Similar Factors Research Articles

Concept of Due Care in Medical Law in a Comparative Perspective.

In many European legal systems, the provisions of medical legislative acts impose directly on healthcare professionals an obligation to act with due care. This imperative may be considered a basic principle of practising all medical professions, and even a generally accepted principle of medical law. Due care is the manner of conduct by medical professionals that meets the requirements contained in an objective and external standard of conduct created for each specific obligational relationship. Despite the differences between European legal systems, from a comparative perspective it is possible to notice similar factors taken into account when determining the standards of due care in medicine. This is because the conduct of medical professionals is largely determined by actual state of medical knowledge, medical standards and deontological codes relating to all medical professional activities. The aim of the article is to discuss in detail these issues in comparative perspective.

Prognostic value of isolated tumor cells in sentinel lymph nodes in low risk endometrial cancer: results from an international multi-institutional study

ObjectiveThe prognostic significance of isolated tumor cells (≤0.2 mm) in sentinel lymph nodes (SLNs) of endometrial cancer patients is still unclear. Our aim was to assess the prognostic value of...

Shared and distinct pathways and networks genetically linked to coronary artery disease between human and mouse

Mouse models have been used extensively to study human coronary artery disease (CAD) or atherosclerosis and to test therapeutic targets. However, whether mouse and human share similar genetic factors and pathogenic mechanisms of atherosclerosis has not been thoroughly investigated in a data-driven manner. We conducted a cross-species comparison study to better understand atherosclerosis pathogenesis between species by leveraging multiomics data. Specifically, we compared genetically driven and thus CAD-causal gene networks and pathways, by using human GWAS of CAD from the CARDIoGRAMplusC4D consortium and mouse GWAS of atherosclerosis from the Hybrid Mouse Diversity Panel (HMDP) followed by integration with functional multiomics human (STARNET and GTEx) and mouse (HMDP) databases. We found that mouse and human shared >75% of CAD causal pathways. Based on network topology, we then predicted key regulatory genes for both the shared pathways and species-specific pathways, which were further validated through the use of single cell data and the latest CAD GWAS. In sum, our results should serve as a much-needed guidance for which human CAD-causal pathways can or cannot be further evaluated for novel CAD therapies using mouse models.

Shared and distinct pathways and networks genetically linked to coronary artery disease between human and mouse.

Mouse models have been used extensively to study human coronary artery disease (CAD) or atherosclerosis and to test therapeutic targets. However, whether mouse and human share similar genetic factors and pathogenic mechanisms of atherosclerosis has not been thoroughly investigated in a data-driven manner. We conducted a cross-species comparison study to better understand atherosclerosis pathogenesis between species by leveraging multiomics data. Specifically, we compared genetically driven and thus CAD-causal gene networks and pathways, by using human GWAS of CAD from the CARDIoGRAMplusC4D consortium and mouse GWAS of atherosclerosis from the Hybrid Mouse Diversity Panel (HMDP) followed by integration with functional multiomics human (STARNET and GTEx) and mouse (HMDP) databases. We found that mouse and human shared >75% of CAD causal pathways. Based on network topology, we then predicted key regulatory genes for both the shared pathways and species-specific pathways, which were further validated through the use of single cell data and the latest CAD GWAS. In sum, our results should serve as a much-needed guidance for which human CAD-causal pathways can or cannot be further evaluated for novel CAD therapies using mouse models.

Pelatihan Senam Pencegahan Osteoporosis dan Penyuluhan Kesehatan Gigi Mulut pada Masyarakat Pre dan Lanjut Usia Anggrek 3

Living a healthy life as a senior is the desire of everyone. However, keeping an elderly healthy is not easy. There are many challenges to face, because the elderly are susceptible to a variety of diseases. As you age, your body undergoes many changes or aging processes, and the changes you feel cover the entire limb. Vascular problems such as hypertension and other heart problems are common. Not only that, the elderly are also at risk of suffering from bone diseases such as osteoporosis, which can be dangerous because it can result in bone fractures and inhibit the activity of the elders because they have to lie more. Osteoporosis is often associated with periodontitis, as both are diseases of the bone caused by inflammation and old age. Both osteoporosis and periodontitis have similar risk factors such as smoking, poor nutritional status, age and immune deficiency. Osteoporosis can be prevented by eating foods rich in calcium, avoiding smoking and alcoholic beverages, having regular and regular physical activity, and exposure to sufficient sunlight. Preventing osteoporosis can reduce the risk of periodontitis in the elderly. This community service (PkM) is held for the elderly living in Grand Depok City Depok Residential, West Java. It is hoped that these activities will raise awareness of the elderly in particular, and the general public of the importance of health. It is expected that osteoporosis gymnastics for the elderly can be performed on a regular basis at Posbindu Anggrek 3.

