly (60% vs 89%, p < 0.001). The proportion of women with sub-optimally debulked or Stage IV cancer who received first-line chemotherapy with a platinum/taxane doublet and bevacizumab was significantly lower in elderly women compared to non-elderly (10% vs 30%, p < 0.001) . Enrolment in clinical trials or translational research was significantly lower in elderly women compared to non-elderly (13% vs 21%, p=0.002). The remaining CQIs showed no significant differences between the age groups. Conclusions: In this cohort, most measures of best practice were not significantly different between elderly and non-elderly women, with the exception of elderly women receiving less first line doublet chemotherapy, less doublet chemotherapy with bevacizumab in sub-optimally debulked or Stage IV cancer, and less likely to be enrolled in clinical trials or translational research. While these 3 CQIs represent a minority of the overall list of CQIs, such lack of compliance may result in significant differences in quality of life and overall survival for elderly women with ovarian cancer. Subsequent investigation is therefore warranted to confirm and explain these findings. [Table: see text]

Smart Platform for PUC Vendors about PUC Expiration & Reminders

Abstract: Air pollution caused by vehicular emissions is a significant environmental and public health concern, and regulatory measures, such as Pollution Under Control (PUC) certificates, are implemented to monitor and control vehicle emissions. However, the majority of the people fail to renew their PUC certificates because they don’t get any reminders, unlike reminders sent by insurance companies, The PUC vendor have to manually send the PUC expiration reminder message to the client. The PUC vendors often have to keep track of their clients using notebook and pen and manually check the expiration dates of certificates daily, which can be a time-consuming and error-prone process. These inefficiencies can lead to a poor customer experience, increased workload for PUC vendors, resulting in lack of compliance with PUC regulations and potential fines. The proposed platform provides a smart and innovative online platform designed specifically for PUC vendors to streamline their operations and improve compliance with PUC regulations. The platform is built using the MERN (MongoDB, Express.js, React, Node.js) stack, providing a modern and scalable solution for PUC vendors to manage their clients and send PUC expiration reminders via SMS and WhatsApp

0489 Two Years Of Experience Managing OSA Patients Using Remote Patient Monitoring

Abstract Introduction Remote-Patient-Monitoring(RPM) is gaining implementation but to date, nightly-monitoring of OSA other than PAP devices, has not become a standard of care. We have taken the lead on OSA-RPM and developed a platform that imports data from a FDA-approved technology based on Cardiopulmonary-Coupling software linked to a ring oximeter (SleepImage) worn at night. Last year we presented on the practicality and patient adherence of our approach. Here we are presenting our experience over the past two years of using our platform to assist in the management of a wide range of OSA treatment approaches. Methods We developed software to manage the work-flow involved with nightly RPM of sleep. Patients wear a ring oximeter at night designed to provide data to a cloud-based platform for retrieval by our staff using our tracking software platform. Inclusion criteria: OSA with an abnormal baseline AHI. Also included are narcolepsy patients on oxybate, known to enhance OSA. Patient self-reported inputs regarding therapy are captured. Treatment approaches range from PAP (CPAP/BiLevel), Inspire-HGNS, Oral-Appliance-Therapy, Surgical-Interventions (i.e. MMA), orthodontics and combinations of the above. Results Since 1-1-2021, 140pts enrolled, 85 since 1/1/2022, and 87 currently monitored (12/1/2022). Ave 59yrs +/- 13, 64% Males. Discontinuation resulted for reasons ranging from clinical improvement, financial limitations, lack of compliance and other. Numerous treatment modifications have been guided without repeat NPSG/HSAT testing. OSA-RPM has influenced management of PAP, Inspire-HGNS, Oral-Appliance, orthodontics, and surgical therapies, as well as combination of the above. Detailed outcomes to be furnished. In brief, OSA-RPM with our system has provided extensive insight into efficacy of treatment approaches. Additionally, night to night variability can be better appreciated with this RPM technique, implying the limitation of single-night sleep studies. Conclusion Using this approach has allowed direct ongoing assessment of the impact of therapy modifications directed by both the clinician and the patient. There are currently no established protocols or guidelines for the use of this type of OSA-monitoring. It is important that guidelines be implemented to provide an improved level of care and not abused to just increase reimbursements with little added value, as abuse could hinder the growth of this type of care. Support (if any)

Capillary-Driven Water Transport by Contrast Wettability-Based Durable Surfaces.

