Quality Of Process Research Articles

Optimizing MEP Design in Pharmaceutical Cleanroom with the Integration of 2D To 7D in BIM

Abstract: This paper examines the optimization of pharmaceutical cleanroom design using 2D to 7D Modelling in Building Information Modelling (BIM). The goal is to enhance the reliability, different methods, statistical data, and performance of pharmaceutical production plants by effectively allocating components within design constraints. Mathematical optimization techniques improve facility design, ensuring robustness and operational efficiency. The study proposes a reliable optimal design for air-conditioning systems in pharmaceutical cleanrooms, considering uncertainties in design parameters and operational strategies. Resilient cleanroom systems are developed, and adaptable to various conditions while maintaining high performance standards. Additionally, the research explores the application of experimental design methodologies in optimizing drug delivery systems, such as factorial and etc, to enhance the quality and efficiency of pharmaceutical products and processes.

Physics-guided neural network for grinding temperature prediction

Creep-feed grinding is a high-efficiency, high-precision grinding process widely used in the manufacturing of aviation engines. However, the workpiece burn and other quality issues caused by high processing temperature limit the yield of grinding. Therefore, the accurate model of grinding temperature has become the key to improving processing efficiency and quality. Different from the traditional physical or data-driven models, this paper attempts to combine both perspectives based on Physics-Guided Neural Networks (PGNN) to accurately predict grinding temperature with a small number of experiments. At the level of data acquisition, real grinding experiment data was obtained and a data augmentation method had been proposed. At the level of neural network structure, optimisation processes were implemented to enhance prediction performance, and a physics-guided loss function was inserted to guide network training. The experiment results shows that PGNN had better prediction accuracy than the physical model, while also mitigating the limitations of data-driven models on small sample sets. PGNN also performed better with noisy data and predictions out of the training data range, this reveals the benefits of PGNN for small sample problems in processing scenarios.

Process evaluation of the implementation of the ABC method, an intervention for nurses dealing with challenging behaviour of patients with brain injury

BackgroundIntroducing new working methods is common in healthcare organisations. However, implementation of a new method is often suboptimal. This reduces the effectiveness of the innovation and has several other negative effects, for example on staff turnover. The aim of the current study was to implement the ABC method in residential departments for brain injured patients and to assess the quality of the implementation process. The ABC method is a simplified form of behavioural modification based on the concept that behaviour operates on the environment and is maintained by its consequences.MethodsFour residential departments for brain injured patients introduced the ABC method sequentially as healthcare innovation using a stepped-wedge design. A systematic process evaluation of the implementation was carried out using the framework of Saunders et al. Descriptive statistics were used to analyse the quantitative data; open questions were clustered.ResultsThe training of the ABC method was well executed and the nursing staff was enthusiastic and sufficiently involved. Important aspects for successful implementation had been addressed (like a detailed implementation plan and implementation meetings). However, facilitators and barriers that were noted were not addressed in a timely manner. This negatively influenced the extent to which the ABC method could be properly learned, implemented, and applied in the short and long term.ConclusionsThe most challenging part of the introduction of this new trained and introduced method in health care was clearly the implementation. To have a successful implementation serious attention is needed to tailor-made evidence-based implementation strategies based on facilitators and barriers that are identified during the implementation process. Bottlenecks in working with the ABC method have to be addressed as soon as possible. This likely requires ‘champions’ who are trained for the job, next to an organisation’s management that facilitates the multidisciplinary teams and provides clarity about policy and agreements regarding the training and implementation of the new method. The current process evaluation and the recommendations may serve as an example for the implementation of new methods in other healthcare organisations.