An advanced assessment framework for seismic resilience of railway continuous girder bridge with multiple spans considering 72h golden rescue requirements

Given the common sense that people in danger could survive with high probability in the golden rescue time of 72 h after earthquakes, railway bridges that are important transportation hubs and the lifelines for earthquake relief have been required to satisfy the necessities of safe passage and fast traffic for emergency response personnel in this critical period. To ensure the post-earthquake temporary functionality of the railway bridges to a sufficient safety level in golden rescue scenario, an advanced resilience assessment framework, including seismic resilience determinations for individual bridge components based on residual responses with respect to the plastic capacities originated from performance limit state definitions, definitions of three recovery levels considering repair efficiency for different recovery phases, and the series-parallel and parallel-serial system resilience models developed in temporal and spatial domains, was established. A commonly constructed irregular railway multi-span continuous girder bridge was chosen to verify the practicability of the aforementioned framework. The finite-element model of the illustrative bridge was developed taking abutment-girder interaction effects and nonlinear seismic behaviors of girder into account. Average spectral acceleration was taken as the intensity measure (IM) to consider the response variations originated from higher modes and natural period extension during earthquakes, and the site-matched and IM-based scaled ground records were adopted in the multiple stripe analysis to obtain instantaneous peak and residual seismic responses. Based on the framework, post-event resilience characteristics of bridge components were discussed, four recovery strategies were proposed for bridge system, and the seismic resilience of the illustrated bridge was assessed at system level. The research shows that the response contribution of fundamental dominant mode is only 64.37 %, indicating the dynamic response contributions from higher modes are considerable and the case bridge can show a strong irregularity during seismic events. Obvious nonlinear seismic behaviors occur to the superstructure where material strain in girder critical sections can increase to 0.00422 during earthquakes, which illustrates the inaccuracy of girder modeling only taking elastic behavior into consideration. Also, the prestress loss after earthquakes can reach 31.14 % and attention should be paid to the prestress recovery in subsequent repair works. Most components can satisfy the easy recovery resilience level, and the resilience is closely related to ground intensities and repair-waiting time; earthquake-induced functionality reduction can be 46.57 %, and resilience can increase by 25.35 % if the waiting time is shortened by 5 h. System resilience is influenced by the similar factors with component and varies in cases of different repair sequences due to the accumulation effect of repair-waiting time for various subsystems.

Pazarlamanın “Gümüş Pazarı” Yaşlı Tüketiciler Üzerine Nitel Bir Araştırma

Abstract Rapidly flowing time, changing/transforming world and developing technology challenge us in the vital struggle of humanity. In every period of life, people try to keep up with this process and have to follow many parameters such as the global world and business disciplines. While doing this, one must also manage the troubles and difficulties brought by periods such as infancy, childhood and old age. The importance and size of this market of elderly consumers, which has become very popular in recent years and defined as the "silver market" of marketing, has accelerated with the aging of the world population. In this study; using a semi-structured interview form; through analogous sampling, the purchasing behaviors of a total of 9 elderly consumers aged 60 and over were examined in depth using descriptive and content analysis methods. In this regard, when the general outcomes of the study are considered in three themes; In terms of their purchasing behavior, they go shopping alone once a week, on weekdays and weekends; It has been observed that they do not consult the social circle when purchasing products/services from markets and neighborhood markets via credit card. Comparisons are made in terms of product/service usage, taking into account quality, price and similar factors; Priority is given to reliable brands for food, cleaning and health. In terms of the pandemic period, it has been determined that hygiene-mask causes changes in the shopping environment and shyness/fear. In summary, this study; it is important in the marketing sector to increase the awareness of older consumers about their daily life purchasing behavior and to raise awareness of this consumer group. In addition, they were asked questions within the scope of in-depth interview technique with the qualitative research method and the answers to these questions were interpreted. Keywords: Older consumers, Consumer behavior, Purchasing behavior, Silver market, Qualitative research

