Pilot Sites Research Articles

Problems in ensuring effective parasitological control on the territory of the Russian Federation

Introduction. Modern parasitology is an area of interdisciplinary research that uses the methods and approaches of various biological disciplines, such as genomics, proteomics, bioinformatics, ecology, biology, medicine, veterinary medicine, climatology, using methods of landscape-geographical mapping, mathematical modeling to assess the parasitological situation and predict its dynamics. New problems associated with the parasitic aspects of global climate change, the introduction of new host species and parasites (pathogens), and anthropogenic transformation of natural ecosystems become topical. In this regard, the primary tasks for optimizing the socio-hygienic monitoring of the parasitic safety of the environment is the introduction of new methodological approaches for ranking territories - the risk according to the species composition and intensity of circulation of pathogens of parasitic diseases, the trend in changes in their range of pathogens and epidemiological properties in anthropogenically determined conditions. The purpose of the study is to substantiate the methodology for choosing a territory for optimizing social and hygienic monitoring and substantiating proposals for the unification of hygienic standards for parasitological indicators of environmental safety. Materials and methods. Experimental parasitological monitoring was carried out at the pilot site. 712 samples were studied using unified methods of parasitological research of biomaterial (MUK 4.2.3145-13 “Laboratory diagnostics of helminthiases and protozooses”) and environmental objects (MUK 4.2.2661-10 “Methods of sanitary and parasitological research”). Results. Data were obtained on the high intensity of the circulation of pathogens of parasitic diseases in the environment - 25%. More than 15 types of pathogens of parasitic diseases have been systematized. Limitations. The limitations of the study were associated with the lack of development of diagnostic tools for the genetic identification of parasitic pathogens within the same systematic group by PCR analysis. Conclusion. Methodological disagreements in various normative documents to the composition of the “target indicators” of research are determined. The practical part of the work included the collection of material from people and animals, from environmental objects. A new approach to the hygienic standardization of parasitological indicators based on group systematization of the propagative stages of development of parasites with subsequent methodological determination of their taxonomic affiliation is substantiated.

Addressing Therapeutic Inertia: Development and Implementation of an Electronic Health Record-Based Diabetes Intensification Tool.

To assess whether an electronic health record (EHR)-based diabetes intensification tool can improve the rate of A1C goal attainment among patients with type 2 diabetes and an A1C ≥8%. An EHR-based tool was developed and sequentially implemented in a large, integrated health system using a four-phase, stepped-wedge design (single pilot site [phase 1] and then three practice site clusters [phases 2-4]; 3 months/phase), with full implementation during phase 4. A1C outcomes, tool usage, and treatment intensification metrics were compared retrospectively at implementation (IMP) sites versus nonimplementation (non-IMP) sites with sites matched on patient population characteristics using overlap propensity score weighting. Overall, tool utilization was low among patient encounters at IMP sites (1,122 of 11,549 [9.7%]). During phases 1-3, the proportions of patients achieving the A1C goal (<8%) were not significantly improved between IMP and non-IMP sites at 6 months (range 42.9-46.5%) or 12 months (range 46.5-53.1%). In phase 3, fewer patients at IMP sites versus non-IMP sites achieved the goal at 12 months (46.7 vs. 52.3%, P = 0.02). In phases 1-3, mean changes in A1C from baseline to 6 and 12 months (range -0.88 to -1.08%) were not significantly different between IMP and non-IMP sites. Times to intensification were similar between IMP and non-IMP sites. Utilization of a diabetes intensification tool was low and did not influence rates of A1C goal attainment or time to treatment intensification. The low level of tool adoption is itself an important finding highlighting the problem of therapeutic inertia in clinical practice. Testing additional strategies to better incorporate, increase acceptance of, and improve proficiency with EHR-based intensification tools is warranted.

