Performance Scale Research Articles

Integration of cloud, fog, and edge technologies for the optimization of high-load systems

The study is dedicated to analyzing methods and tools for optimizing the performance of high-load systems using cloud, fog, and edge technologies. The focus is on understanding the concept of high-load systems, identifying the main reasons for increased load on such systems, and studying the dependency of the load on the system's scalability, number of users, and volume of processed data. The introduction of these technologies implies the creation of a multi-level topological structure that facilitates the efficient operation of distributed corporate systems and computing networks. Modern approaches to load management are considered, the main factors affecting performance are investigated, and an optimization model is proposed that ensures a high level of system efficiency and resilience to peak loads while ensuring continuity and quality of service for end-users. The methodology is based on a comprehensive approach, including the analysis of existing problems and the proposal of innovative solutions for optimization, the application of architectural solutions based on IoT, cloud, fog, and edge computing to improve performance and reduce delays in high-load systems. The scientific novelty of this work lies in the development of a unique multi-level topological structure capable of integrating cloud, fog, and edge computing to optimize high-load systems. This structure allows for improved performance, reduced delays, and effective system scaling while addressing the challenges of managing large data volumes and servicing multiple requests simultaneously. The conclusions of the study highlight the significant potential of IoT technology in improving production processes, demonstrating how the integration of modern technological solutions can contribute to increased productivity, product quality, and risk management.

Associations between psychological stress, discrimination, and oral health-related quality of life: the buffering effects of social support networks.

Stress and discrimination negatively affect quality of life, but social support may buffer their effects. This study aims: (1) to examine the associations between psychological stress, discrimination, and oral health-related quality of life (OHRQoL); and (2) to assess whether social support, stress and discrimination interact to modify their associations with OHRQoL. We used cross-sectional household-based data from a study including 396 individuals aged 14 years and over from families registered for government social benefits in a city in Southern Brazil. OHRQoL was measured with the Oral Impacts on Daily Performance (OIDP) scale; psychological stress was assessed with the Perceived Stress Scale (PSS); social support was assessed based on the number of close relatives or friends of the participant, and discrimination was assessed with a short version of the Everyday Discrimination Scale. Interactions were estimated using the relative excess of risk due to interaction (RERI). Adjusted effects were calculated with logistic regression. The prevalence of oral impacts among people with higher and lower PSS scores was 81.6% and 65.5%, respectively (p < 0.01). Social support was found to have no interactions with stress levels and discrimination. The association between social discrimination and OHRQoL (OIDP score > 0) was OR = 2.03 (95%CI: 1.23; 3.34) among people with a low level of stress, but was OR = 12.6 (95%CI: 1.31; 120.9) among those with higher levels (p = 0.09, for interaction). Individuals who reported experiencing higher levels of psychological stress and discrimination had worse OHRQoL; a synergistic effect with social support was not clear.

The management of patients with predominant negative symptoms in Slovakia: A 1-year longitudinal, prospective, multicentric cohort study.

Predominant negative symptoms (PNSs) in schizophrenia can affect the patients' psychosocial functioning immensely and are less responsive to treatment than positive symptoms. The aim of the study was to observe negative symptoms and psychosocial functioning in PNS schizophrenia patients and to understand whether PNS can be improved and with what treatment strategies. This was a 1-year, prospective, multicentric cohort study conducted in Slovakia. Adult outpatients with diagnosis of schizophrenia according to ICD-10 and PNS evaluated using the criteria by the European Psychiatric Association's (EPA) guidance were included. Change in negative symptoms, functionality, and treatment patterns were observed. Treatment effectiveness was evaluated using the modified Short Assessment of Negative Domain (m-SAND), the Self-evaluation of Negative Symptoms (SNS) scale, the Personal and Social Performance (PSP) scale, and the Clinical Global Impression - Severity (CGI-S) and the Clinical Global Impression - Improvement (CGI-I) scales. Least-squares (LS) means were calculated for the change from baseline to final visit for the outcomes. The study included 188 patients. Functionality improved as, by the end of the study, fewer patients were unemployed (53%) and more worked occasionally (21%). PNS improved significantly according to both physicians and patients (LS mean change from baseline in m-SAND total score: -10.0 (p-value <0.0001)). Most patients received polytherapy throughout the study. Cariprazine was utilized most (20% monotherapy and 76% polytherapy). Only a few patients discontinued treatment due to adverse drug reactions. With the right treatment strategy, it is possible to achieve improvement in PNS and everyday functioning in schizophrenia outpatients.