Канонический и церковно-административный аспекты спора о прерогативах митрополитов Никеи и Никомидии на Халкидонском соборе

Introduction. On October 30, 451, during the 4th Ecumenical Council in Chalcedon, the dispute between Metropolitan Eunomius of Nicomedia and Metropolitan Anastasius of Nicaea was considered. Eunomius believed that his rights as the metropolitan of the entire province of Bithynia, in regard to ordinations, were violated by Anastasius of Nicaea, who had deposed a number of clerics of the city of Vasilinopolis. Information about this lawsuit is taken from the published acts of the 14th session of the Chalcedon Council. Methods. The work is based on the application of the historical-critical method of data processing of the source text used in the original in Greek according to the standard critical edition and quoted by the author in his own translation. Analysis. Based on the analysis of the act material, the author restores the course, content and internal logic of the conciliar audition of the claim of Eunomius of Nicomedia. It also reveals the cause of the claim, external factors and figures that had influenced the course of the case and become the cause of its occurrence. The factors include the unsettled status of the Metropolitan of Nicaea within the province of Bithynia, the limits of his competence and jurisdiction. Similar factor is the unsettled status of the Metropolitan of Nicomedia as bishop of the provincial capital (metropolis), that lead to a conflict of jurisdictions over the Bithynian city of Vasilinopolis. Decisive is also the influence in Bithynia of the patriarchal see of Constantinople and persons who occupied it, beginning with John Chrysostos. The decision of the Ecumenical Council on this lawsuit turns out to be half-hearted: the city of Vasilinopolis and its clergy are recognized as belonging to the jurisdiction of the Metropolitan of Nicomedia, declared the first Metropolitan of Bithynia, but the question of the subordination of the Metropolitan of Nicaea, recognized as the second, remains open. This is evident from later sources, in which the Metropolitan of Nicaea is designated as an independent ruling metropolitan within the province of Bithynia, with his own district and jurisdiction. Results. The decision of the Ecumenical Council in Chalcedon failed to approve in Bithynia the canonical definition of the Council of Nicaea that there should be only one ruling metropolitan in the province. It is obvious that the decision of the judges was influenced by the ancient tradition of intercity rivalry between Nicaea and Nicomedia, dating back to pre-Christian times. The latter was clearly manifested in the fact that the main argument of the litigants was the recognition of the secular title of metropolis for both cities, confirmed by imperial letters. Thus, the dispute between Nicaea and Nicomedia shows that the decisions of the Ecumenical Councils were embodied in church-political and church-administrative practice in so far as they corresponded, or at least did not contradict the established tradition of socio-political relations.

Clusters of dementia risk factors are distinctively associated with socioeconomic factors

AbstractBackgroundFor effective dementia prevention, the understanding of the local population’s risk profile and its socioeconomic associations is mandatory. Our aim is to explore if there are clusters of dementia risk factors in Chilean adults and if they are associated with different socioeconomic variables.MethodDementia‐free subjects ≥45 years old, from the 2016‐2017 Chilean National Health Survey, were analyzed stratified by sex and age (midlife/ later life), searching for profiles of association of 6 variables that had been related with dementia risk (years of education, systolic blood pressure, body mass index (BMI), alcohol consumption, physical activity, and depressive symptoms).ResultWe found 3 clusters that shared similar risk factors in each sex/age group (Figure 1 Women, Figure 2 Men). There was a cluster with high systolic blood pressure (HSBP) generally associated with high BMI in all sex/age groups; A cluster with depressive symptoms, and a physically inactive cluster in ¾ of sex/age groups. In men later life, in addition there was a cluster with excessive alcohol consumption and in women midlife a low risk profile. The cluster with HSBP alone or with high BMI, had lower years of education and lower family income than the other clusters. In contrast, the physically inactive and the low risk clusters had higher levels of education, while the depressive cluster had variable association with educational levels. The HSBP and the depressive clusters had a high proportion of multimorbidity, with a very high burden of risk factors for dementia.ConclusionThe clusters of health conditions related with dementia risk in Chilean adults that are distinctively associated with socioeconomic variables.

Prevention of childhood overweight and obesity in Mongolia, the Philippines and Vietnam: identifying priority actions.