Time series monitoring and prediction of coal mining subsidence based on multitemporal InSAR technology and GSM-HW model

The surface subsidence caused by coal mining will cause serious environmental problems, and an effective monitoring and prediction system is indispensable. Aiming at this phenomenon, a mining subsidence monitoring and dynamic prediction model combining time series stacking differential interferometric synthetic aperture radar (TSS-DInSAR) technology, small baseline subset InSAR technology (SBAS-InSAR), and golden section method-Holt–Winters (GSM-HW) model was proposed. First, based on the nine scene images of Sentinel-1A satellite in the study area, the time series subsidence of 811 work-face in Guobei coal mine from April 5 to July 10, 2021, was obtained using TSS-DInSAR and SBAS-InSAR monitoring technologies, respectively. Then, the original training samples of the GSM-HW model were generated by combining the cumulative surface subsidence results monitored by TSS-DInSAR and SBAS-InSAR, and the monitoring and prediction of surface subsidence were realized using this model. The experimental results show that the application of TSS-DInSAR and SBAS-InSAR monitoring technology to the impact of surface mining in mining areas has certain reliability, and the GSM-HW prediction model can make up for the deficiency of a single HW model in parameter optimization. The maximum fitting accuracy and prediction accuracy of the model for the 10 monitoring pilot sites are 96.9% and 98.4%, respectively, which can provide a reference for the design of surface monitoring and prediction system in the mining area.

Возможности применения цифровых сервисов на кормовых угодьях

A narrow circle of large agricultural producers have the financial capacity to purchase new equipment, use IT equipment and platforms. Along with the high costs of their implementation, this is due to the lack of examples of the use of such technologies showing their advantages. For the purpose of testing and practical application of advanced digital intelligent production technologies, taking into account the trends in the development of electronic (e-agriculture) and digital (digital-agriculture) agriculture, since 2017, a project using digital agricultural platforms has been launched at pilot sites in the Tver region. The purpose of the introduction of digital agricultural platforms in experimental fields is the unification of the production process, operational planning, accounting and control of agricultural work, monitoring the use of machinery. In the future — monitoring of crops and control of the harvesting company. When preparing information on land use, cultivated crops and its introduction into the systems, factors and parameters were identified that need to be adjusted to obtain maximum profit from 1 hectare with an optimal cost ratio and a deficit-free balance of nutrients.

Pilot implementation of the PharmNet naloxone program in an independent pharmacy

BackgroundThe U.S. overdose epidemic has continued to escalate with more than 100,000 deaths per year in the past several years, most of which involve opioids. Widespread availability of naloxone is part of a national solution to the crisis, and community pharmacies are well-poised to facilitate such distribution and provide additional harm reduction services. ObjectivesThe primary objectives of this study were to (a) examine the usability of each of the separate intervention components prepared for PharmNet, (b) observe intervention fidelity through regularly scheduled site visits, and (c) explore the association between PharmNet implementation and the volume of naloxone sales and distribution in the pilot site. Practice descriptionHere, we describe a carefully designed and tailored pharmacy harm reduction intervention called PharmNet that is designed to maximize harm reduction impact while minimizing utilization of pharmacist resources. It is a pragmatic awareness, service provision, and referral program that was developed through careful, iterative feasibility studies with pharmacists. Practice innovationPharmNet procedures include tools and steps to create awareness (e.g., yard signs and messaging for patients, reminder tools for pharmacists), facilitation of naloxone delivery from nonprofits, and provision of referral cards featuring local resources. Evaluation methodsEvaluation included direct data collection and randomly scheduled fidelity site visits. ResultsThe intervention was associated with an increase of 3.33 naloxone doses/mo being dispensed at cost (34.4% relative increase) and an overall increase of 9.33 naloxone doses/mo being dispensed via any mechanism (96.48% relative increase). Around 2.85 referral cards were issued to patients daily. Intervention fidelity was moderate, and the study provides valuable information for how to modify the study prior to a randomized trial. ConclusionWith modifications informed by this pilot study, the PharmNet intervention merits a randomized trial to determine whether it causes increased naloxone dispensing in independent community pharmacies.

Viability of Point of Care Ultrasound screening in Primary Health Care Setting: A Kenyan Experience