Promotion of a social prescribing pathway to general practitioners in a rural area (a feasibility study protocol)

PurposePsychosocial problems, including social isolation and loneliness, are prevalent in rural communities and can impact the use of health services and health outcomes. Current approaches to managing patients with predominantly psychosocial issues may not be the most appropriate. Social prescribing (SP) is a relatively new way of linking patients with sources of non-medical support within the community. Emerging literature suggests that community-based, non-medical activities are an effective and preferred approach to managing psychosocial problems. However, there is little evidence describing the attitudes of general practitioners (GPs) towards formal SP pathways.Design/methodology/approachThis research will occur in a general practice in a rural area of Tasmania, Australia. The project will deliver an education module to rural GPs to highlight the benefits of SP and provide a streamlined pathway for referring patients to community support hubs. Existing community organisations will act as “link workers” to connect patients with suitable community activities. GPs will complete a baseline and follow-up survey to measure their perception of SP and the acceptability, feasibility and appropriateness of such an intervention.FindingsThe acceptability, feasibility and appropriateness of the pathway will be assessed using published measures. Free-text responses to open-ended questions will be used to complement the quantitative data. A hybrid effectiveness-implementation method will be used to gather information about the rate of uptake and quality of the SP referral process and identify barriers and facilitators of the process in a real-world setting.Research limitations/implicationsWhile qualitative data for SP programmes is predominantly positive, quantitative data is lacking. Although the planned project is relatively short, it will provide a basis for future SP programme implementation and guide the approach to data collection and implementation assessment.Social implicationsThe barriers to and facilitators of introducing a SP programme in a rural general practice setting may be used to guide the development and implementation of future large-scale SP interventions. This research is both timely and relevant as the problem of social isolation and loneliness, especially in rural areas of Australia, is becoming more well-recognised as a driver of poor health and unnecessary health service usage.Originality/valueUsing SP to address psychosocial risks may reduce healthcare burden and costs. Few SP programmes have been delivered and formally assessed in Australia, and the best way to implement SP locally remains unclear. By delivering a SP intervention in a rural setting and assessing GPs’ responses, future SP projects will be better able to design and integrate social and medical care services.

Patient-oriented optimization of the quality of care in aspecialized outpatient clinic in atertiary rheumatology center : Aqualitative study

The adaptation of structures and processes in treatment procedures can contribute to increasing patient satisfaction and is the focus of patient-oriented quality assurance. To identify patient satisfaction as well as needs, expectations and preferences with respect to care and, based on this, to formulate recommendations for action to optimize the quality of care at alarge tertiary rheumatology center. As part of aqualitative research approach, semi-structured patient interviews and afocus group interview consisting of physicians in rheumatology training in outpatient specialist care were conducted. The quality dimensions of Donabedian were recorded. The data material was evaluated and analyzed using the content-structuring qualitative content analysis according to Kuckartz with the MAXQDA evaluation software. Using 12patient interviews and afocus group of 3future rheumatologists, recommendations for action to optimize the quality of care were derived on the basis of the structural, process and outcome quality. There was aneed for optimization in the areas of personnel management, internal practice processes, practice equipment and treatment processes in the outpatient clinic. The results from the patient interviews and the focus group revealed the aspects in need of optimization. The methodology and results of this study can serve as areference point for analyses of other rheumatology clinics in order to improve the quality of care within the framework of patient-oriented quality management and continuous further development.

Failure Mechanism of Rear Drive Shaft in a Modified Pickup Truck

This paper investigates the failure mechanism of the rear drive shaft in a modified pickup truck which had operated for about 3000 km. The investigation included macroscopic and microscopic evaluation to document the morphologies of the fracture surface, measurement of the material composition, metallographic preparation and examination, mechanical testing, and finite element modelling and calculations. The results obtained suggest that rotation-bending fatigue was the primary cause of the drive shaft failure. The crack initiation is located in the root of the machined threads on the drive shaft surface and expanded along the side of the machining line surface. The main cause of fatigue cracks is attributable to a high stress concentration owing to a large unilateral bending impact under overload. Meanwhile, the bidirectional torsional force also produces a higher stress concentration and thus accelerates the fatigue crack to expand radially along the surface. Furthermore, the hardness of the central section of the drive shaft was marginally below standard. This deficiency results in harm to the bearings and other mechanical components, as well as expediting the enlargement of cracks. Finite element analysis revealed significant contact stress between the bearing and drive shaft, with stress levels exceeding the fatigue limit stress of the parent material. This highlights the need for reevaluation of the heat treatment process and vehicle loading quality to enhance the drive shaft’s longevity.