A 6.4-Gb/s/pin nand Flash Memory Multichip Package Employing a Frequency Multiplying Bridge Chip for Scalable Performance and Capacity Storage Systems

A 6.4-Gb/s/pin nand Flash Memory Multichip Package Employing a Frequency Multiplying Bridge Chip for Scalable Performance and Capacity Storage Systems

Brightness enhancement on random-distributed-feedback Raman fiber lasers pumped by multimode diodes

Abstract The power scaling on short wavelength (SW) fiber lasers operating around 1 μm are in significant demand for applications in energy, environment and industry. The challenge for performance scalability of high-power SW lasers based on rare-earth-doped fiber primarily lies in the physical limitations, including reabsorption, amplified spontaneous emission and parasitic laser oscillation. Here, we demonstrate an all-fiberized, purely passive SW (1018 nm) random-distributed-feedback Raman fiber laser (RRFL) to validate the capability of achieving high-power output at SWs based on multimode laser diodes (LDs) direct pumping. Directly pumped by multimode LDs, the high-brightness RRFL delivers over 656 W, with an electro-optical efficiency of 20% relative to the power. The slope efficiency is 94%. The beam quality M2 factor is 2.9 (which is ~20 times that of the pump) at the maximum output signal power, achieving the highest brightness enhancement of 14.9 in RRFLs. To the best of our knowledge, this achievement also represents the highest power record of RRFLs utilizing multimode diodes for direct pumping. This work may not only provide a new insight into the realization of high-power, high-brightness RRFLs but also is a promising contender in the power scaling of SWs below 1 μm.

Novel Techniques for Smart Adaptive Multiprocessor SoCs

The growing concerns of power efficiency, silicon reliability and performance scalability motivate research in the area of adaptive embedded systems, i.e. systems endowed with decisional capacity, capable of online decision making so as to meet certain performance criteria. The scope of possible adaptation strategies is subject to the targeted architecture specifics, and may range from simple scenario-driven frequency/voltage scaling to rather complex heuristic-driven algorithm selection. This paper advocates the design of distributed memory homogeneous multiprocessor systems as a suitable template for best exploiting adaptation features, thereby tackling the aforementioned challenges. The proposed solution lies in the combined use of a typical application processor for global orchestration along with such an adaptive multiprocessor core for the handling of data-intensive computation. This paper describes an exploratory homogeneous multiprocessor template designed from the ground up for scalability and adaptation. The proposed contributions aim at increasing architecture efficiency through smart distributed control of architectural parameters such as frequency, and enhanced techniques for load balancing such as task migration and dynamic multithreading.

Effects of Yipi Huayu decoction on tumor markers, immune function, and adverse reactions during chemotherapy in gastric cancer patients: a retrospective propensity score-matched study.

