Number Of Diagnostic Tests Research Articles

Islamic Finance and Economic Performance: A Panel Analysis in Selected Countries

Financial crises, and stock markets over the years have amply shown how investors’ sentiment affect asset prices and the effectiveness of stock markets. Such a crisis brought down financial institutions sent stock markets tumbling, and left consumers scrambling due to subprime mortgages. With this, Islamic finance adoption has driven demand for Islamic financial products being free from interest. Hence, this study aimed to determine how Islamic finance can influence the economy of 19 selected countries adopting Islamic finance. These countries have marginal to significant scores in Islamic Finance across the years. This study utilized panel data from 2013 to 2021, which was gathered from the Global Islamic Finance Report, Global Innovation Report, and World Bank. A number of diagnostic tests and analyses were performed in order to reach a result that addressed the objectives and problem statement. The Panel Corrected Standard Errors analysis was used as the final model to treat heteroscedasticity, cross-sectional dependence, and autocorrelation. Based on the regression results, Islamic finance has a positive and statistically significant effect on the economy. The regression results indicate a positive and statistically significant impact of Islamic finance on the economies of the studied countries. This finding underscores the potential of Islamic finance to stimulate economic growth, enhance financial stability, and foster inclusivity in financial markets. Consequently, the findings highlight the pivotal role of macroeconomic variables and the adoption of Islamic finance principles in shaping economic outcomes.

The skåne emergency medicine (SEM) cohort

BackgroundIn the European Union alone, more than 100 million people present to the emergency department (ED) each year, and this has increased steadily year-on-year by 2–3%. Better patient management decisions have the potential to reduce ED crowding, the number of diagnostic tests, the use of inpatient beds, and healthcare costs.MethodsWe have established the Skåne Emergency Medicine (SEM) cohort for developing clinical decision support systems (CDSS) based on artificial intelligence or machine learning as well as traditional statistical methods. The SEM cohort consists of 325 539 unselected unique patients with 630 275 visits from January 1st, 2017 to December 31st, 2018 at eight EDs in the region Skåne in southern Sweden. Data on sociodemographics, previous diseases and current medication are available for each ED patient visit, as well as their chief complaint, test results, disposition and the outcome in the form of subsequent diagnoses, treatments, healthcare costs and mortality within a follow-up period of at least 30 days, and up to 3 years.DiscussionThe SEM cohort provides a platform for CDSS research, and we welcome collaboration. In addition, SEM’s large amount of real-world patient data with almost complete short-term follow-up will allow research in epidemiology, patient management, diagnostics, prognostics, ED crowding, resource allocation, and social medicine.

EFFICACY AND PHARMACOECONOMICS STUDY OF SPINAL CORD STIMULATION (SCS) CONDUCTED AT THE PAIN THERAPY HUB, SAN GIULIANO HOSPITAL ASL NAPOLI 2

EFFICACY AND PHARMACOECONOMICS STUDY OF SPINAL CORD STIMULATION (SCS) CONDUCTED AT THE PAIN THERAPY HUB, SAN GIULIANO HOSPITAL ASL NAPOLI 2

Diagnosis of Irritable Bowel Syndrome: Primary Care Physicians Compared with Gastroenterologists.