Controlling water transport and management is crucial for continuous and reliable system operation in harsh weather conditions. Passive strategies based on nonwetting surfaces are desirable, but so far, the implementation of superhydrophobic coatings into real-world applications has been limited by durability issues and, in some cases, lack of compliance with environmental regulations. Inspired by surface patterning observed on living organisms, in this study we have developed durable surfaces based on contrast wettability for capillary-driven water transport and management. The surface fabrication process combines a hydrophobic coating with hard-anodized aluminum patterning, using a scalable femtosecond laser microtexturing technique. The concept targets heavy-duty engineering applications; particularly in aggressive weather conditions where corrosion is prevalent and typically the anodic aluminum oxide-based coating is used to protect the surface from corrosion, the concept has been validated on anodic aluminum oxide coated aluminum alloy substrates. Such substrates with contrast wettable characteristics show long-term durability in both natural and lab-based artificial UV and corrosion tests where superhydrophobic coatings tend to degrade.

Disable access compliance to university infrastructure: built environment students’ perceptions

PurposeHigher education institutions are the citadel of knowledge and are heavily involved in formulating building regulations and building infrastructure designs that must conform to the building regulations. The study aims to identify university infrastructures compliant with disabled access from the perspective of the built environment students in Ghanaian universities.Design/methodology/approachQuestionnaire surveys were administered to 500 built environment students across ten technical universities in Ghana with a total population of 3066; 341 were expected based on the formula used. However, upon several reminders, 176 responded. Data collected were analysed using Statistical Package for the Social Sciences.FindingsThe findings show that all university facilities are not fully compliant with disabled access. Structures found to be least compliant are the laboratories, canteens, hall of residence, toilet facilities, football fields, places of worship and transport stations. The facilities with high compliance are the administration block, library, hospital building, lecture halls, department offices and ATM areas. The leading causes for this non-compliant are lack of enforcement of the building regulations, low level of disabled students’ enrolment, age of the building, lack of knowledge and poor building designs.Practical implicationsCompliance with disabled access makes universities world class and creates safe learning spaces for individuals with disabilities, enforcing the right to education for all individuals, particularly those with disabilities. Lack of compliance with disabled access will hamper the full utilisation of these facilities, thereby affecting quality education delivery to people with disabilities.Originality/valueThe findings are essential to the Ghanaian built environment, the lives of disabled individuals and universities. The results provide knowledge on areas of improvement for complete access to structures and facilities by disabled individuals.

The social contention over a new labour law in post- 2014 Egypt: Understanding regime choices and strategies

ABSTRACT Discussions surrounding a new labor law in Egypt, started after the 2011 uprising. However, this law has not yet been promulgated until today. How can this delay be explained? The present article argues that the delay reflects the difficult position in which the post-2014 regime found itself and the difficult choices it had to make. Building on a systematic reading of Egyptian media from 2014 to 2020, this article reconstructs discussions about different versions of the draft law, identifying dilemmas the post-2014 regime faced: on one hand, it sought to opt for a more nuanced approach to flexibility and deregulation while also limiting the arbitrary power of employers over workers that had led to wildcat strikes under Mubarak. On the other hand, it sought to prevent international companies from stopping imports from Egyptian factories and suppliers due to their lack of compliance with international labor standards. In response, the regime coopted moderate segments of the independent unionist movement and adopted some labor-friendly measures that were rejected by employer representatives. This led to a postponement of a decision regarding the law.