To analyze the effects of Yianpi Huayu Decoction on tumor markers, immune function and adverse reactions during chemotherapy in patients with gastric cancer. The clinical data of 154 patients with progressive gastric cancer who attended Baoji Maternal and Child Health Hospital (Daijiawan Branch) from January 2020 to March 2022 were retrospectively analyzed. The patients were divided into an observation group (61 cases) and a control group (93 cases) according to the treatment method and were matched using propensity score matching (PSM). The control group was given SOX neoadjuvant chemotherapy regimen (oxaliplatin + tiglio), and the observation group was given spleen-strengthening and blood-stasis-reducing tonics as adjuvant treatment on the basis of the treatment given to the control group. Clinical efficacy in the two groups was observed, as well as Carbohydrate Antigen 19-9 (CA19-9), Carbohydrate Antigen 72-4 (CA72-4), and Carcinoembryonic Antigen (CEA) levels, immune function (IgA, IgM, and IgG), Karnofsky Performance Scale (KPS), and occurrence of adverse reactions. After matching, there was no significant difference in the total clinical efficiency between the two groups (P > 0.05). After matching, there were no differences in CA19-9, CA72-4, and CEA levels between the observation group and the control group before or after treatment (P > 0.05). After matching, the IgA, IgM, and IgG levels in the observation group were significantly better than those in the control group after treatment (P < 0.05). The incidence of leukopenia (P = 0.011) and diarrhea (P = 0.011) during treatment was higher in the control group than in the observation group after matching. The KPS score of the observation group was higher than that of the control group after matching (P < 0.05). After matching, Cox regression analysis found that the treatment regimen (P < 0.001, HR = 2.527), TNM staging (P = 0.001, HR = 0.471), local recurrence (P = 0.001, HR = 2.147), and pretreatment CEA (P = 0.011, HR = 1.131) were independent prognostic factors affecting patients' 2-year survival. While the spleen-enhancing and blood-stasis-removing herbal formula combined with the SOX chemotherapy regimen did not improve therapeutic outcomes in gastric cancer patients, it did enhance immune function, reduce adverse reactions, and improve quality of life.

Relationship Between Effectiveness of Teleworking and Job Performance on Online Shop Employees

Employee performance influences company development. Like employees in general, the performance of online shop employees affects the productivity or effectiveness of the business carried out to achieve profits. Technology-based online shops require effective implementation of teleworking. Empirically, this research determines the relationship between the effectiveness of teleworking and the performance of online shop employees. Researchers put forward the hypothesis that there is a positive correlation between the effectiveness of teleworking and the job performance of online shop employees. The respondents for this research consisted of 101 online shop employees in Yogyakarta. Researchers used the Employee Performance Scale (EPS) compiled by Tabouli et al. (2016), and the E-Work Life Scale (EWL) from Grant et al. (2018). Data analysis through Pearson product moment revealed a significant relationship between teleworking effectiveness variables and performance variables (R=0.261 and p=0.008). These results indicate that the higher the effectiveness of teleworking, the higher the performance of online shop employees, and vice versa. The contribution of teleworking effectiveness to employee performance is only 0.068 or 6.8%, of which the remaining 93.2% is other influential variables. Researchers put forward implications and suggestions based on these findings.&#x0D; Highlights:&#x0D; &#x0D; Teleworking's impact: The study reveals a positive correlation between teleworking effectiveness and job performance among online shop employees.&#x0D; Data significance: Analysis indicates a significant relationship between teleworking effectiveness and employee performance.&#x0D; Contribution insight: Teleworking effectiveness contributes 6.8% to employee performance, with other factors playing a substantial role.&#x0D; &#x0D; Keywords: Employees, Effectiveness of Teleworking, Job Performance

Surgical Management of Foramen Magnum Meningiomas: Clinical Insights and Outcomes

Objective: This retrospective study aimed to provide a comprehensive analysis of the surgical management of foramen magnum meningiomas (FMMs), focusing on patient characteristics, surgical approaches, complications, and postoperative outcomes. Materials and Methods: The study included 23 patients diagnosed with anterior or anterolateral FMMs who underwent surgical treatment between 2014 and 2022. The study encompassed clinical records, neurological assessments, radiological findings, and surgical approaches, with a focus on the far lateral approach (FLA). Evaluation of outcomes included Karnofsky Performance Scale (KPS) scores and The Neck Disability Index (NDI) scores. Surgical approaches and postoperative care strategies were detailed. The study also examined the relationship between tumor location and surgical techniques. Results: The analysis revealed that patients with FMMs presented with various clinical symptoms, including lower cranial nerve deficits, pyramidal tract syndrome, and sensory disturbances. The retrocondylar far lateral approach was predominantly utilized, resulting in various Simpson resection grades. Postoperative complications were observed, including cranial nerve deficits, cerebrospinal fluid leakage, and infections. Also, the study found patient KPS scores remained stable, and NDI scores showed no significant increases before and after surgery. Conclusion: Surgical management of FMMs is a complex task requiring meticulous planning, individualized approaches, and close attention to neurovascular structures. The study emphasized the diverse clinical presentations and surgical techniques associated with FMMs and highlighted the importance of ongoing research and collaborative efforts to enhance patient care in this challenging field.