Objective: To examine disparities between primary care provider (PCP) and gastroenterologist diagnosis and management of irritable bowel syndrome (IBS).Design: Retrospective cross-sectional study.Setting: A 547-bed quaternary-care hospital within the Loyola University Healthcare System.Participants: 1000 patients aged 18-65 with an ICD-10 diagnosis of IBSMethods: We randomly selected 1000 patients aged 18 to 65 years within the Loyola University Healthcare System's electronic medical record with an ICD-10 diagnosis of IBS. Physician notes and diagnostic results were reviewed for documentation of symptoms fulfilling Rome IV criteria and resolution of symptoms. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of primary diagnoses assigned by PCPs and gastroenterologists were assessed along with number of diagnostic tests ordered.Results: The mean age (SD) was 45 (12) years, and 76.9% were female. Sensitivity of an IBS diagnosis by a PCP was 77.6% (95% CI 73.3-81.9), compared with 60.1% (95% CI 54.7-65.6) for a gastroenterologist. Specificity of an IBS diagnosis by a PCP was 27.5% (95% CI 23.5-31.5), compared with 71.1% (95% CI 64.6-77.5) for a gastroenterologist diagnosis of IBS. A gastroenterologist diagnosis of IBS carried a high PPV (77.3%, 95% CI 72.0-82.6) compared with 44.6% (95% CI 40.7-48.5) for a PCP. Of 180 patients with outcome data, 69.4% had resolution of symptoms at follow-up.Conclusion: The sensitivity of gastroenterologist diagnosis of IBS closely matches the sensitivity of Rome IV criteria in validation studies. The high specificity and PPV of gastroenterologists suggest more cautious diagnosis by gastroenterologists, with PCPs more likely to assign a diagnosis of IBS incorrectly or without sufficient documentation of symptoms fulfilling Rome IV criteria. Reported resolution rates suggest primary care management of IBS is appropriate, but PCPs may benefit from gastroenterologist consultation and diagnostic guidelines for greater specificity in diagnosing IBS.

Changes in incidence and mortality trend due to COVID-19 in southern Iran, from 2020 to 2021: based on Cochran-Armitage trend test.

In 2020, COVID-19 spread rapidly in Iran and other parts of the world. Some of the epidemiological aspects of this disease remain unknown; therefore, the present study was designed with the aim of determining the trend of incidence and mortality of COVID-19 from February 2020 to July 2021 in southern Iran. The present study was a cross-sectional analytical study that included all people who had COVID-19 in the period from February 2020 to July 2021 and whose information had been registered in the Infectious Diseases Center of Larestan city and MCMC unit. The study area included the cities of Larestan, Evaz, and Khonj, located in the south of Fars province in southern Iran. Since the emergence of COVID-19 until July 2021, a total of 23,246 new cases of infection were reported in the southern region of Fars province. The average age of patients was 39.90±18.30 years and the range of ages varied from 1 to 103 years. The results of the Cochran-Armitage trend test showed that the trend of the disease in 2020 was completely upward. The first positive case of COVID-19 was recorded on February 27, 2020. The incidence curve in 2021 is sinusoidal, but in general, the results of the Cochran-Armitage trend test showed that the incidence of the disease increased significantly (P-trend < 0.001). Most cases were reported in July, April, and the end of March. In general, the incidence rate of COVID-19 has varied sinusoidally from 2020 to mid-2021. Although the incidence of the disease increased, the number of deaths has fallen. It seems that the increase in the number of diagnostic tests and the implementation of the national COVID-19 immunization program have been effective in changing the trend of the disease.

Effect of Point-of-Care Testing for Respiratory Pathogens on Antibiotic Use in Children

Limited data are available on the clinical impact of multiplex polymerase chain reaction (PCR) point-of-care testing for respiratory pathogens in acutely ill children. To evaluate the effect of multiplex PCR point-of-care testing for respiratory pathogens on antibiotic use in acutely ill children. This unblinded, randomized clinical trial was conducted from May 6, 2019, through March 12, 2020. The participants were followed up until hospitalization or discharge from the emergency department (ED) for primary outcome. The study was conducted at the pediatric ED of Oulu University Hospital, Finland. Eligible study participants were children aged 0 to 17 years with fever and/or any respiratory signs or symptoms. Children with underlying medical conditions were included. The statistical analyses were performed between August 11, 2020, and September 14, 2021. The participants were randomly assigned in a 2:1 ratio either to undergo multiplex PCR point-of-care testing (18 respiratory viruses and 3 bacteria with results ready within 70 minutes) upon arrival at the ED or to receive routine care. The primary outcome was the proportion of children receiving antibiotic therapy. The secondary outcomes were the numbers of diagnostic tests and radiographic imaging procedures performed and costs. A total of 1417 children were assessed for eligibility. After exclusions, 1243 children (692 boys [56%]) were randomly allocated to either the intervention (829 children) or control (414 children) group. The mean (SD) age of the participants was 3.0 (3.6) years in the intervention group (median [IQR], 1.7 [0.4-4.1] years) and 3.0 (3.5) years (median [IQR], 1.9 [0.4-4.1] years) in the control group. Multiplex PCR point-of-care testing for respiratory pathogens did not reduce the overall prescribing of antibiotics in the emergency department (226 children [27.3%] in the intervention group vs 118 children [28.5%] in the control group; risk ratio, 0.96; 95% CI, 0.79-1.16). Targeted antibiotic therapy was started in 12 children (1.4%) tested with point-of-care multiplex PCR and 2 children (0.5%) in the control group (risk ratio, 3.0; 95% CI, 0.76-11.9). The numbers of diagnostic tests did not differ between the groups, nor did the costs. In this randomized clinical trial, point-of-care testing for respiratory pathogens did not reduce the use of antibiotics at the pediatric ED. Testing for respiratory pathogens appears to have a limited impact on clinical decision-making for acutely ill children. ClinicalTrials.gov Identifier: NCT03932942.