Processes of Discrimination and Humiliation Experienced by Ecuadorian Immigrant Workers in Spain

The workplace is currently one of the main places of discrimination for socially vulnerable groups such as immigrant workers, who are often required to take on highly stigmatized, menial jobs under supervisors who subject them to daily mistreatment and racism. This study adopted a qualitative approach to 42 semi‐structured interviews of Ecuadorian immigrant workers residing in Spain to explore the processes of discrimination these laborers feel in their everyday workplaces. The findings clearly indicate that immigrant workers can be victims of daily discrimination, which is evidenced by the higher degree of scrutiny and lower levels of trust they suffer compared to their Spanish counterparts, and by their supervisors’ lack of compliance with contractual agreements. As these immigrants are obliged to take on less qualified jobs, they suffer from a lack of recognition and a sense of being undervalued. This analysis also gathered evidence of interviewees’ daily humiliations imparted by their supervisors—and even, at times, by work colleagues—in the form of racial slurs, verbal abuse, and unequal treatment, leaving them feeling powerless and helpless. Most of our respondents in fact find themselves in a predicament they do not know how to confront and cannot reject. All of these factors lead to feelings of humiliation and lack of independence.

Analisa Kegagalan Upaya Perdamaian Turki Dengan Partiya Karkeren Kurdistan (PKK) Tahun 2009-2015

The prolonged separatist conflict that the Partiya Karkeren Kurdistan (PKK) had with the Turkish government was caused by the failure of peace efforts between the two sides, hence raising questions about what caused the failure of the peace effort. Therefore, this article aims to analyze the factors behind the failure of peace efforts between Turkey and the PKK that occurred in 2009-2015. Using Charles Kupchan’s stable peace theory. The article argued that the failure of the peace effort was due to Turkey’s and the PKK’s lack of compliance with Kupchan’s stable peace criteria and conditions, as well as the failure of the peace process at the unilateral accommodation stage as both sides did not trust each other’s commitments. Turkey assumed that if it continued the negotiation process, the PKK would increase their demands. Meanwhile, PKK assumed that the Turkish government was not serious about dealing with the Kurdish Question so that the peace effort was deadlocked.

MP76-03 PROCEDURAL COMPLICATIONS ASSOCIATED WITH MIST AND INVASIVE SURGERY COMPARED TO DISEASE PROGRESSION WITH MEDICAL THERAPY

You have accessJournal of UrologyCME1 Apr 2023MP76-03 PROCEDURAL COMPLICATIONS ASSOCIATED WITH MIST AND INVASIVE SURGERY COMPARED TO DISEASE PROGRESSION WITH MEDICAL THERAPY Steven Kaplan, Ronald Kaufman, Daniel Rukstalis, and Claus Roehrborn Steven KaplanSteven Kaplan More articles by this author , Ronald KaufmanRonald Kaufman More articles by this author , Daniel RukstalisDaniel Rukstalis More articles by this author , and Claus RoehrbornClaus Roehrborn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003350.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To quantify the impact of BPH treatments in the real world, this healthcare utilization analysis attempts to compare complications and procedures subsequent to a surgical intervention vs. daily medication. METHODS: Patient-level data on men with BPH who received medical therapy only, MIST or invasive surgery in an outpatient setting from 2015-2021 were analyzed in a representative sample of US Medicare and commercial claims (IBM Watson). Procedures (post-operative following surgery or occurring after initiation of medical therapy) were identified with CPT codes. Overall event rates through 12 months post-treatment were calculated via cumulative incidence curves. RESULTS: 203,504 medical therapy patients were analyzed with average treatment of 716 days [most common medications: tamsulosin (n=75,698), Tadalafil (n=55,129)]. 5.5% of medication patients underwent procedures within the first year of treatment, the most frequent being cystoscopy (n=9,920), catheterization (n=1,792), and bladder irrigation (n=975). Mean time to onset for any event was 121d. Top diagnoses that drove cystoscopies included LUTS symptoms and urinary retention. For the surgical cohort, 24,035 TURP, 11,911 PVP, 84 Aquablation, 8,649 PUL, and 1,944 Rezum comprised the population. Procedural complication rates continued to be lowest after PUL (17%) with mean onset of 55d, highest for Rezum (28%, mean onset 29d), and comparable among the invasive surgeries: 20%, 21%, 22% for Aquablation (mean onset 18d), TURP (mean onset 35d), and PVP (mean onset 38d), respectively. Top complications for MIST and traditional surgeries were cystoscopies, catheterizations, and bladder irrigations. CONCLUSIONS: Surgical intervention delivers treatment in one setting while medical therapy is affected by lack of compliance and discontinuation. We recognize the difficulties in comparing just one aspect of treatment complications between two treatment paradigms. We reveal∼6% of medical therapy patients undergo procedures through 1 year as disease progresses. Procedure complication rates were similar between TURP and PVP yet lowest for PUL. Although the Aquablation data are relatively immature due to the newness of the technology, the 20% rate reflects a safety profile similar to TURP and higher than PUL. Source of Funding: Teleflex © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1091 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Steven Kaplan More articles by this author Ronald Kaufman More articles by this author Daniel Rukstalis More articles by this author Claus Roehrborn More articles by this author Expand All Advertisement PDF downloadLoading ...

