Performance Goals Research Articles

Comparing upfront catheter-based thrombectomy with alternative treatment strategies for clot-in-transit.

Clot-in-transit (CIT) is associated with high mortality, and optimal treatment strategies remain uncertain. This study compares the efficacy of catheter-based thrombectomy (CBT) with other treatments for CIT, including anticoagulation, systemic thrombolytic (ST) therapy, and surgical thrombectomy. We conducted a retrospective analysis of patients with CIT documented on echocardiography between January 2020 and May 2024, managed with urgent upfront CBT. We compared the all-cause mortality rates of the CBT cohort to performance goal rates for anticoagulation, systemic thrombolysis (ST), and surgical thrombectomy from a published meta-analysis. Our cohort included 26 patients who underwent CBT (mean age 59.3 ± 17.9 years, 42.3% women, 57.7% Black). Compared to 463 patients from the meta-analysis receiving alternative treatments, the CBT group's short-term mortality was significantly lower (7.7% vs 32.4% for anticoagulation, 13.8% for ST, and 23.2% for surgical thrombectomy). CBT demonstrated noninferiority to anticoagulation (P < .001), ST (P = .031) and surgical thrombectomy (P < .001), and was superior to anticoagulation (P = .0056) and surgical thrombectomy (P = .036). This study suggests CBT is a promising treatment for CIT. Further prospective studies are warranted to validate these findings.

Health policy and systems research priority-setting exercise in Ethiopia: a collaborative approach

IntroductionHealth policy and systems research (HPSR) is a multi-disciplinary approach of generating health system and policy-level evidence. Setting HPSR agendas is considered as an efficient strategy to map and identify policy and cost-effective research topics, but its practice in developing countries is limited. This paper aimed to conduct a collaborative health policy and system research priority-setting exercise in Ethiopia.MethodThe WHO’s plan, implement, publish, and evaluate (PIPE) framework and the Delphi technique were used to conduct the priority-setting exercise. The PIPE model was used to lead the priority-setting process from planning to evaluation, while the Delphi technique was used to run the rating and ranking exercise with the aim of reaching a consensus. Two rounds of expert panel workshops supplemented with an online survey were used for the HPSR agenda setting, rating and ranking purposes. Groups were formed using the WHO health system building blocks as a base framework to identify and prioritize the HPSR topics.ResultUnder 8 themes, 32 sub-themes and 182 HPSR topics were identified. The identified research themes include leadership management and governance, health policy, health information system, healthcare financing, human resource for health, medical products and supply, service delivery and cross-cutting issues.ConclusionsPriority HPSR topics focussing on national health priority issues were identified. The identified topics were shared with policymakers and academic and research institutions. Evidence generation on the identified priority topics will guide future research endeavours and improve evidence-informed decision-making practice, health system performance and national health goals and targets.

Dual pathways to high performance: Team achievement goals, cooperation, and competition in elite sports teams

High performance is a key priority for elite sports teams. With this study, we investigate the performance of interdependent elite youth sports teams in relation to team achievement goals and within-team cooperation and competition, generically defined as teams’ shared perception of the extent to which team members engage in cooperative or competitive behaviors. Integrating achievement goal theory and social interdependence theory, we propose that team mastery goals (teams’ collective pursuit of learning and development) relate to within-team cooperation and that team performance goals (teams’ shared focus on winning and demonstrating competence) relate to within-team competition. Next, we propose that within-team cooperation facilitates team performance and explore the link between within-team competition and team performance. After the winter break, 289 players from 42 elite field hockey teams completed online survey questions about team achievement goals, cooperation, and competition. Team performance was represented by teams’ end-of-season point totals. Multilevel path modeling suggests dual pathways to team performance: (1) The more teams fostered team mastery goals, the more cooperative team members’ interactions were and the better the teams performed, and (2) the more teams fostered team performance goals, the more competitive the interactions among team members were and the better the teams performed. We tentatively interpret this dual pattern from the perspective of high-level interdependent youth sports teams as “coopetitive” environments, where teams traditionally focus on learning and development and where baseline levels of cooperation are high, creating conditions in which cooperation and some degree of competition can coincide and jointly contribute to team performance.