Effect of Nitya virechana before intrauterine insemination

In modern medical science, diagnosis and treatment are based on a direct vision which is made by a number of diagnostic tests. When infertility evaluation failed to detect any cause of infertility, it is called “Unexplained Infertility.” Intra-uterine insemination (IUI) is a basic treatment option in such unexplained cases. In Ayurvedic classics, Ritu (~menstruation), Kshetra (~uterus), Ambu (~nutrition), and Beeja (~ovum and/or sperm) are described as essential factors for conception. Adequate physiological functioning of these factors is also necessary with the absence of causative factors to achieve conception. Along with that normal psychology is also described as an important aspect for conception. A 35-year-old female presented to Stree Roga Evum Prasuti Tantra OPD, on December 2019 with chief complaints of long-standing unexplained infertility. The patient was advised IUI along with Ayurvedic management. Vata is a principle Dosha in Vandhyatva (~infertility) and Mridu sanshodhana (~mild purification) described as a line of treatment to treat vitiated Vata dosha. Virechana is also maintained for “Agarbha” Stree (~infertile woman). Hence, the patient was treated with Nitya virechana (~daily therapeutic purgation) by Eranda sneha (~castor oil). Eranda sneha maintains Agni (~digestive power) and normalizes Vata dosha by Vata anulomana karma (~carminatives). It also affects the psychological status of the patient by Medhya (~intellect power) and Smritikara (~improving memory) properties. This concept was followed in this case to manage infertility. After the second cycle of IUI, urine pregnancy was achieved in April 2020, and delivered a healthy male baby in November 2020.

Possibilities of ultrasound in the diagnosis and differential diagnosis of amyotrophic lateral sclerosis: a literature review

Amyotrophic lateral sclerosis is a neurodegenerative disease with a steady and rapid progression, manifested, in addition to the loss of strength of the muscles of the limbs and trunk, the development of fatal bulbar and respiratory disorders. Due to the need for early detection of this pathology, a large number of diagnostic tests have been proposed, which make it possible to suspect a motor neuron disease in a patient with a high probability. However, due to the polymorphic clinical picture of the disease, currently there are diagnostic situations in which existing methods do not allow to establish a reliable diagnosis or it becomes possible only at the later stages of the disease. This review examines the modern possibilities of ultrasound examination of peripheral nerves and muscles in the diagnosis and differential diagnosis of amyotrophic lateral sclerosis.