Relationship between the Use of Mobile Applications and Social Functioning in Patients with Schizophrenia.

The aim of this study is to examine the prevalence of digital technology tool use in individuals with schizophrenia or schizoaffective disorder in Turkey, as well as evaluating the association between the use and psychosocial functionality and clinical symptoms. Data were collected from 100 patients who were diagnosed with schizophrenia or schizoaffective disorder based on the DSM-5 criteria. The use of technology was evaluated with a questionnaire developed for this study. The level of psychosocial functioning was assessed using the Personal and Social Performance Scale (PSP), and the positive and negative symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS). The digital technology users were significantly younger than the non-users. The majority of patients own a mobile phone (86%) and a computer (67%). Furthermore, 61% of patients used mobile applications, with Facebook and WhatsApp being the most popular social media platforms (48%). Patients who used digital technology tools had higher PSP scores. Furthermore, patients who used digital technology tools had significantly lower scores in PANSS negative subscale. There was no difference in PANSS positive subscale scores between digital technology tool users and non-users. Patients diagnosed with schizophrenia may benefit from mobile applications and social media tools that can help them participate in daily activities and improve their overall well-being.

Impact of function-guided glioma treatment on oncological outcome in the elderly

IntroductionMany patients with high-grade gliomas (HGG) are of older age. Research questionWe hypothesize that pre- and intraoperative mapping and monitoring preserve functional status in elderly patients while gross total resection (GTR) is the aim, resulting in overall survival (OS) rates comparable to the general population with HGG. Material and methodsWe subdivided a prospective cohort of 168 patients above 65 years with eloquent high-grade gliomas into four groups ([years/cases] 1: 65–69/58; 2: 70–74/47; 3: 75–79/43; 4: >79/20). All patients underwent preoperative noninvasive mapping, which was also used for decision-making, intraoperative neuromonitoring in 138 cases, direct cortical and/or subcortical motor mapping in 66 and 50 cases, and awake language mapping in 11 cases. ResultsGTR and subtotal resection (STR) could be achieved in 65% and 28%, respectively. Stereotactic biopsy was performed in 8% of cases. Postoperatively, we found transient and permanent functional deficits in 13% and 11% of cases. Postoperative Karnofsky Performance Scale (KPS) did not differ between subgroups. Patients with long-term follow-up (51%) had a progression-free survival of 5.5 (1–47) months and an overall survival of 10.5 (0–86) months. Discussion and conclusionThe interdisciplinary glioma treatment in the elderly is less age-dependent but must be adjusted to the functional status. Function-guided surgical resections could be performed as usual, with maximal tumor resection being the primary goal. However, less network capacity in the elderly to compensate for deficits might cause higher rates of permanent deficits in this group of patients with more fast-growing malignant gliomas.

Current Trends and Innovations in Enhancing the Aerodynamic Performance of Small-Scale, Horizontal Axis Wind Turbines: A Review

Abstract Wind energy has proven to be one of the most promising resources to meet the challenges of rising clean energy demand and mitigate environmental pollution. The global new installation of wind turbines in 2022 was 77.6 GW, bringing the total installed capacity to 906 GW, documenting an astounding 9% growth in just one year (Lee and Zhao, 2023, Global Wind Report, GWEC. Global Wind Energy Council). Sizeable research continues to focus on improving wind energy conversion, safety, and capacity. However, funding allocations and research have not matched this sustained market growth observed over the last few decades. This is particularly the case for small-size wind turbines. We define small-scale wind turbines as those with an output power of 40 kW or less that can nonetheless be interconnected to provide larger power output. Thus, the paper focuses on small-scale horizontal-axis wind turbines (HAWT) with emphasis on current technology trends including data gathering, aerodynamic performance analysis of airfoils and rotors, as well as computational approaches. The paper also highlights the challenges associated with small-scale HAWTs thereby conjecturing about future research directions on the subject. The literature review suggests that small-scale HAWT wind turbines are suitable for harnessing energy in communities with limited resources where grid-supplied power is out of reach. The power coefficient of these turbines ranges from 0.2 to 0.45 which shows that it could greatly benefit from research, built on targeting these modest performance scales by using efficient airfoils, mixed airfoils, optimizing the blade geometry, shrouding the wind turbine rotor, using maximum power tracking control, etc. This review paper is an attempt to prioritize and layout strategies toward evaluating and enhancing the aerodynamic performance of small-scale HAWTs.