Low- and middle-income countries are increasingly faced with a triple burden of malnutrition: endemic underweight, micronutrient deficiencies and rising prevalence of overweight. This study aimed to address existing knowledge gaps and to identify priority policy options in Mongolia, the Philippines and Vietnam. A landscape analysis approach was adopted using methods set out in a UNICEF global toolkit. Quantitative and qualitative data were compiled from a range of global and national sources on childhood overweight and obesity, risk factors and policy responses. Key informant interviews and validation workshops were undertaken with key food and nutrition stakeholders from government and non-government organizations to identify priority policy options for the prevention of overweight and obesity among children. Overweight and obesity among children are increasing in all three countries. Associated risk factors are related to maternal nutrition, birthweight, breastfeeding, as well as diets and physical activity shaped by increasingly obesogenic environments. Key informants identified undefined policy approaches, poor community understanding and food and beverage industry influence as barriers to addressing overweight and obesity. Key policy priorities include restricting the marketing of unhealthy food and beverages, unhealthy food and beverage taxation, introduction of front-of-pack nutrition labels and improving school nutrition environments. Mongolia, the Philippines and Vietnam are all facing an increasing burden of childhood overweight and obesity. Despite differing national contexts, similar environmental factors are driving this rise. A suite of evidence-based policies can effectively be introduced to address obesogenic environments.

Morfofunctional and Molecular Changes in Placenta and Peripheral Blood in Preeclampsia and Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) and preeclampsia (PE) are common pregnancy complications with similar risk factors. Although GDM is associated with PE, the exact mechanism underlying the association is unclear. The objective of this work was to study the morphofunctional and molecular changes in the placenta and peripheral blood in PE and GDM. Local and systemic changes in the production of several placental proteins were assessed along with markers of inflammation and metabolic disorders. Expression of placental lactogen, trophoblastic β1-glycoprotein, placental alpha-1-microglobulin, and proteinase 3 in villi was found to change in complicated pregnancy groups. Similarity of underlying pathogenic mechanisms was demonstrated for PE and GDM.

Understanding the temptation to cheat in online exams

Online proctored exams have become a common experience for a significant number of higher education students. The rationale behind employing online surveillance revolves around the belief that these measures are essential for upholding academic integrity. However, discussions on assessment integrity often focus on comparing the motivations, conditions, and values of cheaters and non-cheaters. This binary approach potentially oversimplifies the complex nature of human motivation and behavior (Henderson et al., 2023). Cheating is influenced by a multitude of factors and motivations that can either encourage or discourage such behaviors (Brimble, 2016; Jenkins et al., 2022; Noorbehbahani et al., 2022). Merely comparing the two groups may overlook the intricacies that push students from one category to another. Therefore, this study aims to shed light on an underexplored group: students who were tempted to cheat but chose not to. These students can be viewed in two ways. Firstly, they represent a group at risk of cheating, necessitating research to develop targeted strategies supporting their integrity decisions. Secondly, they exhibit integrity despite the temptation, potentially offering insights into the nuanced 'tipping points' that go beyond existing binary comparisons. This Pecha Kucha reports on a large-scale study conducted within a single institution that explores the implications of online exams and the integrity behaviours and motivations of three groups of students: those who did not cheat and were not tempted to do so, those who did not cheat but who were tempted to cheat, and those who cheated. The data draws on an anonymous and voluntary student survey conducted in both semester 1 and semester 2 of 2022. Institutional research ethics approval was granted. The data comprises 11,333 fully completed surveys and offers interesting, and sometimes counter-intuitive findings which can help guide institutional responses. Broad insights will be offered in the Pecha Kucha presentation. This abstract offers preliminary findings based on ongoing analysis regarding the 28 motivating factors identified by the students that encouraged or discouraged cheating behaviours. Factors that encouraged cheating: Both the tempted and cheated groups identified similar motivating factors, such as the fear of failure and the financial burden of repeating a course. Surprisingly, the students who cheated chose fewer encouraging factors than those who were tempted but did not cheat. The importance of these motivations was similar for both groups. Factors that discouraged cheating: Regarding factors that discouraged cheating, all three groups (not tempted, tempted, and cheated) were asked their opinions. The non-cheating group listed more reasons and considered them more significant compared to the other two groups. The tempted group selected fewer reasons than the non-tempted group but more than the cheated group. However, the tempted and cheated groups rated the importance of these factors similarly. The Pecha Kucha will expand on the above and comment on some of these somewhat counterintuitive results.