Process Capability Evaluation Using Capability Indices as a Part of Statistical Process Control

This study aims to highlight the importance of a systematic approach to process capability assessment and the importance of following a sequence of steps. Statistical process control provides several different ways of assessing process capability. This study evaluates the process capability of crown cap manufacturing through capability indices. In addition to calculating the indices, the evaluation involves extensive data analysis. Before calculating the capability indices, the assumptions for their correct selection and use were also verified. Several statistical tests were used to verify each assumption. The research value of the study lies in pointing out that not all tests led to the same conclusions. It highlights the importance of selecting the appropriate test type for the evaluated process quality characteristics.

Design of Web-based Report Card Processing Information System at MTS Negeri 4 Kebumen

Based on observations made, the processing of report card scores in MTs N 4 Kebumen is currently still manual, so a lot of time and energy is needed to carry out the task. In addition, the distribution of report cards is also still conventional because parents must come to school to take them, for this reason, a report card application is needed that can improve services to students quickly in terms of distributing report card scores while making it easier for teachers to fill in report cards. The purpose of this study is to design a web-based value processing application. In designing this application, the author uses the stages of SDLC development with the Waterfall process model. The design of this web-based report card processing information system can improve the quality of report card processing in MTs N 4 Kebumen. The programming language that the author uses is PHP and uses a MySQL database. To test the feasibility of the system, the authors used blak bock testing. The final result of this research is the creation of a web-based MTs N 4 Kebumen report card application.

Penggunaan Video Comment dalam Meningkatkan Minat Belajar Peserta Didik Mapel PAI di SDN 4 Mrayan Ngrayun Ponorogo Tahun Pelajaran 2023/2024

This Classroom Action Research (CAR) aims to explore the effectiveness of using Video Comment as a learning medium in enhancing students' interest in Islamic Education subject at SDN 4 Mrayan Ngrayun Ponorogo for the academic year 2023/2024. Recognizing the need for innovation in the learning process dynamics, this study identifies that students' learning interest can be a crucial indicator in achieving an effective and efficient learning process. Implemented in three cycles, this research collected data through observation, interviews, and document analysis to assess changes in students' learning interest since the implementation of Video Comment. The findings indicate a significant increase in students' learning interest from the pre-cycle with a learning interest of 36%, rising to 61% in cycle I, 69% in cycle II, and reaching an average of 78% in cycle III. This increase signifies that the integration of Video Comment in the learning process contributes positively to enhancing students' learning interest. Further analysis reveals that Video Comment successfully provides engaging and interactive content that facilitates students' involvement in the learning material. Moreover, the study identifies supporting and inhibiting factors in the use of Video Comment, where 94% of students showed an increase in learning interest as a direct result of this innovative learning process. The conclusion of this study underscores the importance of using innovative learning media, such as Video Comment, in boosting students' learning interest. The practical implications of this research offer insights for educators to integrate relevant learning technologies with modern students' needs, as a strategy to improve the quality of the learning process in today's educational environment.

Identification and Validation of Quantitative Trait Loci Associated with Fruit Puffiness in a Processing Tomato Population