Endocrine disorders in Beta-Thalassemia major patients at a Tertiary Care Hospital.

To determine the frequency of endocrine disorders in Beta-Thalassemia Major (BTM) patients presenting for Endocrine Evaluation to the Department of Diabetes, Endocrinology and Metabolic Diseases, Hayatabad Medical Complex, Peshawar, Pakistan, a tertiary care hospital. This descriptive study was conducted in the Department of Diabetes, Endocrinology and Metabolic Diseases, Hayatabad Medical Complex, Peshawar from October 2019 to August 2021. All patients with BTM presenting for endocrine evaluation were included in the study. Height and weight were assessed and plotted on the standard charts. For secondary sexual characteristics tanner staging was used. Blood samples for hormonal profile were taken according to standard protocol and sent for endocrine assessment. A Total of 135 patients BTM were enrolled in the study comprising of 70 (51.9%) males and 65 (48.1%) females. Their mean age was 14.8±3.9 years, mean height 138.5±13.01 cm, mean weight 35.9±8.4 kg, mean BMI 18.6±2.8 kg/m2, mean age of transfusion started was 6.7±3.99 months, mean duration of transfusion 13.6±4.03 years and mean duration of chelation therapy received 6.1±4.5 years. Regarding endocrine complications, out of 135 patients assessed, one hundred (74.1%) had height less than 5th centile and fifteen (11.1%) had diabetes mellitus. For thyroid and parathyroid function, 58 and 13 were tested respectively, out of which 16 (27.6%) and 6 (46.2%) had thyroid dysfunction and hypoparathyroidism. Out of 91 patients assessed for pubertal delay, 61 (67.03%) had delayed puberty. High percentage of endocrine complications were found in patients with BTM. Severity and multiplicity of endocrine organs involvement was dependent on duration of the disease and lack of compliance with chelation therapy.

Production of novel elastic bacterial nanocellulose/polyvinyl alcohol conduits via mercerization and phase separation for small-caliber vascular grafts application