Critical Analysis of the Possible Determining Factors of COVID-19 Epidemiological Trend in Bangladesh: A Review

Since its first report on March 08, 2020, COVID-19 positive cases and number of deaths have increased which reached the peak in late June and started to decline slowly in late August in Bangladesh. COVID-19 transmission and disease progression depends on multifaceted determinants e.g. virus genetics, host immunity, social distancing, co-morbidity, socio-demographic and environmental parameters. Therefore observed epidemiological trend may not follow predicted models and thus warrant detail investigation of the contributing factors. In this perspective, in the light of literature we hypothesize that preventive intervention strategies, socioeconomic limitations, climatic and meteorological indexes, acquired immunity of Bangladeshi population, demographic characteristics, health indicators and food habits contributed toward the observed COVID-19 trend. The key limiting factor was number of diagnostic tests in getting real epidemic scenario. Strong immunity of young people compared to the elderly and low prevalence of non-communicable diseases might have kept most of them asymptomatic, less severe with silent recovery. Climatic parameters, less population density in rural areas and certain food habits perhaps helped to restrict and combat the infection up to a level. Genetic polymorphism can also be driving factor in disease progression. Despite several helpful determinants in Bangladesh, person to person contact is still the leading risk factor for COVID-19 transmission. Infection may increase rapidly if safe distance and preventive measures are not strictly followed especially in the coming winter. Expansion of test capacity, intelligent work and vacation planning and public awareness should continue to reduce the infection rate and disease catastrophe. Bangladesh Journal of Infectious Diseases June 2021;8(1): 36-41

EFFECT OF THE INTRODUCTION OF EMERGENCY MEDICINE SPECIALISTS ON THE EMERGENCY DEPARTMENT PERFORMANCE INDICATORS: A RETROSPECTIVE DATA ANALYSIS.

SUMMARYPatient management in the emergency department (ED) is evaluated by performance indicators, such as wait times (time to be seen by a physician), length of stay (LOS) and the number of diagnostic tests per patient. To improve the quality of care, dedicated emergency medicine (EM) specialists are employed to work in the ED. The aim of this study is to evaluate three performance indicators of patient management in the ED compared by specialty, internal medicine (IM) versus EM. Research was conducted in the ED of a large tertiary teaching hospital. A retrospective data analysis of the hospital information system was conducted for the period when only IM specialists were working as attendants, versus a period when two EM specialists joined the ED team. We calculated the percentage of patients seen within the recommended time per Australasian Triage system (AST) category and compared the average LOS and the average number of tests per patient, using data from June 2017 to January 2020. Means, standard deviation, standard error, 95% confidence interval were calculated, and the independent t-test was used to compare means. With the introduction of the EM specialists, the percentage of patients examined within the recommended time frame per AST category was higher. There was a significant reduction in LOS in the ED when comparing only IM specialists to IM specialists with two EM specialists (p<0.001). The IM physicians on average do more tests than EM specialists, which was statistically significant (p<0.05). There was a significant improvement in efficiency in the ED with the introduction of EM specialists which was manifested by shorter patient wait times and shorter length of stay in the Emergency Department and fewer diagnostic test orders.

DETECTION OF VIRAL AND BACTERIAL INFECTIONS IN ORDER TO OBTAIN HIGH QUALITY INITIAL POTATO SEED MATERIAL

The article presents the research results on the selection of clones free from phytoinfection in original potato seed production. It is necessary to use a number of diagnostic tests that complement each other and allow the detection of a wide range of viral infections such as PVX, PVY, PVS, PVM, PLRV, PVA, TRV, PMTV, AMV, PSTV and bacterioses: Ralstonia solanacearum, Pectobacterium carotovorum subsp. Atrosepticum, Clavibacter michiganensis. Moreover, studies have shown the necessity&#x0D; for TRV detection testing when selecting the initial ancestral material for introduction into the in vitro culture.

Piecewise Modeling the Accumulated Daily Growth of COVID-19 Deaths: The Case of the State of São Paulo, Brazil