The Church as a Divine Instrument in Advancing God's Mission through the Implementation of Pastoral Counseling

This research uses a qualitative content analysis approach. The data collection technique is done by looking at books and journal articles related to the topic discussed. The data analysis technique was carried out with qualitative content analysis as the main method for discussing the central role of the church as an instrument for carrying out God’s mission, with a particular focus on the effective implementation of pastoral counseling. This research aims to find out what is meant by the church as an instrument of God’s mission. Furthermore, the research aims to determine the implementation of pastoral counseling in the mission of the church and through the church as an instrument of God’s mission. As a result, the church is sent to proclaim the message in and through Jesus Christ, which must be responded to with true faith and repentance. The pastoral function is an operational goal of God’s mission that can be achieved through pastoral services provided to others. Pastors and counselors should learn counseling approaches and techniques to provide more inclusive and relational ministry by exploring forms of collaboration that can be developed through the use of existing resources within the community or through partnerships with mental health professionals and outreach services. Finally, this integrative collaboration enables the church to do mission service through pastoral care with a holistic approach as a dynamic expression of the church’s commitment to fulfill God’s mission on earth. Keywords: empowering, the church, instrument, God’s mission, implementation, pastoral counseling

A Meta-Analysis on Teachers’ Growth Mindset

The concept of growth mindset—an individual’s beliefs that basic characteristics such as intelligence are malleable—has gained immense popularity in research, the media, and educational practice. Even though it is assumed that teachers need a growth mindset and that both teachers and their students benefit when teachers adopt a growth mindset, systematic syntheses of the potential advantages of a growth mindset in teachers are lacking. Therefore, in this article, we present the first meta-analysis on teachers’ growth mindset and its relationships with multiple outcomes (50 studies, 81 effect sizes; N = 19,555). Multilevel analyses showed a small effect across outcomes. Statistically significant small-to-typical positive associations between teachers’ growth mindset and their motivation in terms of self-efficacy and mastery goals were observed in subgroup analyses. No statistically significant relationships were found with teachers’ performance-approach goals, teachers’ performance-avoidance goals, teachers’ performance on achievement tests, or student achievement. Teachers’ growth mindset was related to instructional practices in terms of mastery goal structures but unrelated to performance goal structures. Moderator analyses indicated that the dimensionality of the mindset measure (recoded from a fixed mindset to a growth mindset measure vs. assessed as a growth mindset), item referent and content of the mindset measure, publication status (published vs. unpublished), world region, educational level, and study quality influenced the strengths of some of the relationships. Overall, our findings extend knowledge about teachers’ mindset and add to the evidence base on teacher characteristics and their links to relevant outcomes.

One-year outcomes of a novel venous stent for symptomatic iliofemoral venous obstruction: prospective cohort study

BackgroundA stent with characteristics of a hybrid design may have advantages in improving the patency of symptomatic iliofemoral vein obstruction. This study assessed the safety and effectiveness of the V-Mixtent Venous Stent in treating symptomatic iliofemoral outflow obstruction.MethodsEligible patients had a Clinical-Etiologic-Anatomic-Physiologic (CEAP) C classification of ≥ 3 or a Venous Clinical Severity Score (VCSS) pain score of ≥ 2. The primary safety endpoint was the rate of major adverse events within 30 days. The primary effectiveness endpoint was the 12-month primary patency rate. Secondary endpoints included changes in VCSS from baseline to 6 and 12 months, alterations in CEAP C classification, Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-14) scores at 12 months, and stent durability measures.ResultsBetween December 2020 and November 2021, 171 patients were enrolled across 15 institutions. A total of 185 endovenous stents were placed, with 91.81% of subjects receiving one stent and 8.19% receiving 2 stents. Within 30 days, only two major adverse events occurred (1.17%; 95% confidence interval [CI], 0.14–4.16%), below the literature-defined performance goal of 11% (P < .001). The 12-month primary patency rate (91.36%; 95% CI, 85.93–95.19%; P < .001) exceeded the literature-defined performance goal. VCSS changes from baseline demonstrated clinical improvement at 6 months (− 4.30 ± 3.66) and 12 months (− 4.98 ± 3.67) (P < .001). Significant reduction in symptoms, as measured by CEAP C classification and CIVIQ-14, was observed from pre-procedure to 12 months (P < .001).ConclusionsThe 12-month outcomes confirm the safety and effectiveness of the V-Mixtent Venous Stent in managing symptomatic iliofemoral venous outflow obstruction, including clinical symptom improvement compared to before treatment.