Physiological disorders impact the yield and quality of marketable fruit in tomato. Puffy fruit caused by cavities inside the locule can be problematic for processing and fresh market quality. In this paper, we used a recombinant inbred line (RIL) and three derived processing tomato populations to map and validate quantitative trait loci (QTLs) for fruit puffiness across environments. Binary interval mapping was used for mapping the incidence of fruit puffiness, and non-parametric interval mapping and parametric composite interval mapping were used for mapping severity. Marker–trait regressions were carried out to validate putative QTLs in subsequent crosses. QTLs were detected on chromosome (Chr) 1, 2, and 4. Only the QTL on Chr 1 was validated in progeny from subsequent crosses. This QTL explained up to 22.5% of the variance in the percentage of puffy fruit, with a significant interaction between loci on Chr 2 and 4, increasing the percentage of puffy fruit by an additional 15%. The allele responsible for puffy fruit on Chr 1 was inherited from parent FG02-188 and was dominant towards increased incidence and severity. Marker-assisted selection (MAS) for the QTL on Chr 1 was as efficient as genomic selection (GS) in reducing the incidence and severity of puffy fruit, despite the potential contribution of other loci.

Knowing the spectral directional emissivity of 316L and AlSi10Mg PBF-LB/M surfaces: gamechanger for quantitative in situ monitoring

AbstractFor a deep process understanding of the laser powder bed fusion process (PBF-LB/M), recording of the occurring surface temperatures is of utmost interest and would help to pave the way for reliable process monitoring and quality assurance. A notable number of approaches for in-process monitoring of the PBF-LB/M process focus on the monitoring of thermal process signatures. However, due to the elaborate calibration effort and the lack of knowledge about the occurring spectral directional emissivity $${{\varepsilon }^{\prime}}_{\lambda }$$ ε ′ λ , only a few approaches attempt to measure real temperatures. In this study, to gain initial insights into $${{\varepsilon }^{\prime}}_{\lambda }$$ ε ′ λ occurring in the PBF-LB/M process, measurements on PBF-LB/M specimens and metal powder specimens were performed for higher temperatures up to T = 1290 °C by means of the emissivity measurement apparatus (EMMA) of the Center for Applied Energy Research (CAE, Wuerzburg, Germany). Also, measurements at ambient temperatures were performed with a suitable measurement setup. Two different materials—stainless steel 316L and aluminum AlSi10Mg—were examined. The investigated wavelength λ ranges from the visible range ($${\lambda }_{VIS}$$ λ VIS = 0.40–0.75 µm) up to the infrared, λ = 20 µm. The influence of the following factors were investigated: azimuth angle φ, specimen temperature TS, surface texture as for PBF-LB/M surfaces with different scan angles α, and powder surfaces with different layer thicknesses $$t$$ t .

Applying Digital Technology Opportunities to Education System of Azerbaijan

One of the areas in which the development of information and communication technologies (ICT) has made the greatest contribution is education. The introduction of new technology in education increases the quality of the educational process and creates conditions for the adoption of ICT by the younger generation. Modern technology opportunities have changed education process. It has opened new ways to a massive amount of information through online books, podcasts, images, and videos. Some years ago technology was only used for completing assignments. But nowadays it is used for various aims, from learning to communicating and collaborating. Technology has also opened up numerous opportunities for communication and collaboration. For instance, students in a classroom in rural part of the world can learn from an article published by a other developed countries. Students can communicate through email and even have a lecture, or class virtually via video conference. Furthermore, technology has changed the role of teachers and students. Traditionally, teachers were the centre figure of the learning process, and it was called teacher-centered model. However, with the digital technology sources, information is accessible to everyone, and it gives us more chances for student-centered learning model. In this case the role of teachers is as a guide, and students try to search, to analyze the materials themselves. Of course, the State Program implemented by the Ministry of Education regarding the electronicization of education has created a serious change in this field. During the implementation of the program, modern technological tools were installed in many schools from the capital to the regions. There is no such school that does not have a computer room for the use of students, and does not have an Internet network installed. In most of the capital's schools, the high stage of the electronicization of the educational process has begun. The main purpose of the study is to search literature materials and policy papers about this topic and making description. Keywords: modern education system, digital technology, ITE-Innovative technologies in Education.