The pandemic scenery caused by the new coronavirus, called SARS-CoV-2, increased interest in statistical models capable of projecting the evolution of the number of cases (and associated deaths) due to COVID-19 in countries, states and/or cities. This interest is mainly due to the fact that the projections may help the government agencies in making decisions in relation to procedures of prevention of the disease. Since the growth of the number of cases (and deaths) of COVID-19, in general, has presented a heterogeneous evolution over time, it is important that the modeling procedure is capable of identifying periods with different growth rates and proposing an adequate model for each period. Here, we present a modeling procedure based on the fit of a piecewise growth model for the cumulative number of deaths. We opt to focus on the modeling of the cumulative number of deaths because, other than for the number of cases, these values do not depend on the number of diagnostic tests performed. In the proposed approach, the model is updated in the course of the pandemic, and whenever a “new” period of the pandemic is identified, it creates a new sub-dataset composed of the cumulative number of deaths registered from the change point and a new growth model is chosen for that period. Three growth models were fitted for each period: exponential, logistic and Gompertz models. The best model for the cumulative number of deaths recorded is the one with the smallest mean square error and the smallest Akaike information criterion (AIC) and Bayesian information criterion (BIC) values. This approach is illustrated in a case study, in which we model the number of deaths due to COVID-19 recorded in the State of São Paulo, Brazil. The results have shown that the fit of a piecewise model is very effective for explaining the different periods of the pandemic evolution.

Obstetric Anal Sphincter Injury Detection Using Impedance Spectroscopy with the ONIRY Probe

Anal sphincter injuries occurring during natural deliveries are often a reason for severe complications, including fecal incontinence. Currently, approximately 80% of these injuries remain unrecognized. Therefore, it is crucial to focus on finding a way to diagnose such injuries as early as possible to apply the tailored treatment. This study aimed to assess the accuracy of impedance spectroscopy in the diagnostics of obstetric anal sphincter injuries (OASIs) using a specially designed rectal probe called the ONIRY Probe. The protocol of the clinical trials is described at NCT03769792. Twenty women after natural delivery were enrolled in the study and divided into two groups referring to the stage of a perineal tear (Group A: 1- or 2-degrees, and Group B: 3- or 4-degrees of a perineal tear; without or with sphincter injury, respectively). The study design included three visits during which a number of diagnostic tests were performed, including impedance spectroscopy, and 3-dimensional endoanal ultrasound, anorectal manometry, and physical examination as a reference. Statistical analysis comprised raw data analysis, as well as post-processing with the Synthetic Minority Oversampling Technique (SMOTE) method, as the output reference grade was highly imbalanced. A variety of machine learning techniques were applied for the OASI classification (≤2 vs. &gt;2), and Wexner scale (=0 vs. &gt;0). The best efficacies were obtained using Random Forest and k-Nearest Neighbors methods. Best accuracies were 93.3% and 99.6%, for raw and re-analyzed data, respectively, for ultrasound assessed by the OASI classification; and 79.8% and 97.0%, respectively, for clinical evaluation using the Wexner scale. Impedance spectroscopy performed using the ONIRY Probe appears to be a promising diagnostic technique for anal sphincter injury detection but requires further investigation (the next phase of the pilot clinical trial is described at NCT04181840).

Bayesian latent class analysis when the reference test is imperfect.

Latent class analysis (LCA) has allowed epidemiologists to overcome the practical constraints faced by traditional diagnostic test evaluation methods, which require both a gold standard diagnostic test and ample numbers of appropriate reference samples. Over the past four decades, LCA methods have expanded to allow epidemiologists to evaluate diagnostic tests and estimate true prevalence using imperfect tests over a variety of complex data structures and scenarios, including during the emergence of novel infectious diseases. The objective of this review is to provide an overview of recent developments in LCA methods, as well as a practical guide to applying Bayesian LCA (BLCA) to the evaluation of diagnostic tests. Before conducting a BLCA, the suitability of BLCA for the pathogen of interest, the availability of appropriate samples, the number of diagnostic tests, and the structure of the data should be carefully considered. While formulating the model, the model's structure and specification of informative priors will affect the likelihood that useful inferences can be drawn. With the growing need for advanced analytical methods to evaluate diagnostic tests for newly emerging diseases, LCA is a promising field of research for both the veterinary and medical disciplines.

Frequent User System Engagement: A Quality Improvement Project to Examine Outcomes of a Partnership to Improve the Health of Emergency Department Frequent Users.