The Impact of Situational Achievement Goals on Online Learning Behavior: Results from Field Experiments

Given the widespread adoption of online learning, it is crucial to examine how these platforms can effectively maintain learners’ motivation and engagement. This study suggests that the prevalent hands-off, self-directed design approach, which relies heavily on learners’ intrinsic motivation, can potentially neglect crucial aspects like achievement emotions and lead to disengagement. Our findings show that online learning providers can address this issue through motivational interventions based on situational achievement goals. Specifically, our results indicate that among three achievement goals, learning, performance-prove and performance-avoidance, the performance-prove goal is the most effective one in enhancing learner engagement and performance. Additionally, we discuss that a one-size-fits-all course design may not be the most effective strategy for maintaining high engagement. Customizing interventions based on learners’ motivational behavior, prior performance, and social activity can significantly improve engagement. Learners with stronger prior performance benefit more from the performance-prove goal, whereas those with moderate performance levels gain from the performance-avoidance goal, and those with lower prior performance are positively influenced by the learning goal. Socially isolated learners respond best to performance goals.

Flutter Optimization of Carbon/Epoxy Plates Based on a Fast Tree Algorithm

This study focuses on optimizing carbon/epoxy laminate configurations to maximize the flutter speed of composite structures using a Fast Tree Regression algorithm. Initially, a seed dataset was created, using finite element method (FEM) modal analysis for common stack-ups used in composite fins and UAV components. The FEM analysis, based on the Lanczos algorithm for extracting modal frequencies in bending and torsion, was verified through experimental modal analysis using an AS-4/3501-6 composite system. Custom software was developed to interface with the FEA modal software, enabling the generation and augmentation of laminate dataset scenarios. The seed dataset was expanded until the coefficient of determination (R2) reached at least 0.95. Various regression algorithms, including Fast Forest Regression, Fast Tree Regression, Sdca Regression, and Lbfgs Poisson Regression, were evaluated. The Fast Tree Regression algorithm was selected for further analysis due to its superior performance. This algorithm was applied to a design space of nearly 2000 potential laminate candidates, focusing on symmetric lay-ups to avoid undesirable coupling between bending and torsion in UAV and missile control surfaces. The final optimized lay-ups, exhibit the highest Delta function values (the squared difference of modal frequencies in torsion and bending), indicating the expected highest flutter speeds. The results demonstrate the efficacy of tailored composite materials in achieving specific aerodynamic performance goals.

Leaders’ Performance Goals and Employees’ Counterproductive Work Behavior

Leaders’ Performance Goals and Employees’ Counterproductive Work Behavior

Seated Pulmonary Artery Pressure Monitoring in Patients With Heart Failure: Results of the PROACTIVE-HF Trial

BackgroundMonitoring supine pulmonary artery pressures to guide heart failure (HF) management has reduced HF hospitalizations in select patients. ObjectivesThe purpose of this study was to evaluate the effect of managing seated mean pulmonary artery pressure (mPAP) with the Cordella Pulmonary Artery sensor on outcomes in patients with HF. MethodsFollowing GUIDE-HF (Hemodynamic-GUIDEd Management of Heart Failure Trial), with U.S. Food and Drug Administration input, PROACTIVE-HF (A Prospective, Multi-Center, Open Label, Single Arm Clinical Trial Evaluating the Safety and Efficacy of the Cordella Pulmonary Artery Sensor System in NYHA Class III Heart Failure Patients trial) was changed from a randomized to a single-arm, open label trial, conducted at 75 centers in the USA and Europe. Eligible patients had chronic HF with NYHA functional class III symptoms, irrespective of the ejection fraction, and recent HF hospitalization and/or elevated natriuretic peptides. The primary effectiveness endpoint at 6 months required the HF hospitalization or all-cause mortality rate to be lower than a performance goal of 0.43 events/patient, established from previous hemodynamic monitoring trials. Primary safety endpoints at 6 months were freedom from device- or system-related complications or pressure sensor failure. ResultsBetween February 7, 2020, and March 31, 2023, 456 patients were successfully implanted in modified intent-to-treat cohort. The 6-month event rate was 0.15 (95% CI: 0.12-0.20) which was significantly lower than performance goal (0.15 vs 0.43; P < 0.0001). Freedom from device- or system-related complications was 99.2% and freedom from sensor failure was 99.8% through 6 months. ConclusionsRemote management of seated mPAP is safe and results in a low rate of HF hospitalizations and mortality. These results support the use of seated mPAP monitoring and extend the growing body of evidence that pulmonary artery pressure–guided management improves outcomes in heart failure. (Multi-Center, Open Label, Single Arm Clinical Trial Evaluating the Safety and Efficacy of the Cordella Pulmonary Artery Sensor System in NYHA Class III Heart Failure Patients trial [PROACTIVE-HF]; NCT04089059)