Size and properties of tubular bacterial nanocellulose (BNC) can be regulated by controllable mercerization with thinner tube walls, better mechanical properties, and improved biocompatibility. Although mercerized BNC (MBNC) conduits have considerable potential as small-caliber vascular grafts (<6 mm), poor suture retention and lack of compliance that cannot match natural blood vessels increase the difficulty of surgery and limit potential clinical application. Polyvinyl alcohol (PVA) is a kind of hydrophilic polymer with good biocompatibility and elasticity, which can precipitate in alkaline solutions. In this study, novel elastic mercerized BNC/PVA conduits (MBP) are manufactured combining mercerization of BNC tubes with precipitation and phase separation of PVA with thinner tube wall, improved suture retention, better elasticity, good hemocompatibility and great cytocompatibility. The MBP obtained with 12.5 % PVA is selected for transplantation in a rat abdominal aorta model. For 32 weeks, normal blood flow is observed using Doppler sonographic inspection, which demonstrates long-term patency. Immunofluorescence staining results also indicate the formation of endothelium and smooth muscle layers. The results indicate the introduction of PVA, and its phase separation into mercerization of tubular BNC can endow MBP conduits with better compliance and suture retention, making it a promising candidate for blood vessel replacement.

Innovative Therapeutic Approaches Based on Nanotechnology for the Treatment and Management of Tuberculosis.

Tuberculosis (TB), derived from bacterium named Mycobacterium tuberculosis, has become one of the worst infectious and contagious illnesses in the world after HIV/AIDS. Long-term therapy, a high pill burden, lack of compliance, and strict management regimens are disadvantageswhich resulted in the extensively drug-resistant (XDR) along with multidrug-resistant (MDR) in the treatment of TB. One of the main thrust areas for the current scenario is the development of innovative intervention tools for early diagnosis and therapeutics towards Mycobacterium tuberculosis (MTB). This review discusses various nanotherapeutic agents that have been developed for MTB diagnostics, anti-TB drugs and vaccine. Undoubtedly, the concept of employing nanoparticles (NPs) has strong potential in this therapy and offers impressive outcomes to conquer the disease. Nanocarriers with different types were designed for drug delivery applications via various administration methods. Controlling and maintaining the drug release might be an example of the benefits of utilizing a drug-loaded NP in TB therapy over conventional drug therapy. Furthermore, the drug-encapsulated NP is able to lessen dosage regimen and can resolve the problems of insufficient compliance. Over the past decade, NPs were developed in both diagnostic and therapeutic methods, while on the other hand, the therapeutic system has increased. These "theranostic" NPs were designed for nuclear imaging, optical imaging, ultrasound, imaging with magnetic resonance and the computed tomography, which includes both single-photon computed tomography and positron emission tomography. More specifically, the current manuscript focuses on the status of therapeutic and diagnostic approaches in the treatment of TB.

Setting Organ Allocation Priorities: A Discrete Choice Experiment with German Patients and Their Relatives.

Organ transplantation systems benefit from guidelines that are harmonious with the preferences of the people involved. Discrete choice experiments are useful tools for eliciting preferences. This study evaluated the preferences of patients and their relatives (n=285) to identify their priorities in organ allocation using a discrete choice experiment. In eight hypothetical allocation decisions, the participants were asked to select the candidate they considered the most suitable The candidates differed in years of life gained after transplantation, quality of life after transplantation, waiting time until transplantation, age, compliance and social support. The most important aspects for setting priority in organ allocation were lack of compliance (β= -2.5, p<0.001) and good quality of life after transplantation (β = +1.4, p<0.001). The lack of social support (ß = -0.8, p<0.05) and the more years of life gained after transplantation (β = +0.5, p<0.001) had less but still a significant amount of influence on this decision, while the waiting list was not considered significantly important (β = 0.1, p>0.05). The comparison of the different relations to transplantation showed that life years gained after transplantation was of high relevance to posttransplant patients (+10 years: β = +0.709, p<0.001 / +15 years: β = +0.700, p<0.001) and of no importance to waitlisted patients (+10 years: β = +0.345, p>0.05 / + 15 years: β = +0.173, p>0.05) and relatives (+ 10 years: β = +0.063, p>0.05 / +15 years: β = +0.304, p>0.05). This study provides useful insights into the unique perspective of patients and their relatives on priority-setting in the allocation of donor organs that should be reflected in improved donor organ allocation rules.

Heterologous Prime-Boost Vaccination with Commercial FMD Vaccines Elicits a Broader Immune Response than Homologous Prime-Boost Vaccination in Pigs.