Patterns of frequent emergency department (ED) use correlate with a variety of care needs. Health care systems should address these needs in collaboration with community health partners. Approximately 600 patients frequent a local ED for nonemergent needs. Approximately 15% of those patients are homeless. A program consistent with the Corporation for Supportive Housing's Frequent User System Engagement (FUSE) model was developed and implemented in a community setting. Eleven participants were enrolled in this pilot program. Eligible candidates enrolled in the program received coordinated multidisciplinary care and stable housing. ED visits, primary care provider visits, and number of diagnostic tests and costs changed significantly over time. The FUSE program is equipped to address the needs of the whole person, resulting in a meaningful impact on overall health while decreasing frequency of ED visits.

Cost-effectiveness of adding a non-invasive acoustic rule-out test in the evaluation of patients with suspected stable angina pectoris. Design of the randomized multicenter FILTER-SCAD trial

Abstract Background Patients with suspected stable coronary artery disease (CAD) are selected for further non-invasive or invasive diagnostic tests depending on their pre-test probability (PTP) of obstructive CAD. However, the PTP, based on age, sex, and type of angina, has shown to grossly overestimate the likelihood of obstructive CAD. Consequently, the use of diagnostic tests has increased over the last decades despite a low diagnostic yield (6–7%). The CAD-score is a risk stratification score for obstructive CAD measured using a novel non-invasive acoustic device, and when added to PTP has shown excellent rule-out capabilities. Purpose To investigate if the addition of the CAD-score to a standard diagnostic examination is superior in terms of reducing overall number of diagnostic procedures and non-inferior in terms of safety as compared to a standard PTP-guided strategy when evaluating patients with suspected stable CAD. Methods The FILTER-SCAD trial is a randomized, controlled, multicenter trial expected to include 2000 subjects ≥30 years of age without known CAD referred for outpatient assessment for suspected CAD at 5 hospitals in Denmark and Sweden. First subject was randomized on October 22, 2019. Subjects will be randomized 1:1 to either 1) a control group undergoing standard diagnostic examination (SDE) according to current guidelines, or 2) an intervention group undergoing SDE plus a CAD-score measurement, using permuted block randomization stratified by study site and PTP (very low vs. low-intermediate). Follow-up will be 12 months for a primary endpoint of cumulative number of diagnostic tests and a combined secondary safety endpoint of all-cause death, non-fatal myocardial infarction, unstable angina pectoris, heart failure, and ischemic stroke. Questionnaires assessing symptom severity, quality of life, life style measures, and medical treatment will be collected at baseline, 3 months, and 12 months after randomization. The study is powered to detect superiority in terms of cumulative number of diagnostic tests with a power of 80% and a significance level of 0.05, and non-inferiority on the safety endpoint with a power of 90% and a significance level of 0.05. The study is conducted in compliance to the principles of the Declaration of Helsinki of the World Medical Association. ClinicalTrials.gov ID: NCT04121949. Results One study site is currently enrolling. Preliminary baseline data is available on the first 77 (44% males) enrolled patients (median age 61 years IQR (51–72) and PTP 22% IQR (13–38)) showing successful randomization with even distribution of baseline characteristic between the two groups including sex, age, and PTP. Perspectives The FILTER-SCAD trial will investigate whether it is feasible to reduce resource consumption without compromising safety in the outpatient assessment of patients with suspected CAD using a simple, non-invasive acoustic device. Enrollment and follow-up are expected to be completed spring 2022. Funding Acknowledgement Type of funding source: Other. Main funding source(s): The company Acarix A/S har provided an unrestricted grant for the study. The Foundation “Fonden for Faglig Udvikling i Speciallægepraksis” has provided a grant for the study.