Supervisor Positive Gossip and Employee Receivers: The Moderation of Performance Goal Orientation

Supervisor Positive Gossip and Employee Receivers: The Moderation of Performance Goal Orientation

Assessment of leak-tightness for nuclear reactor containment under overpressure conditions considering aging effects

This paper assesses the aging effects on the leak-tightness of containment under overpressure conditions. A global containment model and the detailed sub-models for the three main penetration regions in the containment are established. The main aging forms and mechanisms of containment are clarified, and corresponding simulation schemes are provided. Through numerical simulation, the impacts of different aging forms on the failure pressure of containment are discussed from a deterministic perspective. Finally, the fragility and functional failure probability of containment under different aging conditions are evaluated. When 60 years of concrete degradation and prestress loss are considered, the pressure capacities of equipment hatch, personnel airlock, and pipe penetration are reduced by approximately 5%. Upon further considering steel liner corrosion, when the corrosion degree reaches 30%, the pressure capacities of these regions are reduced by 24.37%, 25.52%, and 22.83%, respectively. Within the scope of this study, the impact of steel liner corrosion on the risk of containment leakage is the most pronounced, whereas the impact of concrete degradation is minimal. If steel liner corrosion occurs simultaneously in three penetration regions, the whole containment will fail to meet the probabilistic performance goal when the corrosion degree reaches 30%.

An innovative model to enhance engineer-to-order companies operational efficiency conceived using axiomatic design theory

ABSTRACT The paper introduces the E.OpEx (ETO Operation Excellence) Model, a new framework to improve operational efficiency in Engineer-to-Order (ETO) manufacturing companies. The study used a Systematic Literature Review (SLR) and surveys to identify critical challenges in the ETO sector, which were prioritized through criticality analysis. The research applied Axiomatic Design (AD) theory to address these challenges and create structured solutions. The E.OpEx Model offers practical guidelines for resource management, workflow optimization, and customer satisfaction, aligning with the operational goals of ETO companies. Input from a Focus Group (FG) of industry experts was crucial in refining the model and identifying areas for improvement and practical integration with existing methodologies. This research also contributes to the application of AD to tackle operational challenges and proposes a model that enhances practices and lays the foundation for future innovations. Future research will focus on validating the E.OpEx Model in diverse ETO settings.

Does enterprises agglomeration lead to increased pollution emissions? Evidence from Chinese microdata

Enterprise agglomeration provides significant economic benefits but also carries substantial environmental impacts. Using the China Industrial Enterprise Database, this research develops novel metrics to comprehensively quantify specialization and diversity within enterprise agglomeration patterns in the Chinese industry from 1998 to 2012. Meanwhile, this study also theoretically links levels of enterprise agglomeration to pollution levels by extending established models and testing these relationships empirically with emissions data from the period. The study finds that enterprise agglomeration has a "U-shaped" relationship with environmental pollution that is modified by factors like fossil fuel intensity and strength of environmental regulations. The conclusions suggest priorities for sustainable development include optimizing degrees of enterprise agglomeration and promoting energy efficiency and stricter standards to support long-term compatibility between economic clustering through enterprise agglomeration and environmental performance goals.