Three commercial vaccines are administered in domestic livestock farms for routine vaccination to aid for foot-and-mouth disease (FMD) control in Korea. Each vaccine contains distinct combinations of inactivated serotype O and A FMD virus (FMDV) antigens: O/Manisa + O/3039 + A/Iraq formulated in a double oil emulsion (DOE), O/Primorsky + A/Zabaikalsky formulated in a DOE, and O/Campos + A/Cruzeiro + A/2001 formulated in a single oil emulsion. Despite the recommendation for a prime-boost vaccination with the same vaccine in fattening pigs, occasional cross-inoculation is inevitable for many reasons, such as lack of compliance with vaccination guidelines, erroneous application, or change in vaccine types by suppliers. Therefore, there have been concerns that a poor immune response could be induced by cross-inoculation due to a failure to boost the immune response. In the present study, it was demonstrated by virus neutralization and ELISA tests that cross-inoculation of pigs with three commercial FMD vaccines does not hamper the immune response against the primary vaccine strains and enhances broader cross-reactivity against heterologous vaccine antigens whether they were applied or not. Therefore, it could be concluded that the cross-inoculation of FMD vaccines can be used as a regimen to strategically overcome the limitation of the antigenic spectrum induced by the original regimen.

Guiding Principles for the Conduct of Violence Study of Healthcare Workers and System (ViSHWaS): Insights from a Global Survey

Background Globally many studies have reported on violence faced by healthcare workers. However, there is still a lack of homogeneous data to give us a concrete understanding of the present scenario on a global scale. Conducting a global survey required a robust team organization structure, unique dissemination strategies accounting for the regional limitations, and continual networking to maintain and propagate the pool of survey collaborators and responders. This study aims to describe the strategies that helped carry out a global survey- based study, the lessons learned, and recommendations for future studies. Methods This cross-sectional survey-based study was based on methodology of the “Hub and Spoke” model with the core team and sub-groups about different regions and managing country leads. The study was conducted across eight weeks from 6th June 2022 to 8th August 2022. The key steps included team organization, strategy formulation for survey dissemination and data collection, launching the project on social media, and conducting a post-survey amongst the collaborators. The Core Team convened weekly via video conference platforms to discuss the modus operandi, including the responsibilities of team members in communicating with HCWs from each country; strategies for data extraction and analysis. A standard message was created for the survey in English, which was spread via text, audio and video messages; the message was tailored according to the target region and population. The language barrier was managed by creating an audio translation or shifting to “an interviewer-administered” questionnaire. Call for leads and collaborators was organized through social media platforms and incentivized by proposing collaborative authorship. Results A core team of 11 members from 7 countries was assembled, which expanded to 40 country leads from around 110 countries. We also amassed more than 75 regional collaborators who worked to provide feedback and spread the message. The “Violence Study of Healthcare Workers and Systems” (VISHWAS) amassed 5500 responses across the world. A weekly alternating trend in the number of survey responses was observed for eight weeks. Guiding principles garnered through this collaborative project include focusing on 1. Effective team organization, 2. Ensuring external validation of survey tool, 3. Personalized communication, 4. Global networking, 5. Timely communication for maintaining momentum, and 6. Addressing regional limitations. The post-survey analysis showed that WhatsApp messaging was the most common modality used for survey dissemination, followed by in-person meetings and text messaging. The successful techniques were noted to be 1. Direct communication with respondents, 2. Regular progress updates, 3. Responsiveness for regional and country lead’s needs 4. Timely troubleshooting. The most common barriers for the respondents were limitations in language proficiency, technical fallouts, lack of compliance with, and difficulty understanding the questionnaire. Conclusion In this global survey-based study of more than 5500 responses from over 110 countries, valuable lessons in team management, survey dissemination, and addressing barriers to collaborative research. We thereby recommend incorporating the guiding principles from this study to design future surveys on a global scale.