The limited number of sonographers in developing countries and high cost of conventional obstetric ultrasound screening services has led to only 6.9 percent of pregnant women accessing the service in rural areas. It is a World Health Organization (WHO) requirement to have pregnant women access obstetric ultrasound screening before 24 weeks gestation. This led to Amref International University piloting a business model that can make point of care obstetric ultrasound screening (POCUS) affordable and sustainable. One-year post intervention, an evaluation survey got conducted in the project sites in two pilot counties in Kenya (Kajiado and Kisii counties) to establish the viability of the entrepreneurship driven implementation of POCUS. Two stage cluster sampling was employed with mixed methods of data collection. A sample of 33 Midwives and 196 women of reproductive age from the pilot sites participated in the evaluation. The survey findings were that midst the COVID-19 pandemic, a total of 1250 pregnant women were screened in one year at a fee of USD 5 per scan. Among those interviewed, 168 (85.7%) of the women confirmed the service was affordable and easily accessible. It emerged that 85 (43.4%) of the respondents were screened by midwives in local health centres. Notably,180 (91%) of the women interviewed recommended scaling up of the service and 32 (96%) of the midwives reported that the continuous coaching from radiographers enhanced skills acquisition. Despite the marginal negative net present value of cash flows, the impact generated by the project was of high significance. The conclusion drawn was that the business model is viable from implementation perspective since it demonstrated the potential to reach a Break-Even Point (BEP) at a modest of 1833 ultrasound scans per year. The project has potential for further buy-in by Primary health care professionals having accorded them a gross margin of 60% with a probable increase to 80% in subsequent years. Further, Obstetric Ultrasound screening services can be provided sustainably at low cost by trained Primary Health Care Workers (PHCWs). Financial viability of the POCUS is subject to increasing pregnant women’s access to POCUS.

Estado de neutralidad en la degradación de la tierra en el Chaco Salteño entre 2001 y 2018

Within the framework of the 2030 Agenda for the fulfillment of the Sustainable Development Goals (SDGs), SDG 15 promotes “Life on land”, and Target 15.3 focuses on achieving land degradation neutrality (LDN). This work is focused on the Chaco Salteño region and the semi-arid Chaco pilot site in the province of Salta, Argentina (SPChS). The objectives are 1) to assess the state of LDN in the Chaco Salteño region and in the SPChS between 2001 and 2018, and 2) to determine the structural variables of the vegetation and physical-chemical properties of the soil at a local scale that can be used to complement the LDN evaluation. To evaluate the status of LDN, the indicators of changes in land cover and in aboveground net primary productivity (ANPP) were calculated, based on the coverage maps of the MapBiomas Chaco Project - Collection 2.0 and MODIS biweekly products (MOD 13Q1, annual). To explore the relationship between ANPP with the vegetation and soil variables, a correlation analysis was performed. We found that 14.3% of the Chaco Salteño region experienced negative changes in coverage and 20.8% losses in ANPP associated mainly with the transition from areas with native forests to crops. Meanwhile, in the SPChS, these changes represent a low extension of the surface. The ANPP correlated significantly and positively, in particular, with vegetation cover, organic matter and aggregate stability, so these variables could be used as complementary indicators in the evaluation of LDN at a local scale. Finally, the results of this research constitute a first frame of reference to articulate priorities in the planning of LDN interventions in the Chaco Salteño region, and particularly in the SPChS.

A mixed-methods evaluation of the national implementation of the Hospital-Acquired Pneumonia Prevention by Engaging Nurses (HAPPEN) initiative.

To describe healthcare provider, veteran, and organizational barriers to, challenges to, and facilitators of implementation of the oral care Hospital-Acquired Pneumonia Prevention by Engaging Nurses (HAPPEN) initiative to prevent non-ventilator-associated hospital-acquired pneumonia (NV-HAP). Concurrent mixed methods. Qualitative interviews of staff and patients were conducted in addition to a larger survey of VA employees regarding implementation. Medical surgical or extended care units in 6 high-complexity (01a-c) VA hospitals. Between January 2020 and February 2021, we interviewed 7 staff and 7 veterans, and we received survey responses from 91 staff. Provide education, support, and oral care supplies to prevent NV-HAP. Barriers to HAPPEN implementation and tracking at the pilot sites included maintaining oral care supplies and completion of oral care documentation. Facilitators for HAPPEN implementation included development of supportive formal and informal nurse leaders, staff engagement, and shared beliefs in the importance of care quality and infection prevention. Nurses worked together as a team to provide consistent oral care. Oral care was viewed as an essential infection control practice (not just "a task") and was considered part of the "culture" and "mission" in caring for veterans. Nurse leaders and direct-care staff were engaged throughout HAPPEN implementation, and most reported feeling supported and well prepared as they walked through the steps. Veterans reported positive experiences and increased knowledge about prevention of pneumonia. Lessons learned included building a community of practice and sharing expertise, which led to the successful replication of the HAPPEN initiative nationwide, improving patient safety and care quality and influencing health policy.