Accelerating editorial processes in scientific journals: Leveraging AI for rapid manuscript review

IntroductionArtificial intelligence (AI) integration in business is increasingly recognized for enhancing productivity and efficiency. AI automates routine tasks and accelerates decision-making processes, optimizing operations and data analysis. This paper discusses the emergence of AI chat assistants in various sectors, focusing on models like GPT-3, Watson Assistant, Dialogflow, Alexa, Siri, Cortana, and Google Bard. These AI chat assistants exemplify the transformative impact of AI technologies in everyday life. Materials and methodsThe study explores AI's role in chatbot development, examining how AI algorithms and machine learning facilitate human-like conversations in diverse industries. The method includes a detailed analysis of AI-powered chatbots' customer service, healthcare, and e-commerce applications. The manuscript also introduces an AI-assisted peer review methodology, employing ChatGPT to analyze and comment on scientific manuscripts, aiming to enhance the efficiency and quality of the academic review process. ResultsThe AI-assisted review of selected manuscripts demonstrates the potential of ChatGPT in providing insightful feedback and suggestions. The study showcases how AI can contribute to improved manuscript quality, increased efficiency in review processes, and enhanced accessibility. The results highlight the importance of addressing ethical considerations, including privacy and bias, in deploying AI technologies. ConclusionsThis research illustrates the significant role of AI in revolutionizing business processes and academic practices. AI chat assistants and AI-assisted peer review methodologies represent pivotal advancements in their respective fields. The study underscores the need for continuous evaluation of the ethical implications of AI technologies to ensure their responsible and equitable use.

Application of Endoscopic Submucosal Dissection (ESD) in Treatment of Gastrointestinal Lesions-Single Center Experience.

Background and Objectives: Endoscopic resection of gastrointestinal (GI) tract lesions, originating from Japan, is becoming more frequently used in European countries. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) ensure minimally invasive removal of benign, premalignant, and early neoplastic tumors of esophagus, stomach, and intestine in selected group of patients. Aim of this study was to determine the outcomes, radical resection rate (R0), and complication rate of ESD procedures performed in our department. Methods: The data from 100 ESD procedures of esophageal, gastric, duodenal, and colorectal lesions performed in out unit between 02.01.2020 and 30.06.2023 were collected and analyzed retrospectively. Results: A total of 42 male and 58 female patients in the median age of 64 years (range, 31-89 years) underwent ESD. Mean duration of the procedure was 66 minutes (ranging 25-185 minutes). Tumors were located in the esophagus in 8 cases (8%), stomach in 25 cases (25%), duodenum in 1 case (1%), and colon in 66 cases (66%). Radical resection was achieved in 98 cases (98%); 2 patients were qualified for surgical treatment. Average size of dissection lesions was 26 × 19 mm. The biggest one was 60 × 60 mm (sigmoid adenoma), and the smallest one was 5 × 5 mm (gastrointestinal neuroectodermal tumors). Complication occurred in 10 patients (10%)-9 perforations of the wall of intestine (9%) and 1 hemorrhage, which required endoscopic intervention (1%). Conclusions: Implementation of ESD to clinical practice gives the opportunity for minimally invasive, radical treatment of benign, premalignant, and early neoplastic lesions of gastrointestinal tract in selected group of patients. Experienced endoscopists, following current guidelines and standardized process of qualification, are crucial to minimize the risk of severe complications.