Improvements in Therapy Experience With Evoked Compound Action Potential Controlled, Closed-Loop Spinal Cord Stimulation—Primary Outcome of the ECHO-MAC Randomized Clinical Trial

Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic pain. However, over- or underdelivery of the SCS may occur because the spacing between the stimulating electrodes and the spinal cord is not fixed; spacing changes with motion and postural shifts may result in variable delivery of the SCS dose and, in turn, a suboptimal therapy experience for the patient. The evoked compound action potential (ECAP)—a measure of neural activation—may be used as a control signal to adapt SCS parameters in real time to compensate for this variability. In this prospective, multicenter, randomized, single-blind, crossover trial, reduction in overstimulation intensity was used as a perceptual measure to evaluate a novel ECAP-controlled, closed-loop (CL) SCS algorithm relative to traditional open-loop (OL) SCS. The primary outcome used a Likert scale to assess sensation during activities of daily living with CL versus OL SCS. Of the 42 subjects in the intent-to-treat analysis set, 97.6% had a reduction in sensation with CL versus OL SCS. The primary objective was met as the lower confidence limit (87.4%) exceeded the performance goal of 50% (P < .001). A total of 88.1% (37/42) of subjects preferred CL and 11.9% (5/42) preferred OL SCS. SCS dose consistency during CL SCS was demonstrated by the reduced variability in ECAP amplitude with CL SCS (standard deviation: 8.72 µV) relative to OL SCS (standard deviation: 19.95 µV). Together, these results demonstrate that the ECAP-controlled, CL algorithm reduces or eliminates unwanted sensation, and thereby provides a more preferred and consistent SCS experience. PerspectivePatients with chronic pain need durable and dependable options for pain relief. SCS is an important therapy option, and new technology advancements could improve long-term therapy use. CL SCS offers a preferred and more consistent therapy experience for patients that could lead to increased therapy utilization and reliable therapy outcomes.

Analyzing Student's Motivation Towards Science Learning in Junior High School

Motivation is one of the factors that influence student learning outcomes, especially science learning. Motivation has an impact on the results of students' learning and must be concerned to enhance student motivation. This research aims to investigate Junior High School students' motivation in science learning. The survey method, which is a quantitative research method, was used in this research. The instrument named Students' Motivation Towards Science Learning Questionnaire (SMTSLQ), and open-ended questions were applied to Junior High School students who studied in Junior High School, West Java, Indonesia. The participants of this research are 1018, with 622 female and 396 male students. The collected data was analyzed with descriptive statistics, then supported by the answers to open-ended questions from the students. The findings showed that the average self-efficacy is 3.38, active learning strategies is 3.83, science learning value is 3.68, performance goal is 2.9, achievement goal is 3.69, and learning environment stimulation is 3.39. The total average is 3.52, which means the students in Junior High School are categorized as having a high level of motivation in science learning. Based on the students' answers to open-ended questions, they are motivated to learn science because science is fun and interesting to learn, and teachers are able to provide experiences from experiments. Meanwhile, students who are not motivated to learn science because science is a complex subject and difficult to understand, and teachers who give a lot of assignments without experimentation

Resilience-Based Approach to the Measurement of Headway Inconsistency

Maintaining a consistent headway is a primary goal in bus operation, but it poses a significant challenge because of fluctuating traffic conditions and uneven passenger demand. This leads to inconsistent headways and even bus bunching, resulting in negative consequences such as increased travel time and reduced vehicle capacity. Various control strategies have been developed to alleviate headway inconsistencies, but most of them have focused on whether an inconsistency occurs while overlooking its duration. This study proposes a resilience-based approach to measure headway inconsistencies considering both the depth and duration of the impacts with deviations from the optimal headway. The approach is devised to analyze the cumulative impacts of inconsistent headways comprehensively. It goes beyond addressing only extreme cases, such as bus bunching, and considers persistently uneven headways. We first identify vehicle trajectories from smart card data, then compute deviations from the center of the preceding and following vehicles as an index of impact. Using the concept of resilience, cumulative impacts are measured and their distribution is utilized to set the failure criterion. The approach is applied to 320 bus lines in Seoul to measure the deviations of headways and is used to analyze the characteristics of the bus lines and links where inconsistencies frequently occur. The proposed method enables transportation planners to identify factors that can lead to headway inconsistency, facilitating tailored and data-informed planning processes. This study provides a comprehensive framework that recognizes line-specific and link-specific factors, thereby contributing to enhancing the reliability and efficiency of public transportation systems.