Driving factors to agriculture total factor productivity and its contribution to just energy transition

This study explores the intricate relationship between agricultural productivity and the pursuit of a just energy transition in China. As the world's largest emitter of greenhouse gases and a nation grappling with environmental degradation and socio-economic disparities, China faces the imperative to transition toward a more sustainable and equitable energy system. This paper investigates the role of agriculture in this transition, recognizing its pivotal position as a significant emitter of greenhouse gases while also being vulnerable to the impacts of climate change. By examining the potential synergies and conflicts between agricultural productivity enhancement and the goals of reducing emissions and promoting social justice, this study aims to shed light on strategies that can effectively align agricultural development with the objectives of a just energy transition. The result indicates substantial internal disparities and strong agglomeration effects (referring to areas with similar agricultural total factor productivity) within China's agricultural total factor productivity distribution. Over the past 17 years (2005–2021), the average agricultural productivity has shown a commendable upward trend, marking a 2.8% growth rate. This increase signifies ongoing efforts and advancements in the agricultural sector, leading to improved productivity levels. Our results also show a significant positive spatial correlation in agricultural total factor productivity, suggesting a tendency for spatial agglomeration. The years 2005 and 2021 stand out as periods marked by significant adverse effects resulting from the interplay of diverse factors on agricultural productivity. By integrating findings from various sectors, this study provides insights into the complex interplay between agriculture and energy transition, emphasizing the need for integrated, holistic approaches that prioritize sustainability, fairness, and resilience in China's pursuit of a just energy future.

697. Characteristics of Hospitalized Patients Colonized with Clostridioides difficile at an Academic Medical Center

Abstract Background Clinical spectrum of C. difficile can range from colonization to fulminant colitis. Patients with toxin antigen negative, C. difficile nucleic acid amplification (NAAT)-positive diarrhea are frequently only colonized and do not suffer consequences of C. difficile associated disease (CDAD) but receive treatment for CDAD due to the perceived low risk of oral vancomycin vs. the risk of developing CDAD. Methods We performed a retrospective cohort study of hospitalized adult patients with positive C. difficile NAAT and negative toxin antigen results at University of Iowa Health Care between 9/1/2021 and 9/30/2022. Chart review was conducted to obtain patient age, immunocompromised state, involvement of infectious disease (ID) consultant, prior C. difficile test status and treatment course. Results Of the 295 NAAT-positive C. difficile results, 210 (71%) were toxin antigen negative. Patient characteristics and frequency of common risk factors are shown in Table 1. C. difficile colonization was detected ≥4 days after admission in 111 (53%), with internal medicine and stem cell transplant (SCT)/hematologic malignancies (HM) services having the most patients with colonization (31% and 18%, respectively). Antibiotic use in the prior 30 days was reported in 154 (73%). Of 134 (64%) patients on systemic antibiotics at time of C. difficile testing, antibiotics were discontinued in 29 (22%). Only 43 patients (20%) did not receive any treatment for C. difficile. Median treatment duration was 10 days with 133 (80%) being treated for 10-14 days (Table 2). ID consult was obtained in 48 (23%) and recommended no treatment initially in 11 (23%), 4 of whom were started on treatment in subsequent days. Oral twice a day vancomycin for prophylaxis was given to 28 (13%) patients, 19 (68%) of whom were immunocompromised (16 SCT/HM and 3 solid organ transplant). Conclusion Patients with C. difficile colonization have similar risk factors as patients with CDAD. Understanding treatment patterns for C. difficile colonization can guide educational activities. Most colonized patients received C. difficile treatment and/or prophylaxis, likely due to ongoing systemic antibiotic use and immunosuppression. Benefit of treatment and prophylaxis in colonized patients remains an unresolved issue. Disclosures Kelly M. Percival, PharmD, Gilead Sciences Inc: Advisor/Consultant

Considering Self-Care in High School Home Economics Education with the Aid of Scoping Reviews of Mindfulness and Cooking and of Mindfulness and Knitting

Mindfulness is regarded as a systematic process of shaping the innate quality of the mind primarily practised through meditation. As a result, this paper aims to uncover the nature and spirit of mindfulness practice, which should go beyond clinical intervention or disciplined practices, to explore how self-care techniques like food preparation, knitting, and mindfulness exercises can be incorporated into home economics education. The current review found 12 research papers with statements about cooking and 6 on crafting/knitting. Beyond mindfulness eating, the retrieved papers in the current review have captured a few studies that put forward the elements of mindfulness in cooking. Nonetheless, most papers did not treat cooking as a mindfulness practice, but rather as a self-care practice that resulted in similar psychological factors such as awareness, behavioural changes, and self-efficacy. Moreover, the studies and documentation of crafts in home economics education, such as knitting, sewing, and needlepoint, have been described as mindfulness-based activities. Additionally, it acts as a type of self-care by calming down, alleviating tension, and encouraging relaxation. Therefore, home economics classes should be promoted in schools, and self-care and mindfulness exercises should be added to the curriculum.