Introduction of a Standardized Maternity Early Warning System: Indicative Data From a Before-and-After Study at a Large Pilot Site Before National Rollout in Aotearoa New Zealand

(Anaesthesia. 2021;76:1600–1606) While there are recognition and response standards in place to decrease preventable adverse outcomes for nonpregnant adult patients and there is maternity-specific observation scoring system (MEOWS) in place for obstetric patients in the United Kingdom. An in-depth multidisciplinary review of study cases in Aotearoa New Zealand showed inadequate recognition and response standards may have significantly impacted maternal morbidity. A major tertiary hospital in Auckland piloted a modified version of the Aotearoa New Zealand early warning system (NZEWS) to promote better recognition and response of deteriorating pregnant women (NZMEWS). This study aimed to determine the efficacy of NZMEWS shown in the number of code blue and code red (cardiorespiratory arrests and very unwell women need an emergency response team, respectively) comparing the occurrence of codes before and after NZMEWS implementation.

Climate Change over the Mediterranean Region: Local Temperature and Precipitation Variations at Five Pilot Sites

The Mediterranean region is one of the most responsive areas to climate change and was identified as a major “hot-spot” based on global climate change analyses. This study provides insight into local climate changes in the Mediterranean region under the scope of the InTheMED project, which is part of the PRIMA programme. Precipitation and temperature were analyzed in an historical period and until the end of this century for five pilot sites, located between the two shores of the Mediterranean region. We used an ensemble of 17 Regional Climate Models, developed in the framework of the EURO-CORDEX initiative, under two Representative Concentration Pathways (RCP4.5 and RCP8.5). Over the historical period, the temperature presents upward trends, which are statistically significant for some sites, while precipitation does not show significant tendencies. These trends will be maintained in the future as predicted by the climate models projections: all models indicate a progressive and robust warming in all study areas and moderate change in total annual precipitation, but some seasonal variations are identified. Future changes in droughts events over the Mediterranean region were studied considering the maximum duration of the heat waves, their peak temperature, and the number of consecutive dry days. All pilot sites are expected to increase the maximum duration of heat waves and their peak temperature. Furthermore, the maximum number of consecutive dry days is expected to increase for most of the study areas.

Re-examine the air pollution control effect of China's pollutant emissions trading system: Evidence from a multi-period causal inference approach

The literature ignores the characteristics of the gradual implementation of the pollutant emissions trading system (PETS) in China and lacks studies investigating whether the PETS meets the quasi-natural experimental conditions. These may lead to biased results when using the single-period difference-in-difference (DID) model to investigate the pollution control effect of PETS. Therefore, this study first investigates whether PETS satisfies the quasi-natural experimental conditions by examining the parallel trend hypothesis, randomness grouping hypothesis, and SUTVA hypothesis. Second, this study identifies the timing of PETS document issuance in different regions. This study adopts a multi-period DID model to investigate the haze pollution control effect of PETS, then employs the single-difference model, the counterfactual method, and the explained variable substitution method to test the robustness. Finally, this article further explores the persistence and heterogeneity of the haze pollution control effect of PETS. The results showed that PETS met the quasi-natural experimental conditions, and PETS effectively reduced the intensity of haze pollution by about 1.6%. The haze pollution control effect of PETS was significant between 2007 and 2011, and insignificant between 2012 and 2016. Overall, the control effect diminished over time. Second, the haze pollution control effect of PETS was heterogeneous, and the pollution control effect was greater in the pilot sites with severe haze pollution. These findings lead to a better understanding of the implementation of the PETS in China, and the conclusions are beneficial to promoting the PETS and haze pollution control.

Monitoring Desertification Using a Small Set of Biophysical Indicators in the Brazilian Semiarid Region

Desertification is defined as land degradation in arid, semiarid, and dry sub-humid regions, and it is caused primarily by human activities and climate change. The semiarid region of Northeast (NE) Brazil is a very large, populous region, and thus, it is hard to monitor the dynamics of its desertified areas; therefore, the present study aimed to develop a minimum set of biophysical indicators to qualify and monitor desertification in this region. This approach included sampling a pair of preserved forested areas and nearby degraded, non-forested areas which had no vegetation growth in the previous years. The study was developed in four stages: (a) pilot site selection; (b) quantification and analysis of soil and vegetation biophysical indicators; (c) biophysical indicator selection; and (d) elaboration of the minimum set of biophysical indicators and desertification levels. Of the analyzed 24 biophysical indicators, 11 were retained and subjected to factor analysis by its principal components. This yielded the minimum set of indicators used to estimate the desertification levels of the pilot sites, which consisted of four soil characteristics: Total Organic Carbon (TOC), cation exchange capacity, clay content, and magnesium content. Regressions were conducted using the SQI, and these indicators showed that the TOC had the highest coefficient of determination. In an exploratory analysis, high SQI (low desertification) showed a positive correlation with the normalized difference vegetation index (R = 0.70) and Aridity Index (R = 0.97). This methodological approach could form the basis of a dynamic monitoring system that is capable of supplying objective, quantitative, and easy to obtain information to decision-makers in NE Brazil and other dry ecosystems around the globe.