STRATEGIES TO MITIGATE THE IMPACT OF POST-COVID-19 SYNDROME ON HIGHER EDUCATION QUALITY

The SARS-CoV-2 pandemic has left a profound impact not only on the physical health of humanity but also on neurological, social, and ecological well-being. Neurological and psychological disorders resulting from the pandemic have negatively affected the quality of learning and significantly worsened learning outcomes among students in higher education institutions. The purpose of this study is to compare the prevalence and evaluate the symptoms of post-COVID syndrome, and to identify their impact on the quality of education among senior students in two higher educational institutions: Poltava State Medical University and Poltava National Pedagogical University named after V.G. Korolenko. It has been observed that damage to the nervous system and the simultaneous appearance of a combination of symptoms including headache, memory impairment, insomnia, anxiety, unmotivated weakness, and excessive fatigue are significantly high among students of both universities. The aforementioned complaints, along with the need for increased time to complete educational tasks post-illness, memory impairment, and sleep disturbances, indicate that the academic performance, psychological state, and psychosomatic background of students are at a low level. Therefore, it is essential to develop recommendations for cognitive rehabilitation tailored to this group of students, considering their significant educational workload (samples were collected from senior students). Moreover, the low and moderate physical activity levels of senior students in higher education may exacerbate symptoms of post-COVID-19 syndrome, necessitating the development of recommendations for physical rehabilitation. Students experiencing weakness, increased fatigue, reduced work capacity, sleep disturbances, and mood instability should consider reviewing the organization of the educational process, especially in distance learning conditions, and making lifestyle changes accordingly. Therefore, thoroughly elaborated healthcare recommendations and rehabilitation measures to enhance the quality of the educational process should be implemented into healthcare practice.

THE ROLE OF LESSON PLANNING AND DESIGN IN THE LEARNING PROCESS

This paper conducts an analysis of e-library publications focusing on the keyword "lesson planning". Through a comprehensive review of relevant literature, the study identifies key advantages associated with lesson planning and underscores its pivotal role in enhancing the quality of the educational process. The findings not only shed light on the overall impact of lesson planning but also provide valuable insights into the nuances that contribute to its effectiveness. Furthermore, the paper offers practical strategies tailored for future educators to optimize their lesson planning endeavors. Drawing upon the insights gleaned from the literature, the suggested approaches aim to empower prospective teachers in crafting detailed and innovative lesson plans. Emphasizing the significance of these strategies, the paper demonstrates their potential to facilitate active student engagement, improve learning outcomes, and maintain classroom discipline. In essence, this analysis serves as a valuable contribution to the field of educational research, offering actionable recommendations for both current teaching practices and the preparation of aspiring educators. The synthesis of literature and practical insights creates a resource that can inform pedagogical strategies and foster continuous improvement in lesson planning methodologies.

Digital citizen participation in policy conflict and concord: Evaluation of a web‐based planning tool for railroad infrastructure

AbstractInfrastructure siting has been shown to lead to high contestation across political systems. To counteract this, policymaking has introduced participatory instruments that were recently supplemented by web‐based tools. Drawing on theoretical perspectives on policy conflict, this paper investigates how different conflict intensities reflected in public discourses can shape citizens' perceptions on the potential and limitations of digital participation tools. To this end, we conducted a survey experiment with students who evaluated the potential functions of a web‐based tool considering criteria, such as transparency, efficiency, and inclusion of new expertise. Participants were randomly assigned fictitious project descriptions that used either conflict or concord words. The results show that while users see several positive influences of digital tools on increased transparency and inclusivity in participation processes, this perception is negatively influenced by a supposedly high level of conflict. Furthermore, digital public participation in railroad planning is perceived as contributing to decreasing escalation and strengthening the democratic quality of policy processes. However, digital participation can only develop its strengths if there are accompanying measures and discourses to secure trust. In addition, the tool's potential seems to be higher in less escalated conflict situations and fully escalated situations than in asymmetrically escalated conflicts.

A lightweight sensor ontology for supporting sensor selection, deployment, and data processing in forming processes

AbstractIn the era of smart manufacturing, modern manufacturing systems face high demands for enhancing process performance and reducing machine downtime. Sensors and process data are essential for successfully implementing data-driven approaches to guarantee robust and reliable process monitoring, tool conditioning, or quality assurance. However, the accuracy and performance of such approaches are highly dependent on the quality of the gathered sensor data and influenced by the implemented data acquisition and processing methods. For this purpose, this work proposes a lightweight sensor ontology to provide a comprehensive overview to characterize underlying relationships between the physical environment and the quality of the data sets. The extended sensor ontology, in combination with domain knowledge, aims to support engineers in fully exploiting the potential of sensor data to obtain trustworthy data sets in forming technologies. As a result, this approach can improve the implementation of automated and data-driven process monitoring of forming systems and tools.