A Sub-$\mu$W Energy-Performance-Aware IoT SoC With a Triple-Mode Power Management Unit for System Performance Scaling, Fast DVFS, and Energy Minimization

A Sub-$\mu$W Energy-Performance-Aware IoT SoC With a Triple-Mode Power Management Unit for System Performance Scaling, Fast DVFS, and Energy Minimization

The role of affective temperaments in self-care and medication adherence among individuals with bipolar disorder: a moderation analysis.

Affective temperament, defined as the fundamental predisposition from which normal affective states originate or as the constitutional core of personality, play a crucial role in mood disorders, particularly bipolar disorders. Understanding the relationship between temperaments, treatment adherence, and self-care is crucial for effective management and improved clinical results. This study aims to (1) assess the correlation between affective temperaments and treatment adherence, (2) investigate the relationship between affective temperaments and self-care abilities, (3) identify predictors of treatment adherence, and (4) explore the moderating effect of self-care on the relationship between treatment adherence and depressive temperament in individuals with bipolar disorder. A cross-sectional study was conducted with 231 individuals diagnosed with bipolar disorder (BD) type I (N=160) and type II (N=71). The participants were evaluated using the following psychometric tools: Temperament Evaluation of Memphis, Pisa, and San Diego (TEMPS) to assess affective temperaments, Personal and Social Performance Scale (PSP) to evaluate social functioning and self-care abilities, and Morisky Medication Adherence Scale (MMAS) to measure treatment adherence. The study involved statistical analyses to examine correlations, identify predictors, and explore moderating effects. The findings revealed significant correlations between affective temperaments and both treatment adherence and self-care abilities. Specifically, hyperthymic temperament was positively associated with higher treatment adherence, whereas cyclothymic and depressive temperaments were linked to lower adherence. Self-care abilities were found to mediate the relationship between depressive temperament and treatment adherence, suggesting that improved self-care can enhance adherence in individuals with depressive temperament. Affective temperaments significantly influence treatment adherence and self-care abilities in individuals with bipolar disorder. The mediating role of self-care highlights the importance of developing targeted interventions to improve self-care practices, thereby enhancing treatment adherence and overall well-being. Personalized treatment strategies based on temperament assessments could lead to better clinical outcomes and quality of life for individuals with bipolar disorder.

Clinical Value of Human Endogenous Retrovirus-H Long Terminal Repeat Associating 2 (HHLA2) in Small Cell Lung Cancer.