Addressing social risk factors in the inpatient setting: Initial findings from a screening and referral pilot at an urban safety-net academic medical center in Virginia, USA

Social Determinants of Health (SDOH) impact health outcomes; thus, a pilot to screen for important SDOH domains (food, housing, and transportation) and address social needs in hospitalized patients was implemented in an urban safety-net academic medical center. This study describes the pilot implementation and examines patient characteristics associated with SDOH-related needs.An internal medicine unit was designated as a pilot site. Outreach workers approached eligible patients (n = 1,135) to complete the SDOH screening survey at time of admission with 54% (n = 615) completing the survey between May 2019 and July 2020. Data from patient screening survey and electronic health records were linked to allow for examination of associations between SDOH needs for food, housing, and transportation and various demographic and clinical characteristics of patients in multivariate logistic regression models. Of 615 screened patients, 45% screened positive for any need. Of 275 patients with needs, 33% reported needs in 2, and 34% – in 3 domains. Medicaid beneficiaries were more likely than patients with private health insurance to screen positive for 2 and 3 needs; Black patients were more likely than White patients to screen positive for 1 and 3 needs; Patients with no designated primary care physician status screened positive for 1 need; Patients with a history of substance use disorder screened positive for all 3 needs.SDOH screening assisted in addressing social risk factors of inpatients, informed their discharge plans and linkage to community resources. SDOH screening demonstrated significant correlations of positive screens with race/ethnicity, insurance type, and certain clinical characteristics.

American College of Surgeons Objective Assessment of Skills in Surgery (ACS OASIS): A Formative Assessment of Junior Residents’ Technical Skills

The objective assessment of technical skills of junior residents is essential in implementing competency-based training and providing specific feedback regarding areas for improvement. An innovative assessment that can be easily implemented by training programs nationwide has been developed by expert surgeon educators under the aegis of the American College of Surgeons (ACS) Division of Education. This assessment, ACS Objective Assessment of Skills in Surgery (ACS OASIS) uses eight stations to address technical skills important for junior residents within the domains of laparoscopic appendectomy, excision of lipoma, central line placement, laparoscopic cholecystectomy, trocar placement, exploratory laparotomy, repair of enterotomy, and tube thoracostomy. The purpose of this study was to implement ACS OASIS at a number of sites to study its psychometric rigor. The ACS OASIS was pre-piloted at two programs to establish feasibility and to gather information regarding implementation. Each skills station was 12 minutes long, and the faculty completed a checklist with 5 to 15 items, and a global assessment scale. The study was then repeated at three pilot sites and included 29 junior residents who were assessed by a total of 44 faculty. Psychometric data for the stations and checklists were collected and analyzed. The pre-pilot sites were Geisinger and University of Tennessee Knoxville.Data were gathered from pilot sites that included Wellspan Health, Duke University, and University of California Los Angeles. The mean checklist score for all learners was 76% (IQR of 66%-85%). The average global rating was 3.36 on a 5-point scale with a standard deviation of 0.56. The overall cut score derived using the borderline group method was at 68% with 34% of performances requiring remediation. Using this criterion, the average number of stations that were completed by each learner without need for remediation was five.The station discrimination index ranged from 0.27 to 0.65 (all above the threshold of 0.25), demonstrating solid psychometric characteristics at the station level. The internal-consistency reliability was 0.76 with SEM of 5.8%. The inter-rater reliability (intraclass correlation) was high at 0.73 with general agreement of 79% between the two raters. The station discrimination was at 0.45 (range of 0.27 to 0.65) indicating a high level of differentiation between high and low performers. Using the generalizability theory, the G-coefficient reliability was at 0.72 with the reliability projection flattening after 8 stations. Overall, 75% to 82% the faculty and learners rated ACS OASIS as realistic and beneficial. ACS OASIS is a psychometrically sound technical skills assessment tool that can provide useful information for feedback to junior residents and support efforts to remediate gaps in performance.