Individual differences in strategy use and performance during fault diagnosis

BackgroundResearch on causal reasoning often uses group-level data analyses that downplay individual differences and simple reasoning problems that are unrepresentative of everyday reasoning. In three empirical studies, we used an individual differences approach to investigate the cognitive processes people used in fault diagnosis, which is a complex diagnostic reasoning task. After first showing how high-level fault diagnosis strategies can be composed of simpler causal inferences, we discussed how two of these strategies—elimination and inference to the best explanation (IBE)—allow normative performance, which minimizes the number of diagnostic tests, whereas backtracking strategies are less efficient. We then investigated whether the use of normative strategies was infrequent and associated with greater fluid intelligence and positive thinking dispositions and whether normative strategies used slow, analytic processing while non-normative strategies used fast, heuristic processing.ResultsAcross three studies and 279 participants, uses of elimination and IBE were infrequent, and most participants used inefficient backtracking strategies. Fluid intelligence positively predicted elimination and IBE use but not backtracking use. Positive thinking dispositions predicted avoidance of backtracking. After classifying participants into groups that consistently used elimination, IBE, and backtracking, we found that participants who used elimination and IBE made fewer, but slower, diagnostic tests compared to backtracking users.ConclusionsParticipants’ fault diagnosis performance showed wide individual differences. Use of normative strategies was predicted by greater fluid intelligence and more open-minded and engaged thinking dispositions. Elimination and IBE users made the slow, efficient responses typical of analytic processing. Backtracking users made the fast, inefficient responses suggestive of heuristic processing.

An optimization model for multi-appointment scheduling in an outpatient cardiology setting

In this paper, we tackle the problem of outpatient scheduling in the cardiology department of a large medical center. The outpatients have to go through a number of diagnostic tests and treatments before they are able to complete the final interventional procedure or surgery. We develop an integer programming (IP) formulation to ensure that the outpatients will go through the necessary procedures on time, that they will have enough time to recover after each step, and that their availability will be taken into account. Our goal is to schedule appointments that are convenient for the outpatients, by minimizing the number of visits that the patients have to make to the hospital and the time they spend waiting in the hospital. We propose formulation improvements and introduce valid inequalities to the IP, which help the running times to decrease significantly. Furthermore, we investigate whether scheduling outpatients in groups can lead to better schedules for the patients. This would require coordination between the different members of the scheduling staff within the cardiology department. The results show improvements in the total objective value over a period of one month, ranging from 0.45% to 2.33% on average, depending on the scenario taken into account.

BCG vaccine protection from severe coronavirus disease 2019 (COVID-19)

A series of epidemiological explorations has suggested a negative association between national bacillus Calmette-Guérin (BCG) vaccination policy and the prevalence and mortality of coronavirus disease 2019 (COVID-19). However, these comparisons are difficult to validate due to broad differences between countries such as socioeconomic status, demographic structure, rural vs. urban settings, time of arrival of the pandemic, number of diagnostic tests and criteria for testing, and national control strategies to limit the spread of COVID-19. We review evidence for a potential biological basis of BCG cross-protection from severe COVID-19, and refine the epidemiological analysis to mitigate effects of potentially confounding factors (e.g., stage of the COVID-19 epidemic, development, rurality, population density, and age structure). A strong correlation between the BCG index, an estimation of the degree of universal BCG vaccination deployment in a country, and COVID-19 mortality in different socially similar European countries was observed (r2 = 0.88; P = 8 × 10-7), indicating that every 10% increase in the BCG index was associated with a 10.4% reduction in COVID-19 mortality. Results fail to confirm the null hypothesis of no association between BCG vaccination and COVID-19 mortality, and suggest that BCG could have a protective effect. Nevertheless, the analyses are restricted to coarse-scale signals and should be considered with caution. BCG vaccination clinical trials are required to corroborate the patterns detected here, and to establish causality between BCG vaccination and protection from severe COVID-19. Public health implications of a plausible BCG cross-protection from severe COVID-19 are discussed.

Methods of labor diagnostics of social and personal competencies of dentists

The article analyzes the most well-known methods of diagnostics of personal competencies of dentists, the mastery of which is necessary both for increasing the efficiency of their work and improving the quality of medical services provided. The process of competence research is implemented through a number of diagnostic tests, combined in seven areas. The paper shows examples of applying some of the methods from the authors « research practice related to various areas of Economics.