Central sleep apnea and exposure to ambient hydrogen sulfide emissions from massive strandings of decomposing sargassum in the Caribbean

BackgroundSargassum invasion of Caribbean and American shorelines is a recurring environmental hazard. Potential health effects of long-term chronic exposure to sargassum gaseous emissions, notably hydrogen sulfide (H2S), are overlooked. H2S plays an important role in neurotransmission and is involved in generating and transmitting respiratory rhythm. Central sleep apnea (CSA) has been attributed to the depression of respiratory centers. ObjectiveEvaluate the effects of exposure to sargassum-H2S on CSA. MethodsThis study, set in the Caribbean, describes the clinical and polysomnographic characteristics of individuals living and/or working in areas impacted by sargassum strandings, in comparison with non-exposed subjects. Environmental exposure was estimated by the closest ground H2S sensor. Multivariate linear regression was applied to analyze CSA changes according to cumulative H2S exposure over time. Effects of air pollution and other sargassum toxic compounds (NH3) on CSA were also controlled. ResultsAmong the 685 study patients, 27 % were living and/or working in sargassum impacted areas. Compared with non-exposed patients, exposed ones had similar sleep apnea syndrome risk factors, but had increased levels of CSA events (expressed as absolute number or % of total sleep apnea). Multivariate regression retained only male gender and mean H2S concentration over a 6-month exposure period as independent predictors of an increase in CSA events. A minimal exposure length of 1 month generated a significant rise in CSA events, with the latter increasing proportionally with a cumulative increase in H2S concentration over time. ConclusionThis pioneer work highlights a potential effect of sargassum-H2S on the central nervous system, notably on the modulation of the activity of the brain's respiratory control center. These observations, jointly with previous studies from our group, constitute a body of evidence strongly supporting a deleterious effect of sargassum-H2S on the health of individuals chronically exposed to low to moderate concentration levels over time.

Exploring the multiband gravitational wave background with a semi-analytic galaxy formation model

ABSTRACT An enormous number of compact binary systems, spanning from stellar to supermassive levels, emit substantial gravitational waves during their final evolutionary stages, thereby creating a stochastic gravitational wave background (SGWB). We calculate the merger rates of stellar compact binaries and massive black hole binaries using a semi-analytic galaxy formation model – Galaxy Assembly with Binary Evolution (GABE) – in a unified and self-consistent approach, followed by an estimation of the multiband SGWB contributed by those systems. We find that the amplitudes of the principal peaks of the SGWB energy density are within one order of magnitude ΩGW ∼ 10−9–10−8. This SGWB could easily be detected by the Square Kilometre Array (SKA), as well as by the planned interferometric detectors, such as the Einstein Telescope and the Laser Interferometer Space Antenna (LISA). The energy density of this background varies as ΩGW ∝ f2/3 in the SKA band. The shape of the SGWB spectrum in the frequency range ∼[10−4,1] Hz could allow the LISA to distinguish the black hole seed models. The amplitude of the SGWB from merging stellar binary black holes at ∼100 Hz is approximately 10 and 100 times greater than those from merging binary neutron stars and neutron-star–black-hole mergers, respectively. Note that, since the cosmic star formation rate density predicted by GABE is somewhat lower than the observational results by ∼0.2 dex at z < ∼2, the amplitude of the SGWB in the frequency range ∼[1, 104] Hz may be underestimated by a similar factor at most.