Public trust in the long-term care insurance pilot program in China: An analysis of mediating effects.

ObjectiveThis study aimed to evaluate the implementation of the long-term care insurance (LTCI) pilot program in China through an examination of public trust in the system and its associated factors of insurance awareness and satisfaction with the LTCI policy.MethodAn online survey was used to collect data from 786 participants in the city of Guangzhou, one of the pilot sites of the LTCI. Ordinal logistic regression models were used to investigate the related factors of public trust in the LTCI. Structural equation modeling (SEM) was conducted to test the mediating effect of satisfaction with LTCI policy on the relationship between insurance awareness and public trust.ResultsMore than 60% of participants gave a positive evaluation of the LTCI pilot program. More than 70% of the participants recognized the important role of the program. Both an understanding of insurance and satisfaction with LTCI policies were associated with public trust. The proportion of the indirect effect with regard to the total effect of satisfaction on trust was 70.133%, greater than the direct effect of 29.867%.ConclusionsOur findings supported the hypothesis that satisfaction with the LTCI policy plays a mediating role between insurance awareness and public trust. Optimalization of the LTCI policy was recommended to improve public trust in the LTCI program.

Fisher perceptions of Belize’s Managed Access program reveal overall support but need for improved enforcement

A major challenge facing global fisheries is gaining support for sustainable management, which is vital for ensuring the longevity of coastal resources for livelihood and ecosystem benefits. Territorial User Rights for Fishing (TURFs) have emerged as a possible solution to overfishing by requiring fishers to report their catch, color-code their vessels, and fish in designated areas. Belize was the first country in the Caribbean to implement TURFs — in a program called “Managed Access” — with two pilot sites opening in 2011 and seven sites added in 2016. This study evaluates the knowledge, attitudes and perceptions of fishers in the Managed Access program, comparing responses between 2014 and 2019. We collaborated with the Belize Fisheries Department and two local conservation organizations to administer surveys to 362 fishers in 2014 and 123 fishers in 2019, from ten communities in southern Belize. Overall, fishers in both years understood the requirements for acquiring and renewing their licenses, but in 2019, significantly more fishers understood the logbook reporting requirement and the benefits of having tenure rights than those in 2014. 69% of respondents from 2019 support the program in the long run, but 62% report observing illegal fishing behavior. These data suggest a need to educate fishers about the benefits of accurate catch reporting, improve enforcement, and develop fisher empowerment programs, while also guiding management decisions on a national scale. Although the Managed Access program in Belize is fairly new, the lessons learned can be applied to other small-scale fisheries contexts.

Factor Associated with Treatment Noncompletion during Implementation of Isoniazid-Preventive Therapy in Ten Pilot Sites of Lome, Togo

BACKGROUND: Tuberculosis (TB) represents the leading cause of death among people living with HIV (PLHIV). Several studies have proven the effectiveness of isoniazid-preventive treatment (IPT) in reducing the incidence and mortality of TB. The study aims to identify the factors associated with noncompletion of the treatment during the pilot phase of IPT implementation. METHODS: This was a retrospective cohort study using data routinely collected in ten PLHIV care centers in Lomé, Togo, conducted between June 1, 2019, and March 31, 2020. All confirmed PLHIV newly enrolled in care who gave consent were included. IPT tolerance and signs of TB were checked at each appointment. To identify the factors associated with noncompletion of treatment, a logistic regression model was developed. RESULTS: Sixty-five percent of the 301 patients were female. The mean age was 39.8 ± 13.2 years. Respectively, 43.8% and 41.9% of the patients were at clinical stages 1 and 2. The mean completion rate was 42.9% with extremes depending on the center ranging from 9.5% to 90.0%. The main causes of noncompletion were isoniazid stockouts (45.9%), lost to follow-up (37.8%), and noncompliance (12.8%). Multivariate analysis identified stockouts, public type of center, and poor general condition at the inclusion as risk factors for noncompletion. CONCLUSIONS: Good results obtained by some centers prove that the implementation of the intervention is indeed possible, as long as good management of drug stocks and better follow-up of patients are ensured.