Objective: Human endogenous retrovirus-H long terminal repeat associating 2 (HHLA2) is a new immune checkpoint in the B7 family, and the value of HHLA2 in small cell lung cancer (SCLC) is unknown. Methods: We retrospectively detected HHLA2 expression by immunohistochemistry in SCLC patients. Moreover, plasma biomarkers of SCLC were detected retrospectively. Results: Seventy-four percent of SCLC patients exhibited HHLA2 expression. HHLA2 staining was localised within the nucleus of SCLC cells, while no staining was detected in normal lung tissue specimens. The correlation between HHLA2 expression and clinical factors was also analysed. Limited stage (LS) SCLC was more common than extensive stage (ES) SCLC among patients with HHLA2 staining. SCLC patients without metastasis had higher HHLA2 expression than SCLC patients with metastasis. HHLA2 expression was more frequently detected in the group with a tumour size greater than 5 cm than in the group with a tumour size less than 5 cm. The proportion of patients with HHLA2-positive staining was greater in the stage III and IV SCLC groups than in the stage I and II SCLC groups. A high proportion of SCLC patients with HHLA2-positive staining had a survival time <2 years. Neuron-specific enolase (NSE), CEA and Ki-67 levels were measured. The NSE level in the HHLA2-positive group was significantly greater than that in the HHLA2-negative group. The CEA and Ki-67 levels did not significantly differ between the HHLA2-positive and HHLA2-negative patients, nor were age, sex, smoking status, nodal metastasis status, Karnofsky Performance Scale (KPS) score, or Ki-67 expression score. HHLA2-positive SCLC patients had higher tumour stages and shorter 2-year survival times than HHLA2-negative patients did. Conclusion: The new immune molecule HHLA2 may be an ideal clinical biomarker for predicting SCLC progression and could serve as a new immunotherapy target in SCLC.

Evaluating the Utility of the Surprise Question Among General Physicians for Appropriate Palliative Care Indication in Brazil.

This study aimed to assess the agreement between established tools, such as the Palliative Performance Scale (PPS) and Brazilian version of the Supportive and Palliative Care Indicators Tool (SPICT-BR), and the subjective assessment of palliative care (PC) need using the Surprise Question (SQ) administered by resident physicians. This assessment was conducted among hospitalized patients, with and without cancer, to determine the efficacy of these tools in indicating the need for PC. A six-month cross-sectional study in 2019 of medical records of patients hospitalized in a single center in IAMSPE-Brazil. The SPICT-BR and PPS were applied to the medical record data, and the SQ was posed to each resident physician. Comparisons for categorical data were made using the chi-square test, with p < 0.05 considered statistically significant. Of 203 patients evaluated, 57.6% were male and 81.2% were older adults (≥60 years). The mean age was 67.40 ± 9.72 years. Chronic disease was nonneoplastic in 78.32% of patients, and 56.65% had not been hospitalized in the preceding year. The PPS score was <70% in 69.4% of patients, and 51.2% met at least one SPICT-BR criterion. Among patients with cancer, 40.9% had over two positive SPICT-BR criteria; 97.5% of these patients received NO responses to SQ by residents (p < 0.0001). Similarly, 90.6% of patients with one SPICT-BR criterion received NO responses to SQ, with no significant difference between groups. The SQ proved to be a valuable tool for PC indication, particularly when administered by untrained professionals. Consistent with SPICT-BR findings, our study highlights the SQ's role in facilitating early identification of patients in need of PC.

Exploration and Practice of Digital Teaching Innovation Path for Art Majors in the Information Age

Abstract This paper proposes a digital teaching innovation path for art majors and builds a digital teaching innovation technology framework with digital teaching resource management and online and offline blended teaching as the main modules. In digital teaching resource management, a SCORM digital teaching resource management model is constructed, and a resource recommendation algorithm is designed in combination with a collaborative filtering recommendation algorithm. In blended teaching, a meta-learning recommendation algorithm is utilized to complete the design of a teaching system for CDIO. Finally, experimental classes and control classes were set up to carry out digital teaching practices using the Fine Arts Painting major at University A in Zhejiang Province, China, as the research object. In the analysis of students’ learning behavior performance, the score of students in the experimental class was 4.373 points higher than that of the control class, with a significant difference (P&lt;0.05). The total drawing performance score of the experimental class students was 78.45, and the overall drawing performance was satisfactory. In the analysis of students’ learning performance scale, all the index values of the experimental class were higher than those of the control class. In terms of teachers’ teaching behavior performance, except for teaching monitoring behavior, the experimental class showed significant differences from the control class in all other teaching behavior factors.

Efficacy of Moxibustion for Cancer-Related Fatigue in Patients with Breast Cancer: A Systematic Review and Meta-Analysis.