The effect of cognitive orientation to daily occupational performance in children with attention deficit hyperactivity disorder: A pilot randomized controlled study

This single-blind randomized controlled trial (RCT) study was planned to examine the effect of the Cognitive Orientation to Daily Occupational Performance (CO-OP) intervention on occupational performance and executive functions through daily routines children with attention deficit hyperactivity disorder (ADHD). Using a simple random method, the children were divided into two groups: n = 15 in the CO-OP group (4 girls, 11 boys) and n = 15 in the control group (3 girls, 12 boys). CO-OP intervention included 12 sessions (2 sessions per week, each lasting 1 hour, 6 weeks in total) focusing on teaching cognitive strategies to improve daily living activities. These sessions involved personalized goal setting, performance analysis, and the application of cognitive strategies to enhance executive function and occupational performance in children with ADHD. The data were collected by assessing the children with the Canadian Occupational Performance Measure, Goal Attainment Scaling, and Executive Functions and Occupational Routines Scale at the beginning and end of the study. When comparing the pre- and post-evaluations of the CO-OP group, statistically significant improvements were noted in occupational performance and satisfaction (p < 0.001), occupational performance goals (p < 0.001), and executive functions through daily routines (p < 0.05). Test results for differences in posttest scores between the two groups showed that the CO-OP group had significantly better activity performance and satisfaction (p < 0.001), as well as gains in social routines for executive skills (p < 0.05), compared to the control group. The findings suggest that the CO-OP approach represents a promising and effective method for facilitating skill acquisition in various activities among children diagnosed with ADHD. Trial registration: This research was registered to clinical trials with the code NCT05125120.

How learners’ achievement goal motivation influences their metacognitive skills in online social annotations context?

ABSTRACT Online learning requires high self-regulated abilities facilitated by metacognitive skills. Achievement goal motivation impacts metacognition, but their relationship in online learning contexts lacks consensus. One of the components of achievement goal orientation is mastery goal orientation which focuses on learning and self-improvement. The other component, performance goal orientation, emphasises demonstrating competence. This quantitative study collected questionnaire and behavioural log data from 39 learners and examined the interplay between achievement goal motivation and metacognitive skills within an online social annotation environment. Findings revealed that mastery goal orientation positively correlated with metacognitive planning and regulation, while performance goal orientation was predominantly associated with metacognitive regulation. Neither goals significantly correlated with metacognitive monitoring. Cluster analysis indicated that ‘balanced achievers’ with higher performance goal orientation may play a pivotal role in promoting social cognition. These insights deepen understanding of motivating learners and creating effective online learning approaches by leveraging the influence of achievement goal motivation on metacognitive strategies.

Analisis Hubungan Skill dan Motivasi dengan Penginputan Data Istitha‘Ah Jemaah Haji Wilayah Kerja Dinas Kesehatan Provinsi Sumatera Barat

According to the presentation coverage report, the number of Hajj pilgrims' health data on SISKOHATKES within 2 (two) weeks of departure must be 100% input. However, there has been a decrease in the percentage of target achievement in inputting SISKOHATKES data for 5 years until 2022 (96.98%). This research aims to determine the factors related to inputting health istitha'ah data for Hajj pilgrims by the management of the integrated Hajj computerized health system in the work area of the West Sumatra Provincial Health Service in 2023. This research is a type of observational research with a cross-sectional approach. The research was conducted at the West Sumatra Provincial Health Service from May to August 2023. The sample for this research was all 48 Siskohatkes managers. Data was obtained through a Google Form survey. The analysis uses the Chi-square test, namely connecting two variables, the independent variable and the dependent variable. The significance level is 95% (α= 0.05). Based on the research results, it is known that (P-value = 0.008) there is a relationship between Ability (Skill) and the Performance of SISKOHATKES Managers, (P-value= 0.001) there is a relationship between Work Motivation and Performance of SISKOHATKES Managers. The conclusion of this research is that there is a relationship between skills, work motivation and training and employee performance in the work area of the West Sumatra Provincial Health Service. It is hoped that organizations in improving employee performance will focus more on motivation, training and improving their abilities to achieve performance goals.