Значимость комплексной оценки селекционных индексов и параметров стрессоустойчивости сортов озимой ржи

Abstract. Among grain crops, winter rye is one of the most popular crops, well adapted to the conditions of the North-West. Currently, most breeders use various selection indices in conjunction with the definition of stress resistance. Purpose. The aim is to study the collection samples of winter rye by yield and elements of the productivity structure and to identify the most adaptive for breeding in the conditions of the North-Western region. Methods. The experimental part was carried out at the VIR pilot site during 2018-2021 located in the North-Western region. The following were determined: Mexican index (Mx), Canadian index (Ki), linear ear density index (LPC), plant productivity index (IPR), Finnish-Scandinavian index (FSj), prospects index (J.P), index of the ratio of the mass of 1000 grains to the number of grains in the ear (j). The calculation of stress resistance parameters was carried out using the following indicators: stress resistance (Ymin- Y max), genetic flexibility (Ymin+Ymax)/2, stability of the variety (Ymin/Ymax), stress resistance coefficient (Kst.) was determined by A.A. Bykov. Results. The best conditions for the formation of yields were in 2020 and 2021 (Ij = +2.03; +1.8). In 2018 and 2019 – unfavorable (Ij = -1.3; -2.5). The maximum yield was obtained in 2020 in diploid rye varieties: Ophelia (10.3 t/ha) and Yaselda (9.0 t/ha), in tetraploid varieties Siberia 4. The results of these studies showed that the greatest advantage have variety: Siberia (Ʃ rank= 41), Eureka (Ʃ rank=55), ilmenite (Ʃ rank= 55), Ophelia (Ʃ rank=56), Siberia 4 (Ʃ rank= 58), Verisim (Ʃ rank= 59). Scientific novelty lies in the study of 12 varieties – seven diploids and five tetraploid winter rye. Thanks to the evaluation of varieties, they are divided according to the reaction of varieties to the environmental condition, stress-resistant and non-resistant.

Experiences of a Digital Twin Based Predictive Maintenance Solution for Belt Conveyor Systems

Availability of belt conveyor systems is essential in production and logistic lines to safeguard production and delivery targets to customers. In this paper, experiences from commissioning, validation, and operation of an interactive predictive maintenance solution are reported. The solution and its development is formerly presented in Al-Kahwati et.al. (Al-Kahwati, Saari, Birk, &amp; Atta, 2021), where the principles to derive a digital twin of a typical belt conveyor system comprising component-level degradation models,estimation schemes for the remaining useful life and the degradation rate, and vision-based hazardous object detection. Furthermore, the validation approach of modifying the belt conveyor and thus exploiting the idler misalignment load (IML) for the degradation predictions for individual components (including long-lasting ones) together with the actionable insights for the decision support is presented and assessed. Moreover, the approach to testing and validation of the object detection and its performance is assessed and presented in the same manner. An overall system assessment is then given and concludes the paper together with lessons learned. As pilot site for the study a belt conveyor system at LKAB Narvik in northern Norway is used.

INV-FLOW: New Possibilities to Evaluate the Technical Condition and Function of Extraction Wells

The declining supply of available groundwater resources is increasing the importance of extraction wells. To maximize the yield of extraction wells, the operators do not always respect the sustainable use of groundwater resources. These efforts can affect water quality and impact the service life of an extraction well, mainly through the clogging process. As part of the INV-FLOW project, an apparatus for evaluating the functionality of an extraction well by measuring the vertical water flow through its screen and filter was designed and tested. The apparatus consists of two electromagnetic induction flowmeters, two pneumatic seals, and a pump with the possibility of regulation. After an initial laboratory verification of the fundamental concept, the apparatus was successfully tested in real conditions. Two extraction wells, HJ-3 and HJ-4, intended for water supply to an agricultural production plant, were measured at a pilot site in the Czech Republic using the INV-FLOW apparatus. Although the HJ-3 extraction well is at the end of its service life, the HJ-4 extraction well is a newly installed well. In the new extraction well, HJ-4, a high proportion of water flowing through the gravel pack relative to the total pumping flow (93–97%) was measured using the INV-FLOW apparatus at different pumping rates. In the case of the HJ-3 extraction well, screen and filter clogging contributed significantly to the limited water flow through the gravel pack. In the most affected parts of the extraction well (15–20 m b.g.l.), the proportion of water flowing through the gravel pack relative to the total pumping flow ranged from 10 to 20%. The pilot tests confirmed the functionality of the apparatus and the possibility of using it to evaluate the degree of clogging and incrustation of an extraction well. The pilot tests thus demonstrated the usability of the INV-FLOW apparatus. The extraction well operator can assess the level of clogging or incrustation of the extraction well and decide on the need for the rehabilitation of an extraction well, or the termination of its operation.