Safety Management Research Articles

Clustering in point processes on linear networks using nearest neighbour volumes

This study introduces a novel method specifically designed to detect clusters of points within linear networks. This method extends a classification approach used for point processes in spatial contexts. Unlike traditional methods that operate on planar spaces, our approach adapts to the unique geometric challenges of linear networks, where classical properties of point processes are altered, and intuitive data visualisation becomes more complex. Our method utilises the distribution of the Kth nearest neighbour volumes, extending planar-based clustering techniques to identify regions of increased point density within a network. This approach is particularly effective for distinguishing overlapping Poisson processes within the same linear network. We demonstrate the practical utility of our method through applications to road traffic accident data from two Colombian cities, Bogota and Medellin. Our results reveal distinct clusters of high-density points in road segments where severe traffic accidents (resulting in injuries or fatalities) are most likely to occur, highlighting areas of increased risk. These clusters were primarily located on major arterial roads with high traffic volumes. In contrast, low-density points corresponded to areas with fewer accidents, likely due to lower traffic flow or other mitigating factors. Our findings provide valuable insights for urban planning and road safety management.

Equecabtagene Autoleucel in Patients With Relapsed or Refractory Multiple Myeloma

ImportanceEquecabtagene autoleucel (eque-cel), a fully human-derived B-cell maturation antigen-targeting chimeric antigen receptor (CAR) T-cell therapy, has exhibited potential for the treatment of relapsed or refractory multiple myeloma (RRMM), and further investigation in a larger cohort is necessary.ObjectiveTo evaluate whether eque-cel can benefit patients with RRMM and determine the overall response rate postinfusion.Design, Setting, and ParticipantsThe FUMANBA-1 trial was a single-arm, open-label, phase 1b/2 trial that evaluated eque-cel in adult patients with RRMM. Enrollment began in April 2020, and patients who received eque-cel will be monitored for a minimum of 15 years following the infusion. As of September 2022, patients with heavily pretreated RRMM who received at least 3 prior courses of therapy from 14 centers were enrolled. Data were analyzed from April 2020 to September 2022.InterventionsPatients received a single infusion of eque-cel at 1.0 × 106 CAR-positive T cells/kg after the lymphodepletion.Main Outcomes and MeasuresEfficacy was the primary objective, and safety, pharmacokinetics, and pharmacodynamics were secondary objectives.ResultsOf 103 patients who received an eque-cel infusion, 55 (53.4%) were male, and the median (range) age was 58 (39-70) years. A total of 101 patients were evaluable for efficacy. At a median (range) follow-up of 13.8 (0.4-27.2) months, the overall response rate was 96.0% (97 of 101), with 74.3% (75 of 103) achieving a complete response or better. Among the 12 patients who had prior CAR T-cell treatment, 75% (9 of 12) achieved a response. The median progression-free survival was not reached, with a 12-month progression-free survival rate of 78.8% (95% CI, 68.6-86.0). A total of 96 patients (95.0%) achieved minimal residual disease negativity at a sensitivity threshold of 10−5. Adverse events were favorable: 96 of 103 patients (93.2%) experienced cytokine release syndrome (grade 1 to 2 in 95 patients [92.3%]) and 2 (1.9%) experienced immune effector cell–associated neurotoxicity syndrome (grade 1 to 2). All cases of immune effector cell–associated neurotoxicity syndrome and 94 of 96 cases of cytokine release syndrome resolved with treatment. Additionally, only 20 patients (19.4%) developed antidrug antibodies. Cellular kinetic analysis confirmed CAR-positive T cells in all patients, with the longest duration at 735 days.Conclusions and RelevanceIn this trial, eque-cel led to early, deep, and durable responses in patients with heavily pretreated RRMM with a manageable safety profile. Patients with prior CAR T-cell therapy also benefitted from eque-cel.Trial RegistrationChinese Clinical Trial Registry Identifier: ChiCTR2000033946

Construction Safety Management: Analyzing the Effectiveness of Safety Training Programs on Job Sites

Occupational injuries and fatalities at work are a worldwide problem, particularly in the construction industry. With technological progression, construction sites are still extremely high risk environments where workers put themselves at the mercy of many hazards. They have emerged as a critical part of reducing these risks and the safety of the workers. In this paper, I examine in detail the effectiveness of safety training programs in controlling job site hazards with an emphasis on accident reduction, behavioral changes, and safety culture. The paper looks at different types of training programs, the conventional classroom-based instruction, on the job training and innovative programmes such as virtual reality (VR) and simulation based training programmes. The paper also discusses the challenges, including language barriers and the need for site specific training, and suggests approaches for enhancing safety training practice to encourage a good safety culture among construction practitioners. Keywords Construction Safety, Job Site Hazards, Safety Training, Accident Prevention, Worker Behavior, Safety Compliance, Risk Management, OSHA Standards, Safety Management Systems, Safety Culture.

Evaluation of success factors of occupational health and safety management systems with the analytical hierarchy process: the case of ground handling companies in Turkey

Ground handling companies (GHCs) have the highest potential for occupational accidents in the air transportation sector. Understanding the success factors of occupational health and safety management systems (OHSMSs) implemented by GHCs ensures effective and efficient use of resources. Knowing the relative importance of success factors will enable companies to focus their energies on the most important factors. The analytic hierarchy process was used to determine the relative importance of success factors. The data of the study were obtained through a questionnaire survey of participants working as occupational safety and health (OSH) managers in GHCs operating in Turkey. According to the results of the study, the most critical success factor is ‘top management support’, followed by ‘positive safety culture’. The differentiating result of the research from the literature is that ‘OSH professionals’ ranks third as an important success factor. Other success factors include ‘OHSMS practices’, ‘stakeholder attitudes and characteristics’ and ‘regulations’.

Consumer self-protection behavior of online meal safety during the COVID-19 pandemic: the impact of risk perception and effect of satisfaction with management safety performance

PurposeThis study aims to assess the effects of risk perception and management subject satisfaction on consumers' online meal food safety self-protection behavior during the COVID-19 pandemic.Design/methodology/approachThis study uses 742 questionnaires collected via a two-stage online survey conducted during the COVID-19 pandemic, between December 2021 and January 2022. The entropy method, descriptive statistics, ordered logit model, stepwise regression models, interaction terms and decentralization method were used in the quantitative analysis. Respondents’ written responses to self-protection behavior were categorized into five groups.FindingsLess than half of consumers were aware that online food products carry the risk of SARS-COV-2 (44.48%). Between 30 and 40% of consumers took insufficient or no self-protection measures. Risk perception significantly and positively affected self-protection behavior during the COVID-19 pandemic. Consumers' management subject satisfaction has a positive moderating effect on risk perception, with the moderating effect of the satisfaction of online retailers being significant at the 5% level. Risk perception significantly and positively influences consumer self-protection behavior in provinces not affected by the pandemic.Originality/valueThe findings stress the benefits of synergistic interventions by consumers and management subject to food safety measures and the inclusion of tailored interventions during events threatening public health to effectively address food safety. The study offers valuable insights contributing to the improvement of public health outcomes, customer trust and service quality within the online food delivery industry.

Efficacy, safety, and biomarker analysis of TACE combined with lenvatinib plus sintilimab in unresectable hepatocellular carcinoma: a real-world study

BackgroundThe integration of transarterial chemoembolization (TACE) with systemic therapy has demonstrated improved survival outcomes in patients with unresectable hepatocellular carcinoma (HCC). However, there is limited evidence evaluating the combination of TACE with the systemic regimen of anti-PD-1/L1 inhibitor plus lenvatinib. This study aims to assess the efficacy and safety of TACE combined with lenvatinib and sintilimab in unresectable HCC patients.MethodsUnresectable HCC patients who received TACE in combination with sintilimab plus Lenvatinib as first-line treatment from 1 January 2020 to 31 March 2023 were included for the analysis. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) were evaluated by modified Response Evaluation Criteria in Solid Tumors criteria. Exploratory biomarker analysis was conducted.ResultsThe study included 70 patients with unresectable HCC, predominantly male and infected with Hepatitis B. The median follow-up duration for the whole cohort was 13.8 months (95% CI 11.08–16.7). The ORR was 61.4% (95% CI, 49.0%–72.8%) and the DCR was 68.6% (95%CI, 56.4%–79.2%). The median PFS was 13.2 months (95% CI 11.0-NA), with a corresponding 1-year PFS rate of 50.3% (95% CI 39.7%-65.5%). The median OS was not reached, and the 1-year OS rate was 89.3% (95% CI 81.4%–97.9%). The most common treatment-related adverse events (TRAEs) were fatigue 38.6% (27/70), hypertension 32.9% (23/70), and hand-foot syndrome 31.4% (22/70). Most TRAEs were mild-to-moderate and manageable. In addition, significant predictive value was found in alpha-fetoprotein levels (AFP), with patients showing a level of decrease post-treatment having better PFS.ConclusionThe combination regimen demonstrated promising efficacy in treating unresectable HCC, accompanied by manageable safety profiles. Furthermore, the results of this investigation suggest that AFP holds promise as predictive biomarkers for this treatment strategy.

Uncertainty analysis of digital twin model of mine ventilation system

The digital twin model of mine ventilation system (DTMVS) plays an important role in intelligent safety management. However, the uncertainty of the ventilation resistance coefficient, which is the core parameter of the model, makes it challenging to accurately construct a DTMVS. In this study, Latin Hypercube Sampling (LHS) and ventilation resistance coefficient estimation models (VRCEMs) are used to analyze the uncertainty. First, the LHS method was used to explore the effect of uncertainty in the simulated airflow by continuously increasing the level of uncertainty in the ventilation resistance coefficients. Subsequently, the ventilation resistance coefficients were estimated using the VRCEMs, and the uncertainty of the ventilation resistance coefficient and the simulated airflow was analyzed. The results showed that the ventilation resistance coefficients with a 5% coefficient of variation can cause the DTMVS to lose 34% of the real airflow data points. The degree of uncertainty in the ventilation resistance coefficients estimated by the VRCEM-GA (VRCEM using genetic algorithm) and VRCEM-DE (VRCEM using differential evolution algorithm) methods was enhanced by 27.4% and 4.4%, respectively, compared with VRCEM-ES (VRCEM using evolutionary strategy algorithm). The VRCEM-ES model had the least influence on the uncertainty of the simulated airflow of DTMVS. The simulated airflow of the DTMVS constructed based on VRCEMs fluctuated normally within the confidence interval. VRCEMs had a higher sensitivity to the ventilation resistance coefficients of branches with low coefficients of variation.

Vulnerability Comparisons of Various Complex Urban Metro Networks Under Multiple Failure Scenarios

Urban metro networks, characterized by their complex systems of interdependent components, are susceptible to a wide range of operational disturbances and threats. Such disruptions can cascade through the system, leading to service delays, operational inefficiencies, and substantial economic losses. Consequently, assessing and understanding network vulnerabilities have become crucial to ensuring resilient metro operations. While many studies focus on single-failure scenarios, comparative vulnerability analyses of various urban metro networks under multiple or simultaneous failures remain limited. To address this gap, our study introduces a comprehensive analytical framework comprising three key components: quantitative indices operating at both network and node levels, methodological approaches to assess the importance of network components (nodes, edges, and lines), and systematic protocols for evaluating vulnerabilities across multiple failure scenarios (stations, tunnels, lines, and areas). A comparative analysis of the Shenzhen Metro Network (SZMN) and the Zhengzhou Metro Network (ZZMN) validates the proposed methods. The results indicate that the SZMN demonstrates higher connectivity and accessibility than the ZZMN, despite a lower network density. Both networks are disassortative and heterogeneous, with edges connecting multiline transfer stations showing significantly higher edge betweenness centrality compared to those connecting general stations. In the SZMN, 6.63% of node failures and 4.74% of tunnel failures exceed a vulnerability threshold of 0.03, compared to 13.74% and 11.27% in the ZZMN. Failures across different lines and areas yield varying impacts on network performance and vulnerability. This study provides essential theoretical and practical insights, helping metro safety managers identify vulnerable points and strengthen the sustainable development of urban metro systems.

Evolution of treatment strategies for solid tumors with RET rearrangement in China and real-world treatment status of Non-small Cell Lung Cancer (NSCLC)

ObjectiveThe present study endeavors to furnish an exhaustive review of the research advancements on solid tumors harboring RET rearrangement within the Chinese context, particularly emphasizing the examination of real-world therapeutic strategies and clinical outcomes observed in individuals diagnosed with advanced non-small cell lung cancer (NSCLC). The review delves into a critical assessment of the therapeutic efficacy of targeted RET inhibitors, while also scrutinizing the diverse array of treatment modalities employed in the Chinese patient population.MethodsThe study conducted a comprehensive review of the advancements made by Chinese scholars in the realm of RET driver genes. It delved into the analysis of the incidence of RET rearrangements in solid tumors, alongside an examination of the varied treatment paradigms and their current status within China. Utilizing the RECIST 1.1 criteria, the study evaluated the therapeutic efficacy achieved in RET-positive NSCLC patients undergoing diverse treatment modalities. Furthermore, treatment-related adverse events (TRAEs) were meticulously graded following the Common Terminology Criteria for Adverse Events (CTCAE).ResultsA retrospective, multi-center, real-world analysis was conducted, encompassing 64 patients diagnosed with pathologically confirmed RET rearrangement advanced non-small cell lung cancer (NSCLC) between December 2015 and November 2023. Notably, KIF5B-RET emerged as the most prevalent RET fusion partner, accounting for 59.4% of cases. Therapeutic interventions among these patients included specific targeted inhibitors such as Pralsetinib (48.4%), chemotherapy (34.3%), multi-target inhibitors (15.6%), and one case (1.6%) involving immunotherapy combined with anti-angiogenic therapy. In terms of progression-free survival (PFS), Pralsetinib monotherapy demonstrated a median PFS of 16.03 months, outperforming chemotherapy (2.87 months; p < 0.0001), chemotherapy combined with anti-angiogenic therapy (6.90 months; p = 0.048), and multi-target inhibitors (2.50 months; p < 0.0001). Furthermore, the one-year and two-year overall survival (OS) rates for Pralsetinib monotherapy were 64.3% and 46.4%, respectively. Regarding safety, 71.0% of patients receiving Pralsetinib experienced at least one adverse event, with 45.2% classified as grade 3–4 in severity. Notably, no fatalities were attributed to adverse events. Common adverse events included hemoglobin reduction (35.5%) and neutropenia (32.3%), indicative of an overall favorable safety profile for Pralsetinib in this patient population.ConclusionThis study encapsulates the research endeavors and treatment advancements of RET rearrangement solid tumors within the Chinese healthcare landscape, specifically highlighting the diverse real-world therapeutic approaches and their effectiveness in managing advanced RET rearrangement NSCLC among Chinese patients. Notably, targeted RET inhibitors like Pralsetinib have emerged as potent therapeutic agents, exhibiting remarkable efficacy and a manageable safety profile in this patient cohort. These findings underscore the potential of Pralsetinib and similar targeted therapies as novel treatment options for individuals with RET fusion-positive NSCLC.

INFORMATION SYSTEM OF STREET LIGHTING CONTROL IN A SMART CITY

Context. In the context of the rapid development of technologies and the implementation of the concept of smart cities, smart lighting becomes a key element of a sustainable and efficient urban environment. The research covers the analysis of aspects of the use of sensors, intelligent lighting control systems with the help of modern information technologies, in particular such as the Internet of Things. The use of such technologies makes it possible to automate the regulation of lighting intensity depending on external conditions, the movement of people or the time of a day. This contributes to the efficient use of electricity and the reduction of emissions into the atmosphere. Objective. The purpose of the paper is to analyze the procedures for creating an information system as a tool for monitoring and evaluating the level of illumination in a smart city with the aim of improving energy efficiency, safety, comfort and effective lighting management. The implementation of a smart lighting system for Lviv will help improve energy efficiency and community safety. Method. A content analysis of scientific publications was carried out, in which the results of research on the creation of street lighting monitoring systems in real urban environments were presented. The collection and analysis of data on street lighting in the city, such as energy consumption, illumination level, lamp operation schedules, and others, was carried out. Machine learning methods were used to analyze data and predict lighting needs. Using the UML methodology, the conceptual model of the street lighting monitoring information system was developed based on the identified needs and requirements. Results. The role of data processing technologies in creating effective lighting management strategies for optimal use of resources and meeting the needs of citizens is highlighted. The study draws attention to the challenges and opportunities of implementing smart lighting in cities, maximizing the positive impact of smart lighting on modern urban environments. The peculiarities of the development and use of an information system for controlling street lighting in a smart city are analyzed. The potential advantages and limitations of using the developed system are determined. Conclusions. The project on the creation of an information system designed to provide an energy-efficient lighting system in a smart city will contribute to increasing security, particularly, ensuring the safety of the community through integration with security systems, reducing energy consumption, through minimizing the electricity usage in periods when the need for lighting is not necessary. It has been determined that to implement an information system for remote monitoring and lighting control in a smart city, it is advisable to consider the possibility of using a complex lighting control system. Calculations were made on the example of Lviv for the city’s lighting needs. The use of motion sensors to determine the need to turn on lighting was analyzed. A conceptual model of the information system was developed using the object-oriented methodology of the UML notation. The main functionality of the information system is defined.

Phase II trial evaluating the long-term efficacy and peripheral sensory neuropathy of capecitabine plus oxaliplatin (XELOX) as adjuvant therapy in Japanese patients with operated stage III colon cancer

Adjuvant oxaliplatin plus capecitabine (XELOX) therapy is recommended for patients with curatively resected colon cancer. However, prospective data on its practical application in Japanese patients are limited. Therefore, we aimed to conduct a long-term clinical evaluation of the efficacy and safety of adjuvant XELOX in patients with curatively resected stage III colon cancer (MCSCO-1024). This prospective, multi-center, open-label, single-arm, phase II study enrolled patients with curatively resected stage III colon cancer. The treatment protocol consisted of a 120-minute intravenous infusion of oxaliplatin (130 mg/m2) on day 1 and two divided doses oral capecitabine (2000 mg/m2/day) for 14 days in a 3-week cycle, totaling eight cycles (24 weeks). The primary endpoint was 3-year disease-free survival (DFS), and the secondary endpoints were 5-year overall survival and long-term prognosis of peripheral sensory neuropathy. A total of 196 patients were enrolled between November 2011 and August 2014 (34 months). The 3-year DFS rate was 73%, and the 5-year overall survival rate was 87%. The overall incidence of peripheral sensory neuropathy was 17%, with a 1% rate of grade 3 neuropathy after 5 years. Adjuvant XELOX demonstrated utility and safety in the clinical management of Japanese patients with stage III colon cancer.

Predicting deterioration in dengue using a low cost wearable for continuous clinical monitoring

Close vital signs monitoring is crucial for the clinical management of patients with dengue. We investigated performance of a non-invasive wearable utilising photoplethysmography (PPG), to provide real-time risk prediction in hospitalised individuals. We performed a prospective observational clinical study in Vietnam between January 2020 and October 2022: 153 patients were included in analyses, providing 1353 h of PPG data. Using a multi-modal transformer approach, 10-min PPG waveform segments and basic clinical data (age, sex, clinical features on admission) were used as features to continuously forecast clinical state 2 h ahead. Prediction of low-risk states (17,939/80,843; 22.1%), defined by NEWS2 and mSOFA < 6, was associated with an area under the precision-recall curve of 0.67 and an area under the receiver operator curve of 0.83. Implementation of such interventions could provide cost-effective triage and clinical care in dengue, offering opportunities for safe ambulatory patient management.

Integrating the Airway Lead structure into a large healthcare system to appraise the landscape of airway management resources

Airway Leads are clinicians who guide safe airway management institutionally and act as liaisons between the evolving airway management landscape and bedside clinicians. Internationally, resources produced by Airway Leads Networks aid clinicians in establishing emergency airway management protocols and making difficult airway equipment decisions. The creation of an Airway Leads Network within the United States' multi-payer healthcare system is ongoing, spearheaded nationally by groups such as the Society for Airway Management. We aimed to build a committee of airway leaders across the Yale New Haven Health system and to leverage this committee to appraise the airway equipment and personnel resources throughout the system. We identified key stakeholders in airway management across the healthcare system and administered a quality improvement survey to members of the assembled committee querying their knowledge of the availability of airway management devices. The dataset was gathered from 14 airway management leaders identified across 4 surgical facilities, 6 emergency departments and 5 medical intensive care units at 8 hospitals and hospital campuses within the Yale New Haven Health system. Equipment available in greater than 75 % of locations included hyperangulated and standard geometry videolaryngoscopes, rigid tracheal tube stylets, tracheal tube introducers, flexible intubation scopes, scalpels and waveform capnography. Equipment available in 25 % to <75 % of locations included emergency invasive airway kits, wheeled airway towers or airway boxes, intubating oral airways, airway exchange and Aintree catheters, intubation-capable supraglottic airways, and awake intubation supplies. Glidescope (Verathon) was the most common videolaryngoscope and flexible intubation scope, and Aura (Teleflex) was the most common intubation-capable supraglottic airway available. The initiative illustrated the feasibility and utility of developing a committee of airway leaders in a large health system. While all locations had access to a requisite array of airway management devices, there was variation in the availability and brand of individual airway equipment.

New criteria for preoperative liver function assessment with safety margins to avoid postoperative mortality during liver resection for hilar cholangiocarcinoma.

BackgroundDespite recent medical advancements, surgery for hilar cholangiocarcinoma is associated with high complication and mortality rates. This may be partly attributed to the absence of established preoperative liver evaluation criteria for safe surgery. This study aimed to propose a reliable indicator for safe and well-planned management of major hepatectomy with extrahepatic bile duct resection. MethodsWe included 150 patients who underwent major hepatectomy with extrahepatic bile duct resection between 2013 and 2021 in Japan. The risk factors for post-hepatectomy liver failure (PHLF) were retrospectively analyzed. ResultsPHLF was observed in 24 (16.0%) patients who underwent major hepatectomy with extrahepatic bile duct resection. In the multivariate analysis, the identified risk factors for PHLF were the ratio of future remnant liver volume to total liver volume (FRLV/TLV) ≤ 42% and indocyanine green clearance fraction of the future remnant liver (ICGK-F) ≤ 0.07. Patients with these two factors were significantly associated with PHLF compared with those with either one or none of the risk factors (60.0% vs 15.1% and 8.1%, respectively). ConclusionsThe combinational use of ICGK-F and FRLV/TLV is useful for preoperative liver function assessment with a safety margin to avoid PHLF and postoperative mortality in hepatectomy for hilar cholangiocarcinoma.

Investigation of battery safety states based on thermal propagation and expansion analysis: Experimental studies on different packaging forms

Lithium-ion batteries are highly susceptible to thermal runaway under harsh conditions, posing significant safety risks for electric vehicles. The differences in thermal runaway propagation across battery systems with varying manufacturing methods (including packaging and internal stacking) and the study of changes in expansion force within battery modules are crucial for improving safety and developing early warning systems for battery systems. This study investigates the thermal runaway and propagation behavior of lithium-ion batteries under various conditions, focusing on state of charge (SOC), internal manufacturing processes (electrode stacking and winding), and packaging types (pouch and prismatic) through a series of novel experiments. The results show that batteries at high SOC levels are at a greater risk of thermal runaway propagation, with winding pouch cells displaying more severe runaway behavior. In contrast, prismatic cells, despite experiencing intense explosions with an equivalent force of up to 42.3 g of TNT, exhibit relatively milder propagation. Furthermore, the study incorporates heat transfer analysis during thermal runaway propagation, identifying key phenomena such as the formation of negative pressure zones before explosions and changes in expansion forces at the module level. Based on these findings, a new safety evaluation method is proposed to assess the risk, hazards, and severity of thermal runaway, offering valuable insights for enhancing battery safety management and fire prevention strategies.

Integrity and Safety Management Challenges of Supercritical CO2 Pipeline Transportation at Offshore Platforms

Integrity and Safety Management Challenges of Supercritical CO2 Pipeline Transportation at Offshore Platforms

Risks Associated with Using Drones in Construction for Safety Management

Risks Associated with Using Drones in Construction for Safety Management

Disseminated Superficial Actinic Porokeratosis: A Systematic Treatment Review.

Disseminated superficial actinic porokeratosis (DSAP) is a disorder of keratinization characterised by small, brown plaques with elevated keratotic rims, typically occurring on sun exposed areas. DSAP poses a risk for malignant transformation, emphasising the need for effective management strategies. The aim of this study was to review the current reported management options for DSAP. This systematic review was based on a comprehensive search of databases (Cochrane, PubMed, Medline, Embase, Emcare, ProQuest, Web of Science, CINAHL) from inception to 15 March 2024. Studies reporting management of DSAP were included irrespective of study design. Of 923 citations, 61 studies were included, predominantly comprising case reports and retrospective case series. A limited number of randomized and open-label trials were identified. Various treatment modalities were reported, including topical and systemic agents, photodynamic therapy, and laser therapy. Multiple management options are available for DSAP, including topical and systemic agents, photodynamic therapy and laser treatments. However, these approaches vary in their balance between efficacy and toxicity. Currently, there is a paucity of high-quality clinical trial data to guide treatment decisions. Further studies are required to determine the most effective and safe management strategies for DSAP. PROSPEROREGISTRATION: CRD42024514558.

The influencing factors of pediatric nurses' perception of patient safety culture and partnership with patients' parents on patient safety nursing activities in South Korea: a descriptive study.

This study aimed to identify the effects of pediatric nurses' perception of patient safety culture and their partnership with patients' parents on pediatric patient safety nursing activities. This descriptive study was conducted over a two-month period, from October to November 2022, utilizing self-reported questionnaires. The study included 165 nurses, each having at least 6 months of working experience in wards where children were admitted. These nurses were selected from 13 pediatric specialty hospitals, general hospitals, and university hospitals across seven regions. The data analysis was performed using the SPSS/WIN 26.0 program (IBM Corp.) for descriptive statistics, t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis. The average scores for awareness of patient safety culture, partnership with patients' parents, and pediatric patient safety nursing activities were 3.37±0.41, 3.94±0.41, and 4.50±0.38, out of 5 points respectively. The factors influencing pediatric patient safety nursing activities were identified as a partnership with patients' parents (β=.41, p<.001). Among hospital-related characteristics, safety management committee (β=.16, p=.029) and safety management regulations (β=.17, p=.016) were also analyzed as factors influencing patient safety nursing activities. These factors accounted for 29.2% of the explanatory power for pediatric patient safety nursing activities. Based on the above study results, we found that to promote safe nursing activities for pediatric patients, developing and implementing training programs that enhance partnerships with patient's parents was imperative, and establishing work regulations and a safety management committee to systematically manage safety management tasks was deemed important.

Optimizing Solar Power Generation and Integration in Automotive Systems Through IoT

Objective: This study presents an Internet of Things (IoT)- based system with edge intelligence that predicts power production with over 98% accuracy and monitors substations and smart solar installations, ensuring reliable power distribution in industrial IoT environments. This system enhances sustainability, safety, and energy management in smart buildings by reducing power fluctuations by 30% and improving decision-making, leading to a 95% reduction in energy management costs. Method: An IoT-enabled power monitoring system was implemented for smart solar panels and substations, incorporating edge intelligence for instantaneous prediction and decision-making. An IoT-enabled solar charging station was deployed for smart homes and Industry 4.0 applications. The cloud was used for analyzing sensor data, with a response time of less than 1 second. Findings: The proposed framework increased the efficiency and reliability of power production and distribution by 25% across commercial, residential, and industrial contexts. It significantly mitigated power fluctuations, reducing downtime by 40% and achieving a 95% cost reduction in energy management compared to traditional systems. IoT integration improved safety and sustainability metrics by 20% in smart buildings. Novelty: The framework integrates edge intelligence with IoT in smart solar systems and substations, providing a sophisticated control system that enhances power distribution decision-making. It facilitates real-time monitoring and prediction of power production with over 98% accuracy, emphasizing sustainability, safety, and energy management improvements of up to 30% in smart buildings. Keywords: IoT-based control system, Smart solar systems, Edge intelligence, Power substations, Load management, Energy sustainability