Association between hospital ownership and patient selection, management, and outcomes after carotid endarterectomy or carotid artery stenting

BackgroundThis study analyses the association between hospital ownership and patient selection, treatment, and outcome of carotid endarterectomy (CEA) or carotid artery stenting (CAS).MethodsThe analysis is based on the Bavarian subset of the nationwide German statutory quality assurance database. All patients receiving CEA or CAS for carotid artery stenosis between 2014 and 2018 were included. Hospitals were subdivided into four groups: university hospitals, public hospitals, hospitals owned by charitable organizations, and private hospitals. The primary outcome was any stroke or death until discharge from hospital. Research was funded by Germany’s Federal Joint Committee Innovation Fund (01VSF19016 ISAR-IQ).ResultsIn total, 22,446 patients were included. The majority of patients were treated in public hospitals (62%), followed by private hospitals (17%), university hospitals (16%), and hospitals under charitable ownership (6%). Two thirds of patients were male (68%), and the median age was 72 years. CAS was most often applied in university hospitals (25%) and most rarely used in private hospitals (9%). Compared to university hospitals, patients in private hospitals were more likely asymptomatic (65% vs. 49%). In asymptomatic patients, the risk of stroke or death was 1.3% in university hospitals, 1.5% in public hospitals, 1.0% in hospitals of charitable owners, and 1.2% in private hospitals. In symptomatic patients, these figures were 3.0%, 2.5%, 3.4%, and 1.2% respectively. Univariate analysis revealed no statistically significant differences between hospital groups. In the multivariable analysis, compared to university hospitals, the odds ratio of stroke or death in asymptomatic patients treated by CEA was significantly lower in charitable hospitals (OR 0.19 [95%-CI 0.07–0.56, p = 0.002]) and private hospitals (OR 0.47 [95%-CI 0.23–0.98, p = 0.043]). In symptomatic patients (elective treatment, CEA), patients treated in private or public hospitals showed a significantly lower odds ratio compared to university hospitals (0.36 [95%-CI 0.17–0.72, p = 0.004] and 0.65 [95%-CI 0.42-1.00, p = 0.048], respectively).ConclusionsHospital ownership was related to patient selection and treatment, but not generally to outcomes. The lower risk of stroke or death in the subgroup of electively treated patients in private hospitals might be due to the right timing, the choice of treatment modality or actually to better structural and process quality.

An evaluation of air quality impact prediction performance undertaken as part of environmental impact assessment (EIA) in India

Effective implementation of the Environmental Impact Assessment (EIA) is recognised as a global issue, in particular the impact prediction stage, which is the ‘core’ of EIA. Consisting of four stages: impact identification, impact assessment, significance evaluation, and mitigation measures on the possible environmental repercussions of project developmental activities, the efficacy of impact prediction can define the quality of the EIA process, which will better align environmental decision-making to sustainable development. The weakness of impact prediction in EIA demands more study to enhance practice. Although this is widely explored in the context of developed countries such as the UK, it is particularly concerning in India. A specialised review package built from several sources is utilised to assess the efficacy of air quality impact prediction, based on Lee & Colley (1991). 20 EIA reports of Category A (mega-scale projects causing significant environmental impacts) are reviewed. This study's evaluation indicates that significance evaluation and mitigation actions are the weakest phases and a major concern while assessing air quality studies conducted as a part of EIA. Recommendations to improve the process include prioritising the cumulative impact assessment within the regulatory framework, enhancing capacity building, embedding public participation and instilling accountability among stakeholders, which can be adopted globally. Additional recommendations specifically for India are revising the National Ambient Air Quality Standards (NAAQS), restructuring the EIA review mechanism by EAC and improving mitigation measures by adopting GIS and remote sensing technologies.