Comparative study of SPI success factors in global and in-house environment for large-scale software companies

Background Software process improvement (SPI) is an indispensable phenomenon in the evolution of a software development company that adopts global software development (GSD) or in-house development. Several software development companies do not only adhere to in-house development but also go for the GSD paradigm. Both development approaches are of paramount significance because of their respective advantages. Many studies have been conducted to find the SPI success factors in the case of companies that opt for in-house development. Still, less attention has been paid to the SPI success factors in the case of the GSD environment for large-scale software companies. Factors that contribute to the SPI success of small as well as medium-sized companies have been identified, but large-scale companies have still been overlooked. The research aims to identify the success factors of SPI for both development approaches (GSD and in-house) in the case of large-scale software companies. Methods Two systematic literature reviews have been performed. An industrial survey has been conducted to detect additional SPI success factors for both development environments. In the subsequent step, a comparison has been made to find similar SPI success factors in both development environments. Lastly, another industrial survey is conducted to compare the common SPI success factors of GSD and in-house software development, in the case of large-scale companies, to divulge which SPI success factor carries more value in which development environment. For this reason, parametric (Pearson correlation) and non-parametric (Kendall’s Tau correlation and the Spearman correlation) tests have been performed. Results The 17 common SPI factors have been identified. The pinpointed common success factors expedite and contribute to SPI in both environments in the case of large-scale companies.

Infective Endocarditis Following Aortic Valve Replacement: A Systematic Review.

Aortic valve replacement (AVR) successfully treats aortic valve stenosis and aortic regurgitation from aging or bicuspid aortic valves. The procedure intends to restore the obstructed left ventricular outflow tract (LVOT). AVR can be performed surgically (surgical aortic valve replacement (SAVR); open heart) or via transcatheter (transcatheter aortic valve replacement (TAVR)), typically done through a femoral approach as a minimally invasive procedure, allowing for quicker recovery and reduced hospital stays. AVR has many complications, including life-threatening ones, such as infective endocarditis (IE), retarding the recovery processand increasing mortality following surgery. IE is an uncommon and deadly condition that involves multiple organ systems and is caused by bacteremia stemming from amicroorganism that enters the bloodstream. Many manifestations are involved in the development of IE, such as fevers, flu-like symptoms, splinter hemorrhages, Osler nodes, abscesses, and vegetations found on the valves at the leaflets. Vegetations and abscesses tend to create further complications, such as stroke and acute kidney injury, as emboli block blood flow, leading to ischemia and damage. This paper aims to evaluate the difference in SAVR- and TAVR-associated IE, as the goal is to elucidate a danger that diminishes the positive effects of either procedure despite its rarity. Studies have been inconclusive in determining whether or not there is a trend, let alone a difference in incident rates. Both procedures share similar risk factors, but SAVR-associated IE is usually caused by Staphylococcus aureus,and studies indicate possibly Enterococcus spp. in TAVR-associated IE. Incident rates of IE are much higher than they should be, whether or not they differ between procedures, and future research needs to consider the pathways and risk factors that can be used to reduce the occurrence of AVR-associated IE.

Patients With Esophageal Adenocarcinoma With Prior Gastroesophageal Reflux Disease Symptoms Are Similar to Those Without Gastroesophageal Reflux Disease: A Cross-Sectional Study.

A substantial proportion of patients with esophageal adenocarcinoma (EAC) do not report gastroesophageal reflux disease (GERD) symptoms. This study aimed to compare the risk factor profiles and cancer stage at presentation of patients with EAC with and without prior GERD. In this retrospective cross-sectional study, patients with EAC were divided into 2 cohorts: (i) EAC with prior GERD: patients who reported typical GERD symptoms (heartburn or regurgitation) ≥1 year before cancer diagnosis and (ii) EAC without prior GERD: patients who did not report prior GERD symptoms or reported symptoms within 1 year of their cancer diagnosis. Baseline demographics, risk factors, and cancer stage at presentation were compared between the 2 cohorts. In addition, the distribution of patients based on numbers of BE/EAC-associated risk factors (1, 2, 3, 4, and 5 or more) was examined in the symptomatic and asymptomatic cohorts. Over 13 years, 388 patients with EAC with prior GERD and 245 patients with EAC without prior GERD were recruited. Both groups had similar baseline demographics and risk factors, but patients with EAC with prior GERD were more likely to have a history of BE. Asymptomatic patients had more advanced disease. Patients with 3 or more BE/EAC-related risk factors formed the largest proportion of patients in both the symptomatic and asymptomatic cohorts. Patients with EAC with and without prior GERD symptoms are phenotypically similar, suggesting that BE screening efforts to prevent or detect early EAC should not be restricted to just those with GERD.