Breast cancer is the most commonly diagnosed cancer worldwide, and most patients experience fatigue. However, there are no effective treatments for cancer-related fatigue (CRF). Several randomized controlled trials (RCTs) have suggested that moxibustion improves CRF. We conducted a systematic review and meta-analysis to compare the differences in fatigue scale scores, quality of life, and clinical efficacy in patients with breast cancer who developed CRF and did versus did not receive moxibustion. RCTs were searched in 7 databases using a standardized search method from database inception to March 2023, and RCTs that met the inclusion criteria were selected. Among 1337 initially identified RCTs, 10 RCTs involving 744 participants were selected for this study. The meta-analysis involved assessment of the revised Piper Fatigue Scale scores, Cancer Fatigue Scale scores, Karnofsky Performance Scale scores, Athens Insomnia Scale scores, clinical efficacy, and Qi deficiency syndrome scale scores. Compared with the control, moxibustion was associated with significantly better Piper Fatigue Scale scores (P < 0.0001), quality of life [Karnofsky Performance Scale scores (P < 0.0001)], clinical efficacy (P = 0.0007), and Qi deficiency syndrome scale scores (P = 0.02). Moxibustion improves CRF in patients with breast cancer. The efficacy of moxibustion should be further examined by high-quality studies in various countries with patients subdivided by their breast cancer treatment status. PROSPERO ID: CRD42023451292.

Quality of life in dysphagia and functional performance of cancer patients in palliative care.

To correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care. This cross-sectional, quantitative study was conducted at the outpatient clinic and oncology ward of a university hospital. Inclusion criteria required patients to respond positively to the question: "Do you have difficulty or problems swallowing?". Patients were excluded if they had been diagnosed with head and neck cancer, were unable to answer questionnaires due to actively dying status, were in a state of drowsiness, experienced extreme pain and systemic instability, or if data collection instruments were incomplete. Two instruments were used in their Brazilian Portuguese versions: the Palliative Performance Scale (PPS) and the M. D. Anderson Dysphagia Inventory (MDADI). The variables were analyzed using descriptive and inferential statistics, with Pearson's correlation used at a 5% significance level. The sample consisted of 39 participants, with an average age of 65.3 years, of whom 24 (61.5%) were women. The most frequent neoplasm sites were the pancreas and stomach. The results of the PPS indicated that the average patient had reduced ambulation and inability to work, but maintained independence in self-care, with a complete level of swallowing and consciousness. The MDADI showed an average degree of limitation. Outpatients exhibited a moderate correlation between the MDADI result and the level of functionality according to the PPS. Cancer patients at the palliative care outpatient clinic demonstrated a correlation between functional performance and the impact of dysphagia on quality of life.

Effective debriefings in the clinical setting: a pilot study to test the impact of an evidence based debriefing app on anesthesia care providers' performance.

Debriefing enhances team learning, performance, and patient safety. Despite its benefits, it's underused. To address this, we developed an evidence-based debriefing app. This pilot study, conducted at a Swiss hospital, evaluated team performance during two anesthesia inductions using the Team Performance Scale (TPS). Following the first induction, teams engaged with the Zurich Debriefing App, with debriefing sessions meticulously recorded for subsequent evaluation. To mitigate bias, raters underwent comprehensive TPS training. The debriefings were analyzed through the DE-CODE framework. We utilized paired t-tests to examine performance improvements and linear regressions to assess the impact of reflective statements on performance, moderated by psychological safety. Team performance significantly improved from the first to the second induction (t (9) = -2.512, p = 0.033). Senior physicians' (n = 8) reflective statements predicted post-assessment TPS scores (R 2 = 0.732, p = 0.061), while consultants (n = 7) and nurse anesthetists (n = 10) did not. Interaction analysis revealed no moderation effects, but a main effect indicated the significance of senior physicians' reflective statements. This pilot study confirms the efficacy of the evidence-based debriefing app in enhancing anesthesia team performance. Senior physicians' reflective statements positively influenced performance; however, no moderation effects were observed. The study highlights the potential of debriefing apps to streamline and enhance team debriefing processes, with significant implications for improving clinical practice and patient safety. Further research is needed to validate these findings on a larger scale and optimize the integration of debriefing into routine